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Plötzlicher Herztod und Rhythmusstörungen bei Sportlern

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Sudden cardiac death and arrhythmia in athletes

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Zusammenfassung

Die Ursachen des plötzlichen Herztodes unterscheiden sich bei Sportlern <35 Jahre (Kammerflimmern bei hypertropher Kardiomyopathie, arrhythmogene rechtsventrikuläre Kardiomyopathie/Dysplasie, Koronaranomalien) und bei Sportlern >35 Jahre (v. a. koronare Herzkrankheit). Die deutschen und europäischen Empfehlungen beschreiben die Möglichkeiten der Diagnose von Herzerkrankungen bei Sportlern mittels spezieller Screening-Programme, v. a. mittels der Elektrokardiographie (EKG). In bis zu 20% der plötzlichen Todesfälle weisen die Sportler keine autoptisch fassbare strukturelle Herzerkrankung auf. Ursächlich liegen bei diesen Sportlern meist angeborene Herzrhythmusstörungen (z. B. Wolff-Parkinson-White-Syndrom), Ionenkanalerkrankungen (z. B. Brugada-Syndrom) oder erworbene Herzrhythmusstörungen (z. B. Long-QT-Syndrom) vor. Diese Erkrankungen erfordern therapeutische Konsequenzen für die Therapie und eine konsequente Stellungnahme zur Sporttauglichkeit. Weiterhin sollte die Notwendigkeit einer optimierten Notfallversorgung von Sportlern und Zuschauern und das Ausmaß der Bereitstellung von automatisierten Defibrillatoren in Sportstätten beachtet werden.

Abstract

Sports-related acute cardiovascular events and sudden cardiac death in athletes <35 years old are mainly caused by hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia and coronary anomalies. In athletes >35 years old coronary heart disease is the main cause of sudden cardiac death. In Europe preparticipation screening for competitive sports and mass screening programs including 12-lead electrocardiography (ECG) are recommended for the prevention of sudden cardiac death in athletes. Up to 20% of cases of sudden death in athletes show no tangible structural cardiac disease. The causes in these athletes are mostly congenital cardiac arrhythmia (e.g. Wolff-Parkinson-White syndrome), ion channel disorders (e.g. Brugada syndrome) or acquired cardiac arrhythmia (e.g. Long Q-T syndrome). These diseases necessitate that athletes be advised about the individual risk and further sports activities. Moreover, an improvement of the emergency management in sport arenas with availability of automatic cardioverter defibrillators and standardized emergency programs seems to be necessary.

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  1. Medizinische Klinik II (Schwerpunkte Kardiologie und Angiologie), Universitätsklinik Marienhospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland

    T. Butz, A. Meissner, G. Plehn & H.-J. Trappe

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  1. T. Butz
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  2. A. Meissner
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  3. G. Plehn
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  4. H.-J. Trappe
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Butz, T., Meissner, A., Plehn, G. et al. Plötzlicher Herztod und Rhythmusstörungen bei Sportlern. Notfall Rettungsmed 12, 436–441 (2009). https://doi.org/10.1007/s10049-009-1195-0

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