Circulation, Vol 62, 218-229, Copyright © 1980 by American Heart Association
BJ Maron, WC Roberts, HA McAllister, DR Rosing and SE Epstein
The causes of sudden and unexpected death in 29 highly conditioned,
competitive athletes, ages 13-30 years, are summarized. Sudden death
occurred during or just after severe exertion on the athletic field in 22
of the 29 athletes. Structural cardiovascular abnormalities were identified
at necropsy in 28 of the 29 athletes (97%), and in 22 (76%) were almost
certainly the cause of death. The most common cause of death in this series
was hypertrophic cardiomyopathy, which was present in 14 athletes. Other
cardiovascular abnormalities that occurred in more than one athlete were
anomalous origin of the left coronary artery from the right (anterior)
sinus of Valsalva, idiopathic concentric left ventricular hypertrophy,
coronary heart disease and ruptured aorta. Cardiac disease was suspected
during life in only seven of the 29 patients, and in only two of the seven
was the correct diagnosis made clinically. Hence, in this series of young
athletes, sudden death was usually due to structural cardiovascular
disease, and hypertrophic cardiomyopathy was a frequent cause of sudden
death; atherosclerotic coronary heart disease was relatively uncommon.
ARTICLES
Sudden death in young athletes
This article has been cited by other articles:
 |
|
 |
|
  I. Ostman-Smith, A. Wisten, E. Nylander, E.-L. Bratt, A. de-Wahl Granelli, A. Oulhaj, and E. Ljungstrom Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy Eur. Heart J., November 5, 2009; (2009) ehp443v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B J Maron Distinguishing hypertrophic cardiomyopathy from athlete's heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening Br. J. Sports Med., September 1, 2009; 43(9): 649 - 656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Youdelman, G. J. Pelletier, C. I. Mesia, and M. L. Jacobs Coronary Steal Syndrome After Coronary Artery Bypass for Anomalous Aortic Origin of a Coronary Artery Ann. Thorac. Surg., April 1, 2009; 87(4): 1292 - 1295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Rowland Sudden Unexpected Death in Young Athletes: Reconsidering "Hypertrophic Cardiomyopathy" Pediatrics, April 1, 2009; 123(4): 1217 - 1222. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Corrado, C. Basso, M. Schiavon, A. Pelliccia, and G. Thiene Pre-Participation Screening of Young Competitive Athletes for Prevention of Sudden Cardiac Death J. Am. Coll. Cardiol., December 9, 2008; 52(24): 1981 - 1989. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Shank, U. K. Bryant, C. B. Jackson, N. M. Williams, and J. G. Janes Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) in Four Calves Vet. Pathol., September 1, 2008; 45(5): 634 - 639. [Full Text] [PDF]
|
|
|
|
|
|
E E Turk, A Riedel, and K Pueschel Natural and traumatic sports-related fatalities: a 10-year retrospective study Br. J. Sports Med., July 1, 2008; 42(7): 604 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Basavarajaiah, M. Wilson, G. Whyte, A. Shah, W. McKenna, and S. Sharma Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening. J. Am. Coll. Cardiol., March 11, 2008; 51(10): 1033 - 1039. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M M. Lindsay and F. G Dunn Biochemical evidence of myocardial fibrosis in veteran endurance athletes Br. J. Sports Med., July 1, 2007; 41(7): 447 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E R Behr, A Casey, M Sheppard, M Wright, T J Bowker, M J Davies, W J McKenna, and D A Wood Sudden arrhythmic death syndrome: a national survey of sudden unexplained cardiac death Heart, May 1, 2007; 93(5): 601 - 605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Maron and A. Pelliccia The Heart of Trained Athletes: Cardiac Remodeling and the Risks of Sports, Including Sudden Death Circulation, October 10, 2006; 114(15): 1633 - 1644. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Corrado, C. Basso, A. Pavei, P. Michieli, M. Schiavon, and G. Thiene Trends in Sudden Cardiovascular Death in Young Competitive Athletes After Implementation of a Preparticipation Screening Program JAMA, October 4, 2006; 296(13): 1593 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Thompson and B. D. Levine Protecting Athletes From Sudden Cardiac Death JAMA, October 4, 2006; 296(13): 1648 - 1650. [Full Text] [PDF]
