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Mort subite chez le sportif

Sudden death in athletes

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Annales françaises de médecine d'urgence

Résumé

La mort subite du sportif a un impact sociomédiatique majeur. L’épidémiologie de la mort subite du sportif est assez difficile à établir précisément en raison de sa survenue dans des populations et des circonstances très différentes. En France, il y aurait entre 500 et 1000 morts subites par an chez les sportifs, ce qui rend cet événement rare, avec une nette prédominance masculine et une augmentation avec l’âge. La mort subite du sportif a pour origine dans la très grande majorité des cas le déclenchement inopiné d’une fibrillation ventriculaire, le plus souvent liée à une pathologie cardiaque préalablement connue ou non, ou plus rarement secondaire à une myocardite ou à un traumatisme direct répondant alors au nom de « commotio cordis ». Alors que l’intérêt du dépistage systématique des principales anomalies cardiovasculaires a été démontré, les modalités du dépistage avant compétition sont encore extrêmement variables d’un pays à l’autre. La bonne conduite d’une réanimation cardiovasculaire, certes en progrès, reste encore à un niveau très insuffisant dans notre pays. La réalisation de campagnes d’éducation du public et la mise en place de défibrillateurs automatisés externes en libre accès constituent les mesures qui devraient a priori permettre d’améliorer significativement le pronostic de survie des patients victimes de ces accidents.

Abstract

Sudden death in athletes has a major social media impact. The epidemiology of the sudden death in athletes is rather difficult to establish precisely because of its occurrence in very different populations and circumstances. In France, there would be 500 to 1000 sudden deaths per year in athletes, which make it considered as a rare event, with a high male prevalence and an increase with age. In most cases, it is related to the unexpected triggering of a ventricular fibrillation, either related to a pre-existing cardiac known or unknown pathology, or more rarely secondary to a myocarditis or a direct trauma (“commotio cordis”). Whereas the screening strategy has been identified successful in decreasing the cardiovascular mortality rate in competitive athletes, the preparticipation screening strategies remain variable from one country to another. The good practice of cardiopulmonary resuscitation, certainly in progress, still remains at an insufficient level in our country. The realization of campaigns for public education and the free public access to automated external defibrillators constitute the measures which should allow significant improvement in the survival prognostic of the patient’s victim of these unfortunate events.

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Références

  1. Fishman GI, Chugh SS, Dimarco JP, et al (2010) Sudden cardiac death prediction and prevention: report from a National Heart, Lung, and Blood Institute and Heart Rhythm Society Workshop. Circulation 122: 2335–2348

    Article  PubMed  Google Scholar 

  2. Brion R (2007) La mort subite des sportifs. Médecine d’Urgence. 49e Congrès National d’Anesthésie et de Réanimation (pp 571–577), SFAR Ed., Elsevier, Paris

    Google Scholar 

  3. Chevalier L, Hajjar M, Douard H, et al (2009) Sports-related acute cardiovascular events in a general population: a French prospective study. Eur J Cardiovasc Prev Rehabil 16: 365–370

    Article  PubMed  Google Scholar 

  4. Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO (1996) Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 276: 199–204

    Article  PubMed  CAS  Google Scholar 

  5. Marijon E, Tafflet M, Celermajer DS, et al (2011) Sports-related sudden death in the general population. Circulation 124: 672–681

    Article  PubMed  Google Scholar 

  6. Maron BJ (2003) Sudden death in young athletes. N Engl J Med 349: 1064–1067

    Article  PubMed  CAS  Google Scholar 

  7. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G (2003) Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 42: 1959–1963

    Article  PubMed  Google Scholar 

  8. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO (2009) Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation 119: 1085–1092

    Article  PubMed  Google Scholar 

  9. Maron BJ, Haas TS, Doerer JJ, Thompson PD, Hodges JS (2009) Comparison of U.S. and Italian experiences with sudden cardiac deaths in young competitive athletes and implications for preparticipation screening strategies. Am J Cardiol 104: 276–280

    Article  PubMed  Google Scholar 

  10. Maron BJ (1998) Cardiovascular risks to young persons on the athletic field. Ann Intern Med 129: 379–386

    PubMed  CAS  Google Scholar 

  11. Thompson PD (1996) The cardiovascular complications of vigorous physical activity. Arch Intern Med 156: 2297–2302

    Article  PubMed  CAS  Google Scholar 

  12. Pigozzi F, Rizzo M (2008) Sudden death in competitive athletes. Clin Sports Med 27: 153–181

    Article  PubMed  Google Scholar 

  13. Link MS, Mark Estes NA 3rd (2008) Sudden cardiac death in athletes. Prog Cardiovasc Dis 51: 44–57

    Article  PubMed  Google Scholar 

  14. Corrado D, Basso C, Schiavon M, Thiene G (1998) Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 339: 364–369

    Article  PubMed  CAS  Google Scholar 

  15. Maron BJ, Pelliccia A, Spirito P (1995) 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 91: 1596–1601

    PubMed  CAS  Google Scholar 

  16. Corrado D, Thiene G, Nava A, Rossi L, Pennelli N (1990) Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases. Am J Med 89: 588–596

