title: Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles.
abstract: OBJECTIVE
  To develop clinical, demographic, and pathological profiles of young competitive athletes who died suddenly.
  
  
  METHODS
  Systematic evaluation of clinical information and circumstances associated with sudden deaths; interviews with family members, witnesses, and coaches; and analyses of postmortem anatomic, microscopic, and toxicologic data.
  
  
  METHODS
  A total of 158 sudden deaths that occurred in trained athletes throughout the United States from 1985 through 1995 were analyzed. MAIN OUTCOME MEASURES--Characteristics and probable cause of death.
  
  
  RESULTS
  Of 158 sudden deaths among athletes, 24 (15%) were explained by noncardiovascular causes. Among the 134 athletes who had cardiovascular causes of sudden death, the median age was 17 years (range, 12-40 years), 120 (90%) were male, 70 (52%) were white, and 59 (44%) were black. The most common competitive sports involved were basketball (47 cases) and football (45 cases), together accounting for 68% of sudden deaths. A total of 121 athletes (90%) collapsed during or immediately after a training session (78 cases) or a formal athletic contest (43 cases), with 80 deaths (63%) occurring between 3 PM and 9 PM. The most common structural cardiovascular diseases identified at autopsy as the primary cause of death were hypertrophic cardiomyopathy (48 athletes [36%]), which was disproportionately prevalent in black athletes compared with white athletes (48% vs 26% of deaths; P = .01), and malformations involving anomalous coronary artery origin (17 athletes [13%]). Of 115 athletes who had a standard preparticipation medical evaluation, only 4 (3%) were suspected of having cardiovascular disease, and the cardiovascular abnormality responsible for sudden death was correctly identified in only 1 athlete (0.9%).
  
  
  CONCLUSIONS
  Sudden death in young competitive athletes usually is precipitated by physical activity and may be due to a heterogeneous spectrum of cardiovascular disease, most commonly hypertrophic cardiomyopathy. Preparticipation screening appeared to be of limited value in identification of underlying cardiovascular abnormalities.
authors.affiliation: Division of Cardiovascular Research, Minneapolis Heart Institute Foundation, MN 55407, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Maron
authors.forename: J
authors.initials: J
authors.lastname: Shirani
authors.forename: L C
authors.initials: LC
authors.lastname: Poliac
authors.forename: R
authors.initials: R
authors.lastname: Mathenge
authors.forename: W C
authors.initials: WC
authors.lastname: Roberts
authors.forename: F O
authors.initials: FO
authors.lastname: Mueller
mesh_terms: D000293:Adolescent; D000328:Adult; D001344:Autopsy; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002423:Cause of Death; D002648:Child; D003625:Data Collection; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000503:physiopathology; D010808:Physical Examination; D005082:Physical Exertion / Q000502:physiology; D044469:Racial Groups; D012737:Sex Factors; D013177:Sports / Q000502:physiology