Causes of Sudden Death in Athletes Referred from 2011 to 2017 to the Laboratory Diagnostic Center of Tehran Legal Medicine Organization
*Corresponding Author: Abdolrazagh Barzegar: MD, Forensic Medicine Specialist, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
Introduction and Objective
According to the World Health Organization (WHO), sudden death is “death occurring less than 24 hours from the onset of symptoms.” It has different causes. Since there is very little information in Iran on the causes of sudden death during sport, this study aimed to investigate the causes of sudden death during sport in cadavers referred to the Tehran Legal Medicine Organization.
Materials and Method
In this descriptive retrospective study performed cross-sectionally, all cases of sudden death referred to the Tehran Legal Medicine Organization from 2011 to 2017 were examined. The information about age, gender, and cause of death was extracted and analyzed. The pathology slides of the selected cadavers were read again. Data were extracted based on the variables. The statistical sample included 60 cadavers (54 males and 6 females) divided into two groups of under and over 35 years.
Hypertrophic cardiomyopathy (HCM) was the cause of sudden death in 22 out of 60 cases (37%), of which 18 were under 35 years (43%) and 4 were over 35 years (22%). Ischemic atherosclerosis was the second diagnosis in 18 cases (30%), of which 6 were under 35 years (14%) and 12 were over 35 years (67%). Mitral valve prolapse was found in 4 cases (7%) under 35 years. Myocarditis was observed in 2 cases (3%) under 35 years. Cerebral and coronary artery anomalies were observed similarly in 2 cases (3%) under 35 years. Myocardial dysplasia was found in 2 cases (3%) over 35 years, tamponade in 2 cases (3%) under 35 years and 2 cases (3%) over 35 years, and left ventricular hypertrophy in 4 cases (22%) over 35 years.
Discussion and Conclusion
It seems that male gender can be considered a risk factor for sudden death. Congenital heart defects and hypertrophic cardiomyopathy are the most common causes of sudden death in athletes under 35 years, and severe coronary atherosclerosis is the most common cause of sudden death in athletes over 35 years. These findings are consistent with the findings of other studies.
Taking cardiovascular diseases and their risk factors more seriously as well as taking effective preventive measures to reduce their incidence can play a significant role in reducing the incidence of sudden death.
Sudden death, athletes, hypertrophic cardiomyopathy, atherosclerosis.