    Article  PubMed  CAS  Google Scholar 

  17. Corrado D, Basso C, Poletti A, Angelini A, Valente M, Thiene G (1994) Sudden death in the young. Is acute coronary thrombosis the major precipitating factor? Circulation 90: 2315–2323

    PubMed  CAS  Google Scholar 

  18. Daliento L, Turrini P, Nava A, et al (1995) Arrhythmogenic right ventricular cardiomyopathy in young versus adult patients: similarities and differences. J Am Coll Cardiol 25: 655–664

    Article  PubMed  CAS  Google Scholar 

  19. Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olson HG (1995) Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 27: 641–647

    PubMed  Google Scholar 

  20. Mitchell JH, Haskell W, Snell P, Van Camp SP (2005) Task Force 8: classification of sports. J Am Coll Cardiol 45: 1364–1367

    Article  PubMed  Google Scholar 

  21. Kim JH, Malhotra R, Chiampas G, et al (2012) Cardiac arrest during long-distance running races. N Engl J Med 366: 130–140

    Article  PubMed  CAS  Google Scholar 

  22. Elliott PM, Sharma S, Varnava A, et al (1999) Survival after cardiac arrest or sustained ventricular tachycardia in patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 33: 1596–1601

    Article  PubMed  CAS  Google Scholar 

  23. Basavarajaiah S, Wilson M, Whyte G, Shah A, McKenna W, Sharma S (2008) Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening. J Am Coll Cardiol 51: 1033–1039

    Article  PubMed  Google Scholar 

  24. Maron BJ, Casey SA, Hurrell DG, Aeppli DM (2003) Relation of left ventricular thickness to age and gender in hypertrophic cardiomyopathy. Am J Cardiol 91: 1195–1198

    Article  PubMed  Google Scholar 

  25. Maron MS (2012) Clinical utility of cardiovascular magnetic resonance in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 14: 13

    Article  PubMed  Google Scholar 

  26. Loire R (1997) La mort subite: données anatomopathologiques. Sang Thrombose Vaisseaux 9: 120–126

    Google Scholar 

  27. Tamburro P, Wilber D (1992) Sudden death in idiopathic dilated cardiomyopathy. Am Heart J 124: 1035–1045

    Article  PubMed  CAS  Google Scholar 

  28. Raschka C, Parzeller M, Kind M (1999) Organpathologische ursachen des akuten sporttodes. Med Klin (Munich) 94: 473–477

    Article  CAS  Google Scholar 

  29. Tofler GH, Stone PH, Maclure M, et al (1990) Analysis of possible triggers of acute myocardial infarction (the MILIS study). Am J Cardiol 66: 22–27

    Article  PubMed  CAS  Google Scholar 

  30. Davies MJ, Thomas AC (1985) Plaque fissuring—the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. Br Heart J 53: 363–373

    Article  PubMed  CAS  Google Scholar 

  31. Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD (1993) Effect of strenuous exercise on platelet activation state and reactivity. Circulation 88: 1502–1511

    PubMed  CAS  Google Scholar 

  32. Ferreira AG Jr, Trotter SE, König B Jr, Décourt LV, Fox K, Olsen EG (1991) Myocardial bridges: morphological and functional aspects. Br Heart J 66: 364–367

    Article  PubMed  Google Scholar 

  33. Tissier S, Codreanu A, Boccaccini H, Laurent V, Aliot E, Regent D (2005) Pont myocardique superficiel de l’artère coronaire interventriculaire antérieure dans sa portion moyenne. J Radiol 86: 1813–1805

    Article  PubMed  CAS  Google Scholar 

  34. Wellens HJ, Rodriguez LM, Timmermans C, Smeets JP (1997) The asymptomatic patient with the Wolff-Parkinson-White electrocardiogram. Pacing Clin Electrophysiol 20: 2082–2086

    Article  PubMed  CAS  Google Scholar 

  35. Kass RS, Moss AJ (2003) Long QT syndrome: novel insights into the mechanisms of cardiac arrhythmias. J Clin Invest 112: 810–815

    PubMed  CAS  Google Scholar 

  36. Roden DM (2008) Clinical practice. Long-QT syndrome. N Engl J Med 358: 169–176

    Article  PubMed  CAS  Google Scholar 

  37. Gaita F, Giustetto C, Bianchi F, et al (2003) Short QT Syndrome: a familial cause of sudden death. Circulation 108: 965–970

