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Işın A, Turgut A, Peden AE. Epidemiology of Football-Related Sudden Cardiac Death in Turkey. ACTA ACUST UNITED AC 2021; 57:medicina57101105. [PMID: 34684142 PMCID: PMC8540717 DOI: 10.3390/medicina57101105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022]
Abstract
Background and Objectives: Sudden cardiac death (SCD), particular among elite footballers, has attracted much attention in recent times. However, limited information exists on football-related SCD in Turkey. Autopsy-based studies of sports-related sudden deaths in Turkey are rare and often have small sample sizes. To address this, this study aimed to determine the population-based incidence and profile of football-related SCD nationally in Turkey. Materials and Methods: Due to a lack of national data on this issue, football-related SCD (non-elite competitive or recreational football) between 1 January 2011, and 31 December 2019 were identified by dual, independent identification and screening of online media reports. Deaths were explored by sex, age group, season, and phase of exercise. Descriptive statistics were utilised. Age-specific mortality rates and proportional mortality rates were calculated. Results: In total, 118 football-related SCD were identified, a crude mortality rate of 0.41 per 100,000 population. All fatalities were males and the mean age was 35.5 years ± 10.4. Those aged 40–49 years recorded the highest mortality rate (0.67/100,000), three times the risk of those aged 50–59 years (RR = 3.1; 95%CI:1.5–6.4). Those aged 30–39 recorded the highest age-specific proportional mortality rate (0.86/1000 deaths). The highest risk occurred while playing football (n = 97; 82.2%), with another 15% of deaths (n = 18) occurring within 1 h of play. Almost all fatalities (n = 113; 95.8%) occurred during participation in recreational football. Conclusions: This study has identified football-related SCD most commonly occurs during recreational football among males aged 30–49 years. It is recommended males of this age participating in recreational football be encouraged to seek pre-participation heart health checks. Given the value of automated external defibrillators (AEDs) in responding to out-of-hospital cardiac arrest, future research should explore the feasibility and effectiveness of AEDs in preventing football-related SCD in Turkey including training of first responders in cardiopulmonary resuscitation and AED use.
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Affiliation(s)
- Ali Işın
- Department of Coaching Education, Faculty of Sports Sciences, Akdeniz University, Antalya 07070, Turkey;
| | - Adnan Turgut
- Department of Physical Education and Sports, Faculty of Sports Sciences, Akdeniz University, Antalya 07070, Turkey;
| | - Amy E. Peden
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence:
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(Sudden cardiac arrest/death during sports). COR ET VASA 2020. [DOI: 10.33678/cor.2020.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bauman BD, Witt JE, Vakayil V, Anwer S, Irwin ED, Kwaan MR, Pruett TL, Harmon JV. Cecal volvulus in long-distance runners: A proposed mechanism. Am J Emerg Med 2018; 37:549-552. [PMID: 30057073 DOI: 10.1016/j.ajem.2018.07.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/26/2022] Open
Affiliation(s)
- Brent D Bauman
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Jennifer E Witt
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Victor Vakayil
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Shumaila Anwer
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Eric D Irwin
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America
| | - Mary R Kwaan
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - Timothy L Pruett
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
| | - James V Harmon
- Department of Surgery, University of Minnesota, MMC 450, 420 Delaware St SE, Minneapolis, MN 55455, United States of America.
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Sudden death due to catecholaminergic polymorphic ventricular tachycardia following negative stress-test outcome: genetics and clinical implications. Forensic Sci Med Pathol 2017; 13:217-225. [PMID: 28405885 DOI: 10.1007/s12024-017-9862-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
Abstract
This paper discusses the case of a young boy who died suddenly during a football match. The victim's personal and family medical histories were negative for cardiac events. He had undergone a cardiological investigation some months before his death, enabling him to participate in competitive sports. Only post-mortem molecular analysis allowed for a clearer determination of the most plausible cause of death, which was identified as inherited arrhythmogenic heart disease, known as catecholaminergic polymorphic ventricular tachycardia. It was possible to detect a novel, previously undescribed, variant in the RYR2 gene. This case report highlights the importance of a meaningful forensic multidisciplinary investigation in such cases, and also discusses possible medical malpractice claims.
