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一名年轻运动员因两支冠状动脉均起源于共同开口而发生心源性猝死。

Sudden cardiac death in a young athlete due to anomalous origin of both coronaries from a common ostium.

作者信息

Zerbo Stefania, Albano Giuseppe Davide, Malta Ginevra, Alongi Alberto, Maresi Emiliano, Argo Antonina

机构信息

Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, 90129, Italy.

出版信息

Forensic Sci Med Pathol. 2025 Apr 2. doi: 10.1007/s12024-025-00979-9.

Abstract

Sudden cardiac death (SCD) in young people is a tragic event and a worldwide public health issue. SCD is the most common cause of death in young athletes and is related to acquired/congenital cardiac disorders, such as cardiomyopathies, congenital coronary anomalies and ion channelopathies. We report the case of a 14-year-old male non professional athlete who was apparently healthy but suddenly died during a football game. His clinical history was negative for any significant medical illness. At autopsy, a congenital anomalous origin of both the right and left coronary arteries from a single aortic ostium above the aortic cusp was observed with a concomitant hypertophic cardiomyopathy (HCM) The toxicological analysis was negative for common drugs of abuse. The death was attributed to SCD due to hyperkinetic ventricular arrhythmia secondary to myocardial ischemia in a subject with an anomalous origin of both coronary arteries and underlying hypertrophic cardiomyopathy. This report highlights a rare congenital anomalous origin of the coronary arteries associated with a high risk of SCD, particularly in young athletes.

摘要

年轻人的心源性猝死(SCD)是一个悲剧性事件,也是一个全球性的公共卫生问题。SCD是年轻运动员最常见的死因,与获得性/先天性心脏疾病有关,如心肌病、先天性冠状动脉异常和离子通道病。我们报告一例14岁男性非职业运动员的病例,该患者看似健康,但在一场足球比赛中突然死亡。他的临床病史无任何重大疾病。尸检时,观察到左右冠状动脉均起源于主动脉瓣上方单一主动脉口的先天性异常,同时伴有肥厚型心肌病(HCM)。毒理学分析未发现常见滥用药物。死亡归因于SCD,其原因是一名冠状动脉起源异常并伴有潜在肥厚型心肌病的患者,继发于心肌缺血的高动力性室性心律失常。本报告强调了一种罕见的冠状动脉先天性异常,其与SCD的高风险相关,尤其是在年轻运动员中。

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