|
|
|
|
|
|
E. Erez, V. K.H. Tam, N. A. Doublin, and J. Stakes Anomalous coronary artery with aortic origin and course between the great arteries: improved diagnosis, anatomic findings, and surgical treatment. Ann. Thorac. Surg., September 1, 2006; 82(3): 973 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Strickberger, D. W. Benson, I. Biaggioni, D. J. Callans, M. I. Cohen, K. A. Ellenbogen, A. E. Epstein, P. Friedman, J. Goldberger, P. A. Heidenreich, et al. AHA/ACCF Scientific Statement on the Evaluation of Syncope: From the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation In Collaboration With the Heart Rhythm Society J. Am. Coll. Cardiol., January 17, 2006; 47(2): 473 - 484. [Full Text] [PDF]
|
|
|
|
|
|
S. A. Strickberger, D. W. Benson, I. Biaggioni, D. J. Callans, M. I. Cohen, K. A. Ellenbogen, A. E. Epstein, P. Friedman, J. Goldberger, P. A. Heidenreich, et al. AHA/ACCF Scientific Statement on the Evaluation of Syncope: From the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: In Collaboration With the Heart Rhythm Society: Endorsed by the American Autonomic Society Circulation, January 17, 2006; 113(2): 316 - 327. [Full Text] [PDF]
|
|
|
|
 |
|
 W. D. Binder, M. A. Fifer, M. E. King, and J. R. Stone Case 26-2005 - A 48-Year-Old Man with Sudden Loss of Consciousness while Jogging N. Engl. J. Med., August 25, 2005; 353(8): 824 - 832. [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, A. Pelliccia, H. H. Bjornstad, L. Vanhees, A. Biffi, M. Borjesson, N. Panhuyzen-Goedkoop, A. Deligiannis, E. Solberg, D. Dugmore, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol: Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology Eur. Heart J., March 1, 2005; 26(5): 516 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Biancaniello Innocent Murmurs Circulation, January 25, 2005; 111(3): e20 - e22. [Full Text] [PDF]
|
|
|
|
|
|
F. Colivicchi, F. Ammirati, and M. Santini Epidemiology and prognostic implications of syncope in young competing athletes Eur. Heart J., October 1, 2004; 25(19): 1749 - 1753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Corrado, C. Basso, G. Rizzoli, M. Schiavon, and G. Thiene Does sports activity enhance the risk of sudden death in adolescents and young adults? J. Am. Coll. Cardiol., December 3, 2003; 42(11): 1959 - 1963. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Firoozi, S Sharma, and W J McKenna Risk of competitive sport in young athletes with heart disease Heart, July 1, 2003; 89(7): 710 - 714. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sharma, B. J. Maron, G. Whyte, S. Firoozi, P. M. Elliott, and W. J. McKenna Physiologic limits of left ventricular hypertrophy in elite junior athletes: Relevance to differential diagnosis of athlete's heart and hypertrophic cardiomyopathy J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1431 - 1436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. I.P. Dornan Anesthesia for a Patient with Catecholaminergic Polymorphic Ventricular Tachycardia Anesth. Analg., September 1, 2002; 95(3): 555 - 557. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J McKenna and E. R Behr Hypertrophic cardiomyopathy: management, risk stratification, and prevention of sudden death Heart, February 1, 2002; 87(2): 169 - 176. [Full Text] [PDF]
|
|
|
|
 |
|
 M.J. Janse and J.M.T. De Bakker Arrhythmia substrate and management in hypertrophic cardiomyopathy: from molecules to implantable card ioverter-defibrillators Eur. Heart J. Suppl., October 1, 2001; 3(suppl_L): L15 - L20. [Abstract] [PDF]
|
|
|
|
|
|
J. A. Davis, F. Cecchin, T. K. Jones, and M. A. Portman Major coronary artery anomalies in a pediatric population: incidence and clinical importance J. Am. Coll. Cardiol., February 1, 2001; 37(2): 593 - 597. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Pelliccia Congenital coronary artery anomalies in young patients: New perspectives for timely identification J. Am. Coll. Cardiol., February 1, 2001; 37(2): 598 - 600. [Full Text] [PDF]
|
|
|
|
|
|
