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Orvosi Hetilap Jul 2023Sudden cardiac death in athletes is rare (0.5 to 1 per 100 000 athlete years), but sudden cardiac death in known athletes causes general shock.
INTRODUCTION
Sudden cardiac death in athletes is rare (0.5 to 1 per 100 000 athlete years), but sudden cardiac death in known athletes causes general shock.
OBJECTIVE
Our research aim was to collect and study as many sudden cardiac death cases as possible, judge the role of stress and look for ways to reduce fatal tragedies.
METHOD
From registers and newspaper articles found on the Internet, we collected 360 (including 14 women) athletes' sudden cardiac death cases where the sport, age and place of death (during training/competition/after) could be determined. From these, a single database has been prepared in order of the year of death. The cases were grouped and analyzed by sports. Based on our results and literature data, we made recommendations to reduce fatalities.
RESULTS AND CONCLUSION
There were more sudden cardiac deaths in competitions than in trainings (239 vs. 99), but tragedies also happened during warm-ups and chess without physical exertion, furthermore, there was no sudden cardiac death in the stakeless training of marathon/half marathon/triathlon athletes; all these prove the role of stress, so we recommend a psychological conversation before a high-stakes race. There were also a lot of sudden cardiac deaths (79/360) during team sports trainings, so we recommend reanimation readiness there as well. After training/competition, sudden cardiac death happened mainly in sports requiring high static effort, where post-competition monitoring is also recommended. Those who died in training were younger than those who died during the race (p<0.01), so young people should be monitored more closely for medical and (under)fitness. Marathon runners and triathletes were older than team athletes (p<0.005) and only died in competition, so for them a basic examination and an ECG within 1 month before competition are recommended. Conclusions drawn from literature data: sports medicine examination should be standardized and documented in an accessible way; since resuscitation started earlier and professionally is more effective, all competitors should receive reanimation training. Orv Hetil. 2023; 164(29): 1155-1163.
Topics: Humans; Female; Adolescent; Death, Sudden, Cardiac; Sports; Athletes; Exercise; Incidence
PubMed: 37481770
DOI: 10.1556/650.2023.32806 -
The Journal of Pediatrics Jan 2024To evaluate in the Netherlands the national outcomes in providing cause of and insights into sudden and unexplained child deaths among children via the Postmortem...
OBJECTIVE
To evaluate in the Netherlands the national outcomes in providing cause of and insights into sudden and unexplained child deaths among children via the Postmortem Evaluation of Sudden Unexplained Death in Youth (PESUDY) procedure.
STUDY DESIGN
Children aged 0-18 years in the Netherlands who died suddenly were included in the PESUDY procedure if their death was unexplained and their parents gave consent. The PESUDY procedure consists of pediatric and forensic examination, biochemical, and microbiological tests; radiologic imaging; autopsy; and multidisciplinary discussion. Data on history, modifiable factors, previous symptoms, performed diagnostics, and cause of death were collected between October 2016 and December 2021.
RESULTS
In total, 212 cases (median age 11 months, 56% boys, 33% comorbidity) were included. Microbiological, toxicological, and metabolic testing was performed in 93%, 34%, and 32% of cases. In 95% a computed tomography scan or magnetic resonance imaging was done and in 62% an autopsy was performed. The cause of death was explained in 58% of cases and a plausible cause was identified in an additional 13%. Most children died from infectious diseases. Noninfectious cardiac causes were the second leading cause of death found. Modifiable factors were identified in 24% of non-sudden infant death syndrome/unclassified sudden infant death cases and mostly involved overlooked alarming symptoms.
CONCLUSIONS
The PESUDY procedure is valuable and effective for determining the cause of death in children with sudden unexplained deaths and for providing answers to grieving parents and involved health care professionals.
Topics: Infant; Male; Adolescent; Child; Humans; Female; Sudden Infant Death; Autopsy; Magnetic Resonance Imaging; Netherlands; Cause of Death
PubMed: 37852434
DOI: 10.1016/j.jpeds.2023.113780 -
Acta Paediatrica (Oslo, Norway : 1992) Mar 2021To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep-related Sudden Unexpected Death in Infancy...
AIM
To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep-related Sudden Unexpected Death in Infancy (SUDI). To determine compliance with national requirements for SUDI investigation.
METHODS
Electronic survey of CDOPs and pathologists using three vignettes of SUDI cases illustrating: accidental asphyxia, typical Sudden Infant Death Syndrome (SIDS) and SIDS with co-sleeping.
