Myopericarditis and sudden cardiac death due to physical exercise in male athletes

Duraković, Zijad and Mišigoj Duraković, Marjeta and Škavić, Josip and Tomljenović, Andrea (2008) Myopericarditis and sudden cardiac death due to physical exercise in male athletes. Collegium Antropologicum, 32 (2). pp. 399-401. ISSN 0350-6134

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Abstract

In the period 1998-2007, we registered four sudden and unexpected cardiac deaths in male athletes due to myopericarditis during or after physical exercise. Three of them were professional soccer players and the fourth was engaged in swimming. One aged 29, had symptoms of tiredness, heart enlargement and left ventricular premature beats during training. Three of them, aged 17-18-18, were without symptoms. Three died during training and the fourth died in the hospital after head trauma at training. In the first one, aged 29, forensic autopsy showed chronic myopericarditis, thickening of the left ventricular wall of 15 mm and enlargement of the whole heart. The second one, aged 17, had subacute diffuse myopericarditis, suppurative tonsillitis and narrowed ascending aorta. The third, aged 18, had chronic myopericarditis and cardiac aneurysm of the left ventricle. The fourth, aged 18, had fibrinous pericarditis, thickening of the left ventricle 20 mm, hypoplastic ascending aorta, bilateral bronchopneumonia and cerebral contusion with edema. In Croatia, death rate among athletes, including all its causes, reached 0.15/100,000, in athletes suffering from myopericarditis it was 0.34/100,000, in others who practice exercise recreatively it amounted to 0.57/100,000 (p=0.0068), and in all males who practice exercise it measured 0.75/100,000 (p=0.0014). Physical exercise has to be contraindicated in cases of myopericarditis for at least six months from the onset of the illness.

Abstract in Croatian

U 10-godišnjem periodu: 1998–2007 dogodila su se četiri nagla i neočekivana smrtna ishoda u športaša za vrijeme ili nakon tjelovježbe. Tri su bila zanimanjem nogometaši, a četvrti se bavio plivanjem. Jedan dobi 29 g. tužio se na umor, imao je povećano srce i česte ventrikulske ekstrasistole iz lijeve klijetke, dok su trojica dobi 17–18–18 g. bili bez simptoma. Trojica su preminula za vrijeme tjelovježbe, a četvrti u bolnici dva dana po prijamu. Sudsko-medicinskom obdukcijom prvi je, u dobi od 29 g., bolovao od kroničnog mioperikarditisa, zadebljanja stjenke lijeve klijetke od 15 mm i povećanog cijelog srca. Drugi, dobi 17 g. bolovao je od subakutnog difuznog mioperikarditisa, gnojnog tonzilitisa i sužene uzlazne aorte, treći, dobi 18 g. bolovao je od kroničnog mioperikarditisa i aneurizmatskog proširenja lijeve klijetke, dok je četvrti, star 18 g. bolovao od fibrinoznog perikarditisa, zadebljanja lijeve klijetke od 20 mm, hipoplastične uzlazne aorte, obostrane bronhopneumonije i kontuzije mozga s edemom. U Hrvatskoj stopa smrtnog ishoda zbog svih razloga u športaša iznosi 0,15/100.000, u športaša zbog mioperikarditisa iznosi 0.34/100.000, u ostalih koji su se bavili rekreacijskom tjelovježbom iznosi 0,57/100.000 (razlika je statistički značajna, p=0.0068), dok u svih koji se bave tjelovježbom iznosi 0,75/100.000 (razlika je značajna, p=0.0014). U osoba koje boluju od mioperikarditisa tjelovježba treba biti kontraindicirana tijekom najmanje 6 mjeseci.

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