S. Sharma, P. M. Elliott, G. Whyte, N. Mahon, M. S. Virdee, B. Mist, and W. J. McKenna Utility of metabolic exercise testing in distinguishing hypertrophic cardiomyopathy from physiologic left ventricular hypertrophy in athletes J. Am. Coll. Cardiol., September 1, 2000; 36(3): 864 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. J. Maron, I. Olivotto, P. Spirito, S. A. Casey, P. Bellone, T. E. Gohman, K. J. Graham, D. A. Burton, and F. Cecchi Epidemiology of Hypertrophic Cardiomyopathy-Related Death : Revisited in a Large Non-Referral-Based Patient Population Circulation, August 22, 2000; 102(8): 858 - 864. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Quigley A survey of the causes of sudden death in sport in the Republic of Ireland Br. J. Sports Med., August 1, 2000; 34(4): 258 - 261. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Morentin, B. Aguilera, P. M. Garamendi, and M P. Suarez-Mier Sudden unexpected non-violent death between 1 and 19 years in north Spain Arch. Dis. Child., June 1, 2000; 82(6): 456 - 461. [Abstract] [Full Text]
|
|
|
|
|
|
C. Basso, B. J. Maron, D. Corrado, and G. Thiene Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1493 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.P. McCann, D.F. Muir, and W.S. Hillis Athletic left ventricular hypertrophy: long-term studies are required Eur. Heart J., March 1, 2000; 21(5): 351 - 353. [PDF]
|
|
|
|
 |
|
 A. J. Woodiwiss, B. Trifunovic, M. Philippides, and G. R. Norton Effects of an androgenic steroid on exercise-induced cardiac remodeling in rats J Appl Physiol, February 1, 2000; 88(2): 409 - 415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q. Yang, A. Sanbe, H. Osinska, T. E. Hewett, R. Klevitsky, and J. Robbins In Vivo Modeling of Myosin Binding Protein C Familial Hypertrophic Cardiomyopathy Circ. Res., October 29, 1999; 85(9): 841 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Gomez, B. R. Lantry, and K. N. S. Saathoff Current Use of Adequate Preparticipation History Forms for Heart Disease Screening of High School Athletes Arch Pediatr Adolesc Med, July 1, 1999; 153(7): 723 - 726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Henriksen, J. Landelius, T. Kangro, T. Jonason, P. Hedberg, L. Wesslen, C.N. Rosander, C. Rolf, I. Ringqvist, and G. Friman An echocardiographic study of right and left ventricular adaptation to physical exercise in elite female orienteers Eur. Heart J., February 2, 1999; 20(4): 309 - 316. [Abstract] [PDF]
|
|
|
|
|
|
B. J. Maron, T. E. Gohman, and D. Aeppli Prevalence of sudden cardiac death during competitive sports activities in Minnesota High School athletes J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1881 - 1884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. J. Maron, M. J. Mitten, E. F. Quandt, and D. P. Zipes Competitive Athletes with Cardiovascular Disease -- The Case of Nicholas Knapp N. Engl. J. Med., November 26, 1998; 339(22): 1632 - 1635. [Full Text]
|
|
|
|
|
|
D. Corrado, C. Basso, M. Schiavon, and G. Thiene Screening for Hypertrophic Cardiomyopathy in Young Athletes N. Engl. J. Med., August 6, 1998; 339(6): 364 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. W. Glover and B. J. Maron Profile of Preparticipation Cardiovascular Screening for High School Athletes JAMA, June 10, 1998; 279(22): 1817 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Sadoul, K. Prasad, P. M. Elliott, S. Bannerjee, M. P. Frenneaux, and W. J. McKenna Prospective Prognostic Assessment of Blood Pressure Response During Exercise in Patients With Hypertrophic Cardiomyopathy Circulation, November 4, 1997; 96(9): 2987 - 2991. [Abstract] [Full Text]
|
|
|
|
|
|
N R SONI and J E DEANFIELD Assessment of cardiovascular fitness for competitive sport in high risk groups Arch. Dis. Child., November 1, 1997; 77(5): 386 - 389. [Full Text]
|
|
|
|
 |
|
 P. D. Thompson The Cardiovascular Complications of Vigorous Physical Activity Arch Intern Med, November 11, 1996; 156(20): 2297 - 2302. [Abstract] [PDF]
|
|
|
|
|
|
B. J. Maron, P. D. Thompson, J. C. Puffer, C. A. McGrew, W. B. Strong, P. S. Douglas, L. T. Clark, M. J. Mitten, M. H. Crawford, D. L. Atkins, et al. Cardiovascular Preparticipation Screening of Competitive Athletes: A Statement for Health Professionals From the Sudden Death Committee (Clinical Cardiology) and Congenital Cardiac Defects Committee (Cardiovascular Disease in the Young), American Heart Association Circulation, August 15, 1996; 94(4): 850 - 856. [Full Text]