RESULTS
Thirty-eight (41%) of 92 CDOPs returned questionnaires, and 32 were complete. Thirteen (14%) of 90 pathologists returned complete questionnaires. Thirty-one (97%) CDOPs and 7 (53%) pathologists agreed with the cause of death in the accidental asphyxia case; 24 (75%) CDOPs and 9 (69%) pathologists in the typical SIDS case; and 11 (34%) CDOPs and 1 (8%) pathologist in the co-sleeping SIDS case. Pathologists used the terms SUDI or unascertained as the cause of death for the accidental asphyxia case (46%) and the co-sleeping SIDS case (77%). These terms were used by CDOPs for the typical SIDS case (25%) and the co-sleeping SIDS case (41%). Seventeen (46%) CDOPs reported compliance with guidelines for investigation in more than 75% of cases.
CONCLUSION
There is wide variation in classification of deaths, with only limited agreement between CDOPs and pathologists. The terms SIDS and accidental asphyxia are underused, even in typical cases.
Topics: Asphyxia; Child; Humans; Infant; Sleep; Sudden Infant Death
PubMed: 32654334
DOI: 10.1111/apa.15472 -
Journal of the... Mar 2006Sudden cardiac death (SCD) accounts for over 450,000 deaths annually in the USA. Sudden death is estimated to account for approximately 50% of all deaths from... (Review)
Review
Sudden cardiac death (SCD) accounts for over 450,000 deaths annually in the USA. Sudden death is estimated to account for approximately 50% of all deaths from cardiovascular causes. Total cardiac mortality has decreased from 728,115 in 1989 to 719,456 in 1999 but the percentage of deaths that are sudden has actually increased from 38% to 47%. Prevention of SCD in patients with risk factors is a high priority for public health professionals. Aldosterone has been shown to be associated with myocardial inflammation, endothelial dysfunction and fibrosis. There is evidence from clinical trials suggesting the role of aldosterone inhibition in prevention of SCD. We reviewed the potential mechanisms and discuss the clinical implications of Randomised ALdactone Evaluation Study (RALES) and Eplerenone Neurohormonal Efficacy and Survival Study (EPHESUS). The use of aldosterone receptor blockers had an overall effect of 21% risk reduction in SCD. Appropriate monitoring and counselling is essential while using either of the aldosterone inhibitors.
Topics: Anti-Arrhythmia Agents; Death, Sudden, Cardiac; Heart Failure; Humans; Mineralocorticoid Receptor Antagonists
PubMed: 17083069
DOI: 10.3317/jraas.2006.001 -
Journal of Paediatrics and Child Health Oct 1999Given that the diagnosis of sudden infant death syndrome (SIDS) remains one of exclusion, problems still exist in distinguishing possible cases from those where the... (Review)
Review
Given that the diagnosis of sudden infant death syndrome (SIDS) remains one of exclusion, problems still exist in distinguishing possible cases from those where the deaths were due to accidental or inflicted suffocation. The term 'SIDS' cannot be used unless a complete autopsy examination has been performed, augmented by review of the clinical history and examination of the death scene. In the absence of a cause of death, a more suitable designation in the presence of inflicted injury is 'undetermined' rather than 'SIDS'. Use of standard autopsy and death scene protocols that have been endorsed by professional bodies will improve the investigation of unexpected infant death and will increase the likelihood of diagnosing subtle disorders that may be confused with SIDS.
Topics: Asphyxia; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Sudden Infant Death; Whiplash Injuries
PubMed: 10571752
DOI: 10.1046/j.1440-1754.1999.355423.x -
The Medical Journal of Australia Nov 2008Best-practice guidelines mandate a full postmortem examination in these deaths to identify genetic causes and allow potentially life-saving interventions in the victim's...
Best-practice guidelines mandate a full postmortem examination in these deaths to identify genetic causes and allow potentially life-saving interventions in the victim's relatives.
Topics: Australia; Autopsy; Death, Sudden; Humans; New Zealand; Practice Guidelines as Topic
PubMed: 19012547
DOI: 10.5694/j.1326-5377.2008.tb02173.x -
Medicine and Science in Sports and... Sep 1993The pathological causes of sudden death during athletics varies with the age of the competitor. Congenital abnormalities are the predominant cause of exercise-related... (Review)
Review
The pathological causes of sudden death during athletics varies with the age of the competitor. Congenital abnormalities are the predominant cause of exercise-related deaths in subjects under age 30 yr whereas atherosclerotic coronary artery disease is the primary cause of such deaths in adults. Cardiovascular screening programs designed to reduce the incidence of exercise deaths are limited by the rarity of exercise events, the poor predictive value of the tests, and the cost of testing. Nevertheless, we recommend that young athletes be examined to detect conditions associated with exercise complications and that new symptoms in young and old athletes be carefully evaluated.
