Ha Francis J, Han Hui-Chen, Sanders Prashanthan, La Gerche Andre, Teh Andrew W, Farouque Omar, Lim Han S
Department of Cardiology, Austin Health, Melbourne, Victoria, Australia.
St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Intern Med J. 2023 Apr;53(4):497-502. doi: 10.1111/imj.15606. Epub 2022 Aug 20.
Sudden cardiac death (SCD) during physical exercise is devastating.
To evaluate causes and circumstances of exercise-related SCD in the young in Australia.
We reviewed the National Coronial Information System database for deaths in Australia relating to cardiovascular disease in cases aged 10-35 years between 2000 and 2016. Cases who had undertaken physical exercise at the time of the event were included. We collected demographics, circumstances of death, type of physical exercise, bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use prior to ambulance arrival.
Over a 17-year period, 1925 SCD cases were identified, of which 110 (6%) cases (median age 27 years (interquartile range 21-32 years); 92% male) were related to sports/physical exercise. Thirteen (12%) cases occurred in active athletes. Most common causes were coronary artery disease (CAD; 37%) and sudden arrhythmic death syndrome (SADS; 20%). Among Aboriginal and Torres Strait Islanders (n = 10), all deaths were related to CAD. Australian Rules Football (24%), running/jogging (14%) and soccer (14%) were the most frequent physical exercise activities. Prior symptoms were present in 39% (chest pain 37%, pre-syncope/syncope 26%). Most (87%) were witnessed, with bystander CPR in 70%. AED use prior to ambulance arrival was 8%.
The present study demonstrates the high occurrence of CAD and SADS in SCD in the young related to physical exercise. Aboriginal and Torres Strait Islanders were disproportionately affected by CAD. Although events were commonly witnessed, AED was seldom used prior to ambulance arrival and highlights an important opportunity to improve outcomes in the post-arrest chain of survival.
体育锻炼期间的心脏性猝死（SCD）具有毁灭性。
评估澳大利亚年轻人中与运动相关的心脏性猝死的原因和情况。
我们查阅了国家死因裁判信息系统数据库，以获取2000年至2016年间澳大利亚10至35岁心血管疾病死亡病例。纳入事件发生时进行体育锻炼的病例。我们收集了人口统计学信息、死亡情况、体育锻炼类型、旁观者心肺复苏（CPR）以及救护车到达前自动体外除颤器（AED）的使用情况。
在17年期间，共识别出1925例心脏性猝死病例，其中110例（6%）（中位年龄27岁（四分位间距21 - 32岁）；92%为男性）与运动/体育锻炼有关。13例（12%）发生在现役运动员中。最常见的原因是冠状动脉疾病（CAD；37%）和心律失常性猝死综合征（SADS；20%）。在原住民和托雷斯海峡岛民（n = 10）中，所有死亡均与CAD有关。澳大利亚式橄榄球（24%）、跑步/慢跑（14%）和足球（14%）是最常见的体育锻炼活动。39%的病例有前驱症状（胸痛37%，晕厥前/晕厥26%）。大多数（87%）有目击者，70%有旁观者进行心肺复苏。救护车到达前AED的使用率为8%。
本研究表明，在与体育锻炼相关的年轻人心脏性猝死中，CAD和SADS的发生率很高。原住民和托雷斯海峡岛民受CAD的影响尤为严重。尽管事件通常有目击者，但救护车到达前AED很少使用，这凸显了改善心脏骤停后生存链结局的重要机会。
