The incidence of sudden death associated with sports

Sports-related sudden death is very rare and difficult to predict. A population study based on autopsy has shed some light on this question.

This study, conducted by a team including experts from the University of the Basque Country (UPV/EHU), was based on 288 autopsies performed in 25 provinces in Spain between 2010 and 2017. The aim was to find out the incidence rate, clinical characteristics – pathological conditions, habits Toxic and sport activity related sudden death in sport activity in Spain.

A forensic study concluded that sport-related sudden death has a very low rate, affects middle-aged men who engage in recreational sports, and is of cardiovascular origin. The study authors caution that in order to develop prevention strategies, clinical data and toxic habits must be taken into account, and that it is necessary to adapt the sport based on the age, health status and physical conditions of each person.

Dr. Benito Morentin, a member of the research team, Head of the Pathology Service at the Basque Institute of Legal Medicine and Associate Professor in the Department of Medical-Surgical Specialties at UPV/EHU, insists that “sports activities have clear benefits for cardiovascular health, and sport cannot be considered as a threat.” For life. Sports-related sudden death is a rare but catastrophic event, with important clinical and social implications. Therefore, athletes should be screened for possible silent heart disease before participating in sports activities.”

The new study is the largest of its kind among all those conducted in Spain and one of the largest in Europe.

Dr.. Benito Morentin. (Photo: UPV/EHU)

An analysis of 288 autopsies revealed that 98.6% of the cases were male. The incidence rate was 0.38 cases per 100,000 inhabitants per year (0.82 among typical athletes); The majority (54%) were males between the ages of 35 and 54 years. The most popular sports (96% recreational) were cycling (28%), football (18%) and running (17%). The cause of death was cardiovascular in 99%: ischemic heart disease (63%), cardiomyopathy (21%) and sudden cardiac arrest syndrome (6%). In young adults, cardiomyopathy (38%) and ischemic heart disease (30%), from age 20, were most prevalent. Lifetime disease was diagnosed in 23 cases; Relevant medical history was noted in 30 cases and cardiovascular risk factors, particularly obesity, in 95. Toxicology revealed the presence of cardiotoxic substances (alcohol, illegal drugs and psychotropic substances) in 7%, highlighting the relationship between cannabis and acute ischemic heart disease.

Prevention and education measures

This study can serve to assist in the development of preventive strategies, and also as a component of educating the population. In the opinion of Dr. Morntain, “The purpose of medical examinations of people who will participate in a sporting event should be to try to reduce the incidence of sudden death, but it will also serve to educate the population: the kind of diet that can carry, counseling against drug use, warning From that if you have any symptoms you should consult a cardiologist, conditioning sports activity …”. Morentin stresses the importance of exercising “in the safest way possible and recommends adapting the intensity of exercise according to each person’s age, health status and physical condition.”

The researcher also notes that “it is very difficult to predict who might have sudden cardiovascular death,” but stresses that the prevention of sport-related sudden death could be improved if there were more reliable data on its occurrence, factors and causes of death through forensic autopsy, Because it can help develop prevention strategies. He pointed out that “it is necessary to conduct epidemiological studies related to toxic and dietary habits or exposure to toxic environmental factors, in addition to studying genetic factors.” In this sense, the authors of the study issued “an urgent call for the establishment of a mandatory national registry of sport-related sudden death with the participation of forensic pathologists, pathologists, sports physicians, cardiologists and all other interested parties.”

Also involved in the study was Dr. Javier Ballesteros, Professor in the Department of Neurosciences at UPV/EHU. The following entities have also collaborated: the Department of Forensic Pathology of the Basque Institute of Forensic Medicine and Forensic Sciences; Biocruces Institute for Biohealth Research; Department of Medical-Surgical Specialties at UPV/EHU; Department of Histopathology at the National Institute of Toxicology and Forensic Medicine in Las Rozas (Madrid); Department of Forensic Pathology of the Institute of Forensic Medicine and Forensic Sciences of Valencia; Department of Neurosciences at UPV/EHU; Center for Biomedical Research at Mental Health Network, CIBERSAM; and the Department of Forensic Pathology at the Institute of Forensic Medicine and Forensic Sciences of Seville.

The study is titled “Sudden Cardiac Death Associated with Sport in Spain. A multicenter, population-based, forensic study of 288 cases”. It has been published in the academic journal Revista Española de Cardiología. (Source: UPV/EHU)

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