Sport Related Sudden Death: The Importance of Primary and Secondary Prevention

Figures

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  Figure 1. Lifepak-500 (Medtronic, Minneapolis, MI, USA) registered traces during CPR maneuvers. (Panel A) ventricular fibrillation recognition and subsequent 360J shock discharge (red arrow) by AED. (Panel B and C) post-shock normal rhythm restoration and artifacts from chest compressions.

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  Figure 2. Resting ECG performed during sports screening. We can see Sokolow–Lyon Criteria for left ventricular hypertrophy (S wave in V1 + R wave in V5 or V6 ≥ 36 mm in male) and pathological J-ST depression in V6. There is possibly a J-ST depression in leads I and II, but we cannot be sure because of the quality of the resting ECG available. Finally, there is partial right bundle branch block (rSR’ pattern in V1–V2), but it is not a pathological finding.

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  Figure 3. Resting ECG performed during non-competitive-sports screening. A short PQ-interval and a mild delta wave can be observed.

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  Figure 4. Electrophysiological Study: orthodromic atrioventricular reentrant tachycardia degenerating into atrial fibrillation with a very high ventricular rate response along a left accessory pathway.

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  Figure 5. Electrophysiological Study: atrial fibrillation with a very high ventricular rate response along a left accessory pathway degenerating into ventricular fibrillation.

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  Figure 6. Electrophysiological Study: ventricular fibrillation interruption by external DC shock.

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  Figure 7. Resting ECG of 29-year-old female swimming teacher, showing right axis deviation of QRS and diffuse low voltages.

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  Figure 8. Resting ECG of 30-year-old ex-competitive male soccer player. Right axis deviation, traces of early ventricular repolarization in inferior leads, partial right bundle branch block, and negative T waves in lateral leads (D1-aVL and V5–V6). Negative P-wave terminal force in lead V1 is also present.