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Sudden death in competitive athletes: does a circadian variation in occurrence exist? Am J Emerg Med 2012; 30:1306-9. [DOI: 10.1016/j.ajem.2012.04.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 04/17/2012] [Indexed: 11/18/2022] Open
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Primary cardiac arrest following sport or exertion in children presenting to an emergency department: chest compressions and early defibrillation can save lives, but is intravenous epinephrine always appropriate? Pediatr Emerg Care 2012; 28:336-9. [PMID: 22453726 DOI: 10.1097/pec.0b013e31824d8c78] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to describe the characteristics and outcome of pediatric patients presenting to an emergency department (ED) following out-of-hospital primary cardiac arrest (OHPCA), to determine if long-term survival is influenced by specific resuscitation interventions. METHODS This was a prospective observational study of cases of OHPCA during sport or exertion in young patients presenting to an ED over a 5-year period. Cases were identified from a resuscitation database, which documented patient demographics, nature of event, emergency treatment, response times, and clinical progress. These data were analyzed to determine outcomes. RESULTS Nine children were identified who presented following OHPCA during the study period. The mean age was 10.7 (±4.2) years. All were subsequently diagnosed with an underlying primary cardiac disorder. Six patients (66.6%) survived to make a full recovery. All patients who survived had received early chest compressions (within 5 minutes) and early defibrillation (within 10 minutes). The initial cardiac arrest rhythm in all survivors had been an electrically cardiovertable rhythm. Five (83%) of the 6 survivors did not receive epinephrine during resuscitation. CONCLUSIONS The importance of early chest compressions and defibrillation in collapsed young athletes is highlighted in this report. These interventions can result in full long-term neurological recovery. Use of epinephrine in these patients may be dangerous. We suggest that special consideration should be given to this subgroup of patients in the development of future resuscitation guidelines.
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Sarioglu T, Yalcinbas YK, Erek E, Salihoglu E, Turkekul Y, Buyukasik H, Sarioglu A. Surgical Repair of a Cause of Sudden Death. World J Pediatr Congenit Heart Surg 2011; 2:509-12. [DOI: 10.1177/2150135111404088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Left coronary artery originating from the right coronary sinus is one of the most frequent causes of sudden death in young people. We present a reconstructive surgical technique for left coronary artery and main pulmonary artery in a case with anomalous origin of the left coronary artery from the right coronary sinus. A 15-year-old boy underwent unroofing of the left main coronary artery and patch arterioplasty with autologous pericardium after transection of the main pulmonary artery. The pulmonary artery was reconstructed with autologous pericardium and a piece of dacron patch in order to prevent coronary artery compression. This surgical approach resulted in successful clinical outcome.
