Abstract 10655: Sudden Cardiac Death During Physical Exercise: Characteristics of Victims and Autopsy Findings
Background: There has been little information about the risk factors and characteristics of victims of sudden cardiac death (SCD) occurring during physical exercise (PE).
Methods and results: We assessed the characteristics of subjects and findings obtained from the medico-legal autopsy of SCD victims of the FinGesture study population who had experienced a witnessed fatal cardiac arrest (n=1204) at rest (R) or in relation to PE. The FinGesture study population was derived from autopsies of a consecutive series of 2667 victims of SCD in Northern Finland during 1998-2007. A total of 876 of witnessed SCDs occurred at R (73%) (mean age 63±11 y) and 328 (27%) SCDs during or immediately after PE (mean age 62±11 y). Males were more likely to suffer SCD during PE than females (309/987, 31% vs 19/217, 9%, p<0.0001). Coronary artery disease (CAD) was a more common underlying structural heart disease at autopsy than non-ischemic cardiac disease among those who experienced SCD during PE (299/956, 31% vs 18/177, 10%, p<0.0001). Myocardial scarring and cardiac hypertrophy at autopsy were associated with an increased occurrence of PE-related SCD (194/564, 34%, p<0.0001, and 243/828, 29%, p=0.01, respectively). Subjects with PE related SCD had more often 1-2 vessel disease than 3-vessel CAD disease at autopsy (p<0.001), but the type of coronary lesion at histological examination was not associated with PE-related SCD. Male gender, ischemic heart disease and myocardial scarring were associated with exercise related SCD both in subjects with (46%) and without a previously diagnosed cardiac disease (54%) (p<0.001 for all).
Conclusions: Male gender, ischemic heart disease, myocardial scarring and less severe CAD at autopsy, are associated with a higher risk of fatal cardiac arrest occurring during or immediately after exercise both in subjects with and without a known cardiac disease.
- © 2013 by American Heart Association, Inc.