Competitive athlete status in adolescent sudden cardiac death victims was associated with higher rates of arrhythmogenic cardiomyopathy (8% vs 4%; P=0.05) and coronary anomalies (9% vs 1%; P<0.001).
Observational (n=756)
No
Absolute Event Rate: 8% vs 4%
p-value: p=0.05
BACKGROUND Causes and precipitating factors of sudden cardiac death (SCD) in adolescents are poorly understood. OBJECTIVES The authors sought to investigate the etiologies of SCD and their association with physical activity in a large cohort of adolescents. METHODS Between 1994 and June 2022, 7,675 cases of SCD were consecutively referred to our national cardiac pathology center; 756 (10%) were adolescents. All cases underwent detailed autopsy evaluation by expert cardiac pathologists. Clinical information was obtained from referring coroners. RESULTS A structurally normal heart, indicative of sudden arrhythmic death syndrome was the most common autopsy finding (n = 474; 63%). Myocardial diseases were detected in 163 cases (22%), including arrhythmogenic cardiomyopathy (n = 36; 5%), hypertrophic cardiomyopathy (n = 31; 4%), idiopathic left ventricular hypertrophy (n = 31; 4%), and myocarditis (n = 30; 4%). Coronary artery anomalies were identified in 17 cases (2%). Decedents were competitive athletes in 128 cases (17%), and 159 decedents (21%) died during exercise. Arrhythmogenic cardiomyopathy was diagnosed in 8% of athletes compared with 4% of nonathletes (P = 0.05); coronary artery anomalies were significantly more common in athletes (9% vs 1%; P < 0.001), as well as commotio cordis (5% compared with 1% in nonathletes; P = 0.001). The 3 main comorbidities were asthma (n = 58; 8%), epilepsy (n = 44; 6%), and obesity (n = 40; 5%). CONCLUSIONS Sudden arrhythmic death syndrome and myocardial diseases are the most common conditions diagnosed at autopsy in adolescent victims of SCD. Among causes of SCD, arrhythmogenic cardiomyopathy, coronary artery anomalies, and commotio cordis are more common in young athletes than in similar age sedentary individuals.
“We found that sudden cardiac death in children is extremely rare between ages two and eight, but rises sharply during the teenage years. This suggests that the hormonal changes during puberty might increase the risk, particularly for certain heart conditions.”
Finocchiaro et al. (Wed,) conducted a observational in Sudden cardiac death (n=756). Competitive athlete status vs. Nonathletes was evaluated on Arrhythmogenic cardiomyopathy (p=0.05). Competitive athlete status in adolescent sudden cardiac death victims was associated with higher rates of arrhythmogenic cardiomyopathy (8% vs 4%; P=0.05) and coronary anomalies (9% vs 1%; P<0.001).