Clinical and angiographic observations on resuscitated victims of exercise-related sudden ischemic death.
The clinical and angiographic findings of 17 resuscitated victims of exercise-related sudden ischemic death are reported in an attempt to elucidate the mechanism(s) of these deaths. Ten survivors developed cardiac arrest during or after sporting activities (group A) and 7 others during or after an exercise stress test (group B). There were 15 men and 2 women. The mean age of group A was 46 years and of group B 55 years. Coronary risk factors, as well as previous angina and myocardial infarction, were more frequent in group B. Only 3 of the 17 survivors had anginal symptoms before sudden death. Sudden death in group A was associated with acute myocardial infarction in 8 and unstable angina in 2 and was associated in group B with acute myocardial infarction in 2, unstable angina in 3 and silent ischemia in 2. Coronary angiography was acutely performed in 15 patients. In most patients the ischemia-related coronary artery was totally or subtotally occluded. Clinical and angiographic findings indicate that exercise-related sudden ischemic death was due to an acute coronary event--in most cases unexpected and unpredictable. It is suggested that exercise-induced intracoronary changes were probably responsible for the development of acute coronary (sub)occlusion and sudden death.
Ciampricotti
R
R
Department of Cardiology, De Honte Hospital, Terneuzen, The Netherlands.
Taverne
R
R
El Gamal
M
M
D000789:Angina, Unstable / Q000150:complications; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging; D003645:Death, Sudden / Q000209:etiology*; D004562:Electrocardiography; D005080:Exercise Test / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012151:Resuscitation; D012307:Risk Factors