Fontaine G, Fontaliran F, Frank R, Chomette G, Grosgogeat Y
Service de rythmologie et de stimulation cardiaque, hôpital Jean-Rostand, Ivry.
Arch Mal Coeur Vaiss. 1989 Aug;82 Spec No 2:107-11.
Sudden death is rare in athletes, and it is only in recent years that significant series were collected, making it possible to draw the cardiological profile of athletes who died suddenly at the peak of exertion or while recovering. A study of the literature, both medical and paramedical, has yielded 53 cases in which the most frequent causes of sudden death were hypertrophic cardiomyopathy (26 p. 100), (arrhythmogenic right ventricular disease (19 p. 100), congenital abnormalities of coronary arteries (11 p. 100) and coronary atheromatous lesions (9 p. 100), to which must be added various other causes. This study clearly demonstrates the hitherto unrecognized importance of arrhythmogenic right ventricular dysplasia-a condition which, as recent data suggest, is not solely due to a myocardial development disorder but also to an infective disease, an acute of chronic myocarditis. In subjects with this condition, new exploratory methods might detect the presence of an arrhythmogenic substrate during medical screening of athletes, but in any case these causes of sudden death suggest that a fast rhythm disorder was involved in several of these deaths. This disorder could be treated if the attendants were trained to carry out cardiorespiratory resuscitation procedures or if they had access to a defibrillator which should be available on every sports field.
猝死在运动员中较为罕见,直到近年来才收集到大量病例,从而有可能勾勒出在运动巅峰期或恢复过程中突然死亡的运动员的心脏病学特征。一项对医学和辅助医疗文献的研究得出了53个病例,其中猝死的最常见原因是肥厚型心肌病(占26%)、致心律失常性右心室疾病(占19%)、冠状动脉先天性异常(占11%)和冠状动脉粥样病变(占9%),此外还有各种其他原因。这项研究清楚地表明了致心律失常性右心室发育不良迄今未被认识到的重要性——正如最近的数据所显示的,这种病症不仅是由于心肌发育障碍,还与感染性疾病、急性或慢性心肌炎有关。在患有这种病症的受试者中,新的探索性方法可能在对运动员进行医学筛查时检测到致心律失常底物的存在,但无论如何,这些猝死原因表明其中一些死亡涉及快速心律失常紊乱。如果护理人员接受过心肺复苏程序培训,或者他们能够使用每个运动场都应配备的除颤器,这种紊乱是可以治疗的。