National Heart and Lung Institute, Imperial College London, London, UK.
Br J Sports Med. 2014 Aug;48(15):1151-6. doi: 10.1136/bjsports-2013-092195. Epub 2013 Sep 5.
To raise awareness of congenital coronary artery anomalies (CCAAs) as an important cause of sudden cardiac death (SCD) in athletes, we describe a cohort of the malignant subset. Defining the key anatomical features for the cardiologist and pathologist to be aware of and detailing a systematic approach to examining the coronary arteries at autopsy.
Retrospective non-case-controlled analysis of 2304 cases of SCD referred by pathologists between 1994 and January 2012.
31 (1.3%) of the 2304 cases of SCD had CCAAs; 24 men (77%) and 7 women (23%), mean age 28 years (range 16 months-63 years). In 15 cases (48%), SCD occurred during or immediately after physical exertion. Cardiac symptoms were documented to have occurred in only seven patients (23%) prior to SCD. The anomaly had been identified by the referring pathologist in only 11 of the 31 cases (35%).
CCAAs are a rare and mostly benign entity, but a subset has the potential to be fatal without any forewarning. In a significant proportion of cases identified in this large cohort, the victim was under exertion at the time of death, highlighting the relevance of this anomaly to the sports and exercise medicine community.
提高对先天性冠状动脉异常（CCAAs）作为运动员心源性猝死（SCD）的重要原因的认识，我们描述了一组恶性亚组。为心脏病专家和病理学家定义需要注意的关键解剖特征，并详细介绍系统检查冠状动脉尸检的方法。
对 1994 年至 2012 年 1 月期间病理学家转介的 2304 例 SCD 进行回顾性非病例对照分析。
31 例（1.3%）SCD 患者存在 CCAAs；24 例男性（77%）和 7 例女性（23%），平均年龄 28 岁（范围 16 个月-63 岁）。在 15 例（48%）中，SCD 发生在体力活动期间或之后立即。在 SCD 之前，只有 7 例患者（23%）记录到有心脏症状。在 31 例病例中，只有 11 例（35%）由转介病理学家识别出异常。
CCAAs 是一种罕见且多为良性的实体，但有一部分在没有任何前兆的情况下可能致命。在本大队列中确定的病例中，有相当一部分病例在死亡时处于用力状态，这突出了这种异常与运动和运动医学社区的相关性。