    Article  PubMed  Google Scholar 

  38. Priori SG, Napolitano C, Memmi M, et al (2002) Clinical and molecular characterization of patients with catecholaminergic polymorphic ventricular tachycardia. Circulation 106: 69–74

    Article  PubMed  CAS  Google Scholar 

  39. Feldman AM, McNamara D (2000) Myocarditis. N Engl J Med 343: 1388–1398

    Article  PubMed  CAS  Google Scholar 

  40. Maron BJ, Isner JM, McKenna WJ (1994) 26th Bethesda conference: recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force 3: hypertrophic cardiomyopathy, myocarditis and other myopericardial diseases and mitral valve prolapse. J Am Coll Cardiol 24: 880–885

    Article  PubMed  CAS  Google Scholar 

  41. Maron BJ, Poliac LC, Kaplan JA, Mueller FO (1995) Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities. N Engl J Med 333: 337–342

    Article  PubMed  CAS  Google Scholar 

  42. Maron BJ, Gohman TE, Kyle SB, Estes NA 3rd, Link MS (2002) Clinical profile and spectrum of commotio cordis. JAMA 287: 1142–1146

    Article  PubMed  Google Scholar 

  43. Link MS, Wang PJ, Pandian NG, et al (1998) An experimental model of sudden death due to low-energy chest-wall impact (commotio cordis) N Engl J Med 338: 1805–1811

    Article  PubMed  CAS  Google Scholar 

  44. Maron BJ, Wentzel DC, Zenovich AG, Estes NA 3rd, Link MS (2005) Death in a young athlete due to commotio cordis despite prompt external defibrillation. Heart Rhythm 2: 991–993

    Article  PubMed  Google Scholar 

  45. Coris EE, Ramirez AM, Van Durme DJ (2004) Heat illness in athletes: the dangerous combination of heat, humidity and exercise. Sports Med 34: 9–16

    Article  PubMed  Google Scholar 

  46. Maron BJ, Poliac LC, Ashare AB, Hall WA (2003) Sudden death due to neck blows among amateur hockey players. JAMA 290: 599–601

    Article  PubMed  Google Scholar 

  47. Montagnana M, Lippi G, Franchini M, Banfi G, Guidi GC (2008) Sudden cardiac death in young athletes. Intern Med; 47: 1373–1378

    Article  PubMed  Google Scholar 

  48. DiDario AG, Becker JM (45) Asthma, sports, and death. Allergy Asthma Proc 26: 341–344

    Google Scholar 

  49. Furlanello F, Bentivegna S, Cappato R, De Ambroggi L (2003) Arrythmogenic effects of illicit drugs in athletes. Ital Heart J 4: 829–837

    PubMed  Google Scholar 

  50. Furlanello F, Serdoz LV, Cappato R, De Ambroggi L (2007) Illicit drugs and cardiac arrythmias in athletes. Eur J Cardiovasc Prev Rehabil 14: 487–494

    Article  PubMed  Google Scholar 

  51. Dowling GP, Mc Donough III ET, Bost RO (1987) “Eve” and “ecstasy”. A report of five deaths associated with the use of MDEA and MDMA. JAMA 257: 1615–1617

    Article  PubMed  CAS  Google Scholar 

  52. Samenuk D, Link MS, Homoud MK, et al (2002) Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine. Mayo Clin Proc 77: 12–16

    Article  PubMed  Google Scholar 

  53. Neumar RW, Otto CW, Link MS, et al (2010) Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 122: S729–S767

    Article  PubMed  Google Scholar 

  54. Drezner JA, Courson RW, Roberts WO, et al (2007) Inter Association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement. Prehosp Emerg Care 11: 253–271

    Article  PubMed  Google Scholar 

  55. Conseil Français de Réanimation Cardiopulmonaire (CFRC) (2008) Recommandations pour l’organisation de programmes de défibrillation automatisée externe par le public. JEUR 21: 36–39

    Google Scholar 

  56. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G (2006) Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 296: 1593–1601

    Article  PubMed  CAS  Google Scholar 

  57. Maron BJ, Thompson PD, Ackerman MJ, et al (2007) Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update. A scientific statement from the American Heart Association council and nutrition, physical activity, and metabolism. Circulation 115: 1643–1655

    Article  PubMed  Google Scholar 

  58. Prescott EI, Heath FP, Rasmussen HK (2006) Sudden cardiac death among young athletes—should we screen? Ugeskr Laeger 168: 4537–4539

