[Sudden death during sport activities. How can the incidence be reduced?].

Sudden death after sporting activities is not a rare occurrence on the basis of the statistics of a country: there appear to be 100 to 1,500 cases each year in France, and possibly even 10 times as many. This event is of cardiovascular origin or linked to the use of stimulants, if accidental causes are left out. Almost all unexpected deaths of medical origin are due to cardiac arrest. In practice, this only rarely involves an apparently healthy organ. Cardiomyopathies (almost 50% of cases occurring before the age of 35) and coronary disease (80% of individuals dying over 35 and 75% of all cases) are among the essential causes. The final mechanism most often (62.4%) is ventricular fibrillation following a ventricular tachycardia. These sudden deaths are sometimes preceded by cardiorespiratory symptoms (angina pectoris, faintness, dyspnea) and by extrasystoles, with the latter showing their potentially malignant nature in some cases. These features must be sought and identified if an attempt is to be made to reduce sudden cardiac deaths in athletes. Detailed and routine sophisticated investigations would have little to offer and are expensive. It would seem more valid to educate general practitioners and athletes themselves, but this should be on a very wide scale, i.e. at national level.