Topics: Adult; Coronary Disease; Death, Sudden, Cardiac; Exercise; Humans; Male; Middle Aged; Sports
PubMed: 8231781
DOI: No ID Found -
Archives of Disease in Childhood Mar 2006The death of a child is a sentinel event in a community, and a defining marker of a society's policies of safety and health. Child death as a result of abuse and neglect... (Review)
Review
The death of a child is a sentinel event in a community, and a defining marker of a society's policies of safety and health. Child death as a result of abuse and neglect is a tragic outcome that occurs in all nations of the world. The true incidence of fatal child abuse and neglect is unknown. The most accurate incidence data of such deaths have been obtained from countries where multi-agency death review teams analyse the causes of child fatalities, as is done in the United States and Australia.
Topics: Adolescent; Asphyxia; Child; Child Abuse; Child, Preschool; Humans; Infant; Infanticide; Sudden Infant Death
PubMed: 16492892
DOI: 10.1136/adc.2004.066696 -
Pediatrics Jun 2016In March 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop entitled "Sudden Unexpected Death in Fetal Life...
In March 2015, the Eunice Kennedy Shriver National Institute of Child Health and Human Development held a workshop entitled "Sudden Unexpected Death in Fetal Life Through Early Childhood: New Opportunities." Its objective was to advance efforts to understand and ultimately prevent sudden deaths in early life, by considering their pathogenesis as a potential continuum with some commonalities in biological origins or pathways. A second objective of this meeting was to highlight current issues surrounding the classification of sudden infant death syndrome (SIDS), and the implications of variations in the use of the term "SIDS" in forensic practice, and pediatric care and research. The proceedings reflected the most current knowledge and understanding of the origins and biology of vulnerability to sudden unexpected death, and its environmental triggers. Participants were encouraged to consider the application of new technologies and "omics" approaches to accelerate research. The major advances in delineating the intrinsic vulnerabilities to sudden death in early life have come from epidemiologic, neural, cardiac, metabolic, genetic, and physiologic research, with some commonalities among cases of unexplained stillbirth, SIDS, and sudden unexplained death in childhood observed. It was emphasized that investigations of sudden unexpected death are inconsistent, varying by jurisdiction, as are the education, certification practices, and experience of death certifiers. In addition, there is no practical consensus on the use of "SIDS" as a determination in cause of death. Major clinical, forensic, and scientific areas are identified for future research.
Topics: Cause of Death; Child, Preschool; Death Certificates; Death, Sudden; Fetal Death; Humans; Infant; Infant, Newborn; Sudden Infant Death
PubMed: 27230764
DOI: 10.1542/peds.2015-4661 -
Epilepsy & Behavior : E&B Aug 2008The epilepsies are the most common serious neurological condition. People with epilepsy have a two- to threefold increased risk of dying prematurely than those without... (Review)
Review
The epilepsies are the most common serious neurological condition. People with epilepsy have a two- to threefold increased risk of dying prematurely than those without epilepsy, and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). The exact pathophysiological causes of SUDEP remain unknown, but it is very probable that cardiac arrhythmia during and between seizures plays a potential role. Although the pharmacological treatments available for the epilepsies have expanded, antiepileptic drugs are still limited in clinical efficacy. In this regard, several factors such as genetic, environmental, and social can contribute to the inefficacy of therapeutic outcome in patients with epilepsy. Among these factors, nutritional aspects, that is, omega-3 fatty acid deficiency, have an interesting role in this scenario. Animal and clinical studies have demonstrated that omega-3 fatty acids may be useful in the prevention and treatment of epilepsy. Moreover, as omega-3 fatty acids per se have been shown to reduce cardiac arrhythmias and sudden cardiac deaths, it has been proposed that omega-3 fatty acid supplementation in patients with refractory seizures may reduce seizures and seizure-associated cardiac arrhythmias and, hence, SUDEP. Given their relative safety and general health benefits, our update article summarizes the knowledge of the role of dietary omega-3 fatty acids in epilepsy.
Topics: Animals; Anticonvulsants; Arrhythmias, Cardiac; Death, Sudden; Death, Sudden, Cardiac; Epilepsy; Fatty Acids, Omega-3; Humans
PubMed: 18511348
DOI: 10.1016/j.yebeh.2008.04.011