Finocchiaro, G; Radaelli, D; D'Errico, S; Papadakis, M; Behr, ER; Sharma, S; Westaby, J; Sheppard, MN
(2023)
Sudden Cardiac Death Among Adolescents in the United Kingdom.
J Am Coll Cardiol, 81 (11).
pp. 1007-1017.
ISSN 1558-3597
https://doi.org/10.1016/j.jacc.2023.01.041
SGUL Authors: Westaby, Joseph David Sheppard, Mary Noelle
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Abstract
BACKGROUND: Causes and precipitating factors of sudden cardiac death (SCD) in adolescents are poorly understood. OBJECTIVES: The authors sought to investigate the etiologies of SCD and their association with physical activity in a large cohort of adolescents. METHODS: Between 1994 and June 2022, 7,675 cases of SCD were consecutively referred to our national cardiac pathology center; 756 (10%) were adolescents. All cases underwent detailed autopsy evaluation by expert cardiac pathologists. Clinical information was obtained from referring coroners. RESULTS: A structurally normal heart, indicative of sudden arrhythmic death syndrome was the most common autopsy finding (n = 474; 63%). Myocardial diseases were detected in 163 cases (22%), including arrhythmogenic cardiomyopathy (n = 36; 5%), hypertrophic cardiomyopathy (n = 31; 4%), idiopathic left ventricular hypertrophy (n = 31; 4%), and myocarditis (n = 30; 4%). Coronary artery anomalies were identified in 17 cases (2%). Decedents were competitive athletes in 128 cases (17%), and 159 decedents (21%) died during exercise. Arrhythmogenic cardiomyopathy was diagnosed in 8% of athletes compared with 4% of nonathletes (P = 0.05); coronary artery anomalies were significantly more common in athletes (9% vs 1%; P < 0.001), as well as commotio cordis (5% compared with 1% in nonathletes; P = 0.001). The 3 main comorbidities were asthma (n = 58; 8%), epilepsy (n = 44; 6%), and obesity (n = 40; 5%). CONCLUSIONS: Sudden arrhythmic death syndrome and myocardial diseases are the most common conditions diagnosed at autopsy in adolescent victims of SCD. Among causes of SCD, arrhythmogenic cardiomyopathy, coronary artery anomalies, and commotio cordis are more common in young athletes than in similar age sedentary individuals.
Item Type: | Article | |||||||||
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Additional Information: | © 2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/ | |||||||||
Keywords: | adolescence, sport, sudden death, 1102 Cardiorespiratory Medicine and Haematology, 1117 Public Health and Health Services, Cardiovascular System & Hematology | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | |||||||||
Journal or Publication Title: | J Am Coll Cardiol | |||||||||
ISSN: | 1558-3597 | |||||||||
Language: | eng | |||||||||
Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | |||||||||
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PubMed ID: | 36922085 | |||||||||
Go to PubMed abstract | ||||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/115248 | |||||||||
Publisher's version: | https://doi.org/10.1016/j.jacc.2023.01.041 |
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