    PubMed  Google Scholar 

  59. Myerburg RJ, Vetter VL (2007) Electrocardiograms should be included in preparticipation screening of athletes. Circulation 116: 2616–2626

    Article  PubMed  Google Scholar 

  60. Chaitman BR (2007) An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation 116: 2610–2614

    Article  PubMed  Google Scholar 

  61. Corrado D, Pelliccia A, Bjørnstad HH, et al (2005) 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. 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 26: 516–524

    Article  PubMed  Google Scholar 

  62. Maron BJ, Thompson PD, Puffer JC, et al (1996) 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 94: 850–856

    PubMed  CAS  Google Scholar 

  63. Marek J, Bufalino V, Davis J, et al (2011) Feasibility and findings of large-scale electrocardiographic screening in young adults: data from 32,561 subjects. Heart Rhythm; 8: 1555–1559

    Article  PubMed  Google Scholar 

  64. Wilson MG, Basavarajaiah S, Whyte GP, Cox S, Loosemore M, Sharma S (2008) Efficacy of personal symptom and family history questionnaires when screening for inherited cardiac pathologies: the role of electrocardiography. Br J Sports Med 42: 207–211

    Article  PubMed  CAS  Google Scholar 

  65. Maron BJ (2010) National electrocardiography screening for competitive athletes: Feasible in the United States? Ann Intern Med 152: 324–326

    PubMed  Google Scholar 

  66. Maron BJ, Araújo CG, Thompson PD, et al (2001) Recommendations for preparticipation screening and the assessment of cardiovascular disease in master athletes. An advisory for healthcare professionals from the working groups of the world heart federation, the international federation of sports medicine, and the American Heart association committee on exercise, cardiac rehabilitation and prevention. Circulation 103: 327–334

    PubMed  CAS  Google Scholar 

  67. Wheeler MT, Heidenreich PA, Froelicher VF, Hlatky MA, Ashley EA (2010) Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med 2010; 152(5): 276–286

    Google Scholar 

  68. Pigozzi F, Spataro A, Fagnani F, Maffulli N (2003) Preparticipation screening for the detection of cardiovascular abnormalities that may cause sudden death in competitive athletes. Br J Sports Med 37: 4–5

    Article  PubMed  CAS  Google Scholar 

  69. Sofi F, Capalbo A, Pucci N, et al (2008) Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional study. BMJ 337: a346

    Article  PubMed  Google Scholar 

  70. Maron BJ (2002) Hypertrophic cardiomyopathy: a systematic review. JAMA 287: 1308–1320

    Article  PubMed  Google Scholar 

  71. Carre F, Brion R, Douard H, et al Recommandations concernant le contenu du bilan cardiovasculaire de la visite de non contre indication à la pratique du sport en compétition entre 12 et 35 ans. Société Française de Cardiologie. http://www.sfcardio.fr/ (accès le 08/02/2012)

  72. Pelliccia A, Culasso F, Di Paolo FM, Maron BJ (1999) Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med 130: 23–31

    PubMed  CAS  Google Scholar 

  73. Maron BJ, Pelliccia A (2006) The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 114: 1633–1644

    Article  PubMed  Google Scholar 

  74. Link MS, Maron BJ, Wang PJ, Pandian NG, VanderBrink BA, Estes NA 3rd (2002) Reduced risk of sudden death from chest wall blows (commotio cordis) with safety baseballs. Pediatrics 109: 873–877

    Article  PubMed  Google Scholar 

  75. Weinstock J, Maron BJ, Song C, Mane PP, Estes NA 3rd, Link MS (2006) Failure of commercially available chest wall protectors to prevent sudden cardiac death induced by chest wall blows in an experimental model of commotio cordis. Pediatrics 117: e656–e662

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Samu de Paris, département d’anesthésie-réanimation, Hôpital-Necker-Enfants-Malades, 149, rue de Sèvres, F-75015, Paris, France

    M. Jaffry, P. Jabre, Y. Ichay, L. Lamhaut, P. Carli & B. Vivien

  2. Assistance publique — hôpitaux de Paris, Université Paris Descartes, Paris 5, F-75015, Paris, France

    M. Jaffry, P. Jabre, Y. Ichay, L. Lamhaut, P. Carli & B. Vivien

  3. INSERM U970, PARCC-Centre de recherche cardiovasculaire de Paris, 56, rue Leblanc, F-75015, Paris, France

    P. Jabre & L. Lamhaut

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  1. M. Jaffry
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  2. P. Jabre
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Correspondence to B. Vivien.

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Jaffry, M., Jabre, P., Ichay, Y. et al. Mort subite chez le sportif. Ann. Fr. Med. Urgence 2, 97–107 (2012). https://doi.org/10.1007/s13341-012-0185-x

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