|
|
|
|
|
|
B. J. Maron, J. Shirani, L. C. Poliac, R. Mathenge, W. C. Roberts, and F. O. Mueller Sudden Death in Young Competitive Athletes: Clinical, Demographic, and Pathological Profiles JAMA, July 17, 1996; 276(3): 199 - 204. [Abstract] [PDF]
|
|
|
|
|
|
R. R. Liberthson Sudden Death from Cardiac Causes in Children and Young Adults N. Engl. J. Med., April 18, 1996; 334(16): 1039 - 1044. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Mavroudis, C. L. Backer, A. J. Muster, E. Pahl, J. H. Sanders, V. R. Zales, and M. Gevitz EXPANDING INDICATIONS FOR PEDIATRIC CORONARY ARTERY BYPASS J. Thorac. Cardiovasc. Surg., January 1, 1996; 111(1): 181 - 189. [Abstract] [Full Text]
|
|
|
|
|
|
J. A. Quinones, S. Y. DeLeon, D. A. Vitullo, J. Hofstra, D. J. Cziperle, K. P. Shenoy, T. J. Bell, and E. A. Fisher Regression of Hypertrophic Cardiomyopathy After Modified Konno Procedure Ann. Thorac. Surg., November 1, 1995; 60(5): 1250 - 1254. [Abstract] [Full Text]
|
|
|
|
|
|
B. J. Maron, J. M. Gardin, J. M. Flack, S. S. Gidding, T. T. Kurosaki, and D. E. Bild Prevalence of Hypertrophic Cardiomyopathy in a General Population of Young Adults : Echocardiographic Analysis of 4111 Subjects in the CARDIA Study Circulation, August 15, 1995; 92(4): 785 - 789. [Abstract] [Full Text]
|
|
|
|
|
|
B. J. Maron, L. C. Poliac, J. A. Kaplan, and F. O. Mueller Blunt Impact to the Chest Leading to Sudden Death from Cardiac Arrest during Sports Activities N. Engl. J. Med., August 10, 1995; 333(6): 337 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Saumarez, A. K. B. Slade, A. A. Grace, N. Sadoul, A. J. Camm, and W. J. McKenna The Significance of Paced Electrogram Fractionation in Hypertrophic Cardiomyopathy : A Prospective Study Circulation, June 1, 1995; 91(11): 2762 - 2768. [Abstract] [Full Text]
|
|
|
|
|
|
B. J. Maron, A. Pelliccia, and P. Spirito Cardiac Disease in Young Trained Athletes : Insights Into Methods for Distinguishing Athlete's Heart From Structural Heart Disease, With Particular Emphasis on Hypertrophic Cardiomyopathy Circulation, March 1, 1995; 91(5): 1596 - 1601. [Full Text]
|
|
|
|
|
|
B. J. Maron Sudden Death in Young Athletes -- Lessons from the Hank Gathers Affair N. Engl. J. Med., July 1, 1993; 329(1): 55 - 57. [Full Text]
|
|
|
|
 |
|
 C. M. Craven Sudden death in a young athlete: A case report Am. J. Sports Med., September 1, 1992; 20(5): 621 - 623. [PDF]
|
|
|
|
|
|
T. J. Abrunzo Commotio Cordis: The Single, Most Common Cause of Traumatic Death in Youth Baseball Arch Pediatr Adolesc Med, November 1, 1991; 145(11): 1279 - 1282. [Abstract] [PDF]
|
|
|
|
|
|
F. M. McCaffrey, L. D. S. Braden, and W. B. Strong Sudden Cardiac Death in Young Athletes: A Review Arch Pediatr Adolesc Med, February 1, 1991; 145(2): 177 - 183. [Abstract] [PDF]
|
|
|
|
 |
|
 A. S. Manolis, M. Linzer, D. Salem, and N. A. M. Estes III Syncope: Current Diagnostic Evaluation and Management Ann Intern Med, June 1, 1990; 112(11): 850 - 863. [Abstract] [PDF]
|
|
|
|
|
|
J. R. Raymond, E. K. van den Berg Jr, and M. J. Knapp Nontraumatic Prehospital Sudden Death in Young Adults Arch Intern Med, February 1, 1988; 148(2): 303 - 308. [Abstract] [PDF]
|
|
|
|
|
|
M. Phillips, M. Robinowitz, J. R. Higgins, K. J. Boran, T. Reed, and R. Virmani Sudden Cardiac Death in Air Force Recruits: A 20-Year Review JAMA, November 21, 1986; 256(19): 2696 - 2699. [Abstract] [PDF]
|
|
|
|
|
|
B. J. MARON and J. J. MULVIHILL The Genetics of Hypertrophic Cardiomyopathy Ann Intern Med, October 1, 1986; 105(4): 610 - 613. [Abstract] [PDF]
|
|
|
|
|
|
D. R. Neuspiel and L. H. Kuller Sudden and Unexpected Natural Death in Childhood and Adolescence JAMA, September 13, 1985; 254(10): 1321 - 1325. [Abstract] [PDF]
|
|
|
|
 |
|
 D. K. Runyan The Pre-participation Examination of the Young Athlete: Defining the Essentials Clinical Pediatrics, October 1, 1983; 22(10): 674 - 679. [Abstract] [PDF]
|
|
|
|
|
|
P. G. Hanson, C. R. V. Ark, M. C. Besozzi, and G. G. Rowe Myocardial Infarction in a National-Class Swimmer JAMA, November 12, 1982; 248(18): 2313 - 2314. [Abstract] [PDF]
|
|
|
|
|
|
J. B. Handler, R. W. Asay, S. E. Warren, and P. M. Shea Symptomatic Coronary Artery Disease in a Marathon Runner JAMA, August 13, 1982; 248(6): 717 - 719. [Abstract] [PDF]
|
|