Durakovic Z, Misigoj-Durakovic M, Vuori I, Skavic J, Belicza M
Department of Internal Medicine, Rebro University Hospital, School of Medicine and University Hospital Center, Zagreb, Croatia.
J Sports Med Phys Fitness. 2005 Dec;45(4):532-6.
In the period of 30 years, i.e. from 1973 to 2002, we noticed in Croatia 6 sudden and unexpected cardiac deaths in male athletes during or after training. Two were soccer players, 2 athletic runners, one was a rugby player and one was a basketball player. All of them were without cardiovascular symptoms. At the forensic autopsy, the first athlete, aged 29, had chronic myocarditis and thickened left ventricular wall of 15 mm. The second, aged 21, had an acute myocardial infarction of the posterior wall with normal coronaries and thickened left ventricular wall of 15 mm. The third aged 17, had hypoplastic right coronary artery and narrowed ascending aorta, suppurant tonsillitis and subacute myocarditis. Two athletes, aged 29 and 15, had hypertrophic cardiomyopathy and normal coronaries, and one dilated aorta. The sixth, aged 24, had arrhythmogenic cardiomyopathy of the right ventricle. All the 6 athletes died suddenly, obviously because of malignant ventricular arrhythmias. In Croatia the death rate among athletes reached 0.15/100 000, in others who practice exercise reached 0.74/100,000 and the difference is highly significant (c2=14.487, Poisson rates=3.81, P=0.00014) and in physicians-specialists reached 33.6/100,000. Preventive medical examinations are essential, especially in athletes before physical exercise, as are other investigations in every case suspicious of heart disease, including electrocardiogram (ECG), stress ECG, echocardiography and stress-echocardiography and other findings if indicated. Physical exercise is contraindicated in acute respiratory infection: in 2 of those cases had been a cause of death as a trigger.
在30年期间，即从1973年至2002年，我们在克罗地亚注意到有6名男性运动员在训练期间或训练后发生了突然且意外的心脏死亡。其中2名是足球运动员，2名是田径运动员，1名是橄榄球运动员，1名是篮球运动员。他们所有人都没有心血管症状。在法医尸检中，第一名运动员，29岁，患有慢性心肌炎，左心室壁增厚至15毫米。第二名，21岁，后壁急性心肌梗死，冠状动脉正常，左心室壁增厚至15毫米。第三名，17岁，右冠状动脉发育不全，升主动脉狭窄，化脓性扁桃体炎和亚急性心肌炎。两名运动员，分别为29岁和15岁，患有肥厚型心肌病，冠状动脉正常，还有一名主动脉扩张。第六名，24岁，患有右心室致心律失常性心肌病。这6名运动员均突然死亡，显然是由于恶性室性心律失常。在克罗地亚，运动员中的死亡率为0.15/10万，在其他进行体育锻炼的人群中为0.74/10万，差异非常显著（χ²=14.487，泊松率=3.81，P=0.00014），而在专科医生中为33.6/10万。预防性医学检查至关重要，尤其是在运动员进行体育锻炼之前，对于每一例疑似心脏病的情况进行的其他检查也很重要，包括心电图（ECG）、运动心电图、超声心动图和运动超声心动图以及如有指征的其他检查。急性呼吸道感染时禁止体育锻炼：在其中2例中，它是死亡的诱因。