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Affiliation(s)
- Tayyar Sarioglu
- Cardiovascular Surgery Department, Acibadem University School of Medicine, Istanbul, Turkey
| | - Yusuf Kenan Yalcinbas
- Cardiovascular Surgery Department, Acibadem University School of Medicine, Istanbul, Turkey
| | - Ersin Erek
- Cardiovascular Surgery Department, Acibadem University School of Medicine, Istanbul, Turkey
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Gaaloul I, Riabi S, Harrath R, Evans M, Huber S, Aouni M. Coxsackie B3 myocarditis in a case of sudden unexpected death in young athlete: Histopathological, immunohistochemical and molecularpathological for diagnosis. Forensic Sci Int 2011; 208:e10-4. [DOI: 10.1016/j.forsciint.2011.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 01/02/2011] [Accepted: 02/09/2011] [Indexed: 10/18/2022]
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Ferreira M, Santos-Silva PR, de Abreu LC, Valenti VE, Crispim V, Imaizumi C, Filho CF, Murad N, Meneghini A, Riera ARP, de Carvalho TD, Vanderlei LCM, Valenti EE, Cisternas JR, Moura Filho OF, Ferreira C. Sudden cardiac death athletes: a systematic review. BMC Sports Sci Med Rehabil 2010; 2:19. [PMID: 20682064 PMCID: PMC2923123 DOI: 10.1186/1758-2555-2-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 08/03/2010] [Indexed: 01/15/2023]
Abstract
Previous events evidence that sudden cardiac death (SCD) in athletes is still a reality and it keeps challenging cardiologists. Considering the importance of SCD in athletes and the requisite for an update of this matter, we endeavored to describe SCD in athletes. The Medline (via PubMed) and SciELO databases were searched using the subject keywords "sudden death, athletes and mortality". The incidence of SCD is expected at one case for each 200,000 young athletes per year. Overall it is resulted of complex dealings of factors such as arrhythmogenic substrate, regulator and triggers factors. In great part of deaths caused by heart disease in athletes younger than 35 years old investigations evidence cardiac congenital abnormalities. Athletes above 35 years old possibly die due to impairments of coronary heart disease, frequently caused by atherosclerosis. Myocardial ischemia and myocardial infarction are responsible for the most cases of SCD above this age (80%). Pre-participatory athletes' evaluation helps to recognize situations that may put the athlete's life in risk including cardiovascular diseases. In summary, cardiologic examinations of athletes' pre-competition routine is an important way to minimize the risk of SCD.
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Affiliation(s)
- Marcelo Ferreira
- Departamento de Clínica Médica, Disciplina de Cardiologia, Núcleo de Saúde no Esporte, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
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Abstract
A preparticipation cardiovascular screening is recommended for all athletes with the aim of identifying conditions that increase the risk for adverse cardiac event, including sudden death. History and physical examination are the mainstay of cardiovascular screening of young athletes. The ability to identify athletes at risk, however, based on history and physical examination alone is low, and inclusion of an electrocardiogram as a screening tool has been suggested to improve the sensitivity of screening. This article provides an overview of key aspects of cardiovascular screening currently recommended in the United States for young athletes.
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Affiliation(s)
- Saad Siddiqui
- Pediatric Cardiology, Hope Children's Hospital, Oak Lawn, IL, USA.
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Sanchez LD, Pereira J, Berkoff DJ. The Evaluation of Cardiac Complaints in Marathon Runners. J Emerg Med 2009; 36:369-76. [DOI: 10.1016/j.jemermed.2007.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Revised: 04/02/2007] [Accepted: 09/30/2007] [Indexed: 12/22/2022]
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Coronary Anomalies. Curr Sports Med Rep 2007. [DOI: 10.1097/01.csmr.0000306447.71573.fe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rommel M, Griffin R, Harrison EE. Coronary anomalies: Cardiac CT evaluation of the symptomatic adult athlete. Curr Sports Med Rep 2007; 6:85-92. [PMID: 17376336 DOI: 10.1007/bf02941148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Cardiac CT has become widely available as a diagnostic test. It is noninvasive, low risk (for contrast allergies), quick, and highly sensitive for identifying the coronary origins and course. Two coronary anomalies, the left main artery from the right sinus of Valsalva, and the right coronary artery originating from the left sinus, have been associated both with myocardial ischemia and sudden cardiac death when they course between the aorta and pulmonary arteries. These anomalies can go undetected into adulthood. The yield of noninvasive exercise testing is low. In the past, the ability to demonstrate these anomalies depended on a high index of suspicion and an aggressive invasive work-up with cardiac catheterization. Now cardiac CT can demonstrate these anomalies with ease and facilitate appropriate treatment.
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Arias MA, Fernández-Guerrero JC, Herrador J, Pagola C. Catecholaminergic polymorphic ventricular tachycardia as a cause of sudden death in athletes. Am J Emerg Med 2006; 24:253-4. [PMID: 16490665 DOI: 10.1016/j.ajem.2005.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2005] [Accepted: 09/12/2005] [Indexed: 10/25/2022] Open
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