[Causes of sudden death in athletes]

Sudden death is rare in athletes, and it is only in recent years that significant series were collected, making it possible to draw the cardiological profile of athletes who died suddenly at the peak of exertion or while recovering. A study of the literature, both medical and paramedical, has yielded 53 cases in which the most frequent causes of sudden death were hypertrophic cardiomyopathy (26 p. 100), (arrhythmogenic right ventricular disease (19 p. 100), congenital abnormalities of coronary arteries (11 p. 100) and coronary atheromatous lesions (9 p. 100), to which must be added various other causes. This study clearly demonstrates the hitherto unrecognized importance of arrhythmogenic right ventricular dysplasia-a condition which, as recent data suggest, is not solely due to a myocardial development disorder but also to an infective disease, an acute of chronic myocarditis. In subjects with this condition, new exploratory methods might detect the presence of an arrhythmogenic substrate during medical screening of athletes, but in any case these causes of sudden death suggest that a fast rhythm disorder was involved in several of these deaths. This disorder could be treated if the attendants were trained to carry out cardiorespiratory resuscitation procedures or if they had access to a defibrillator which should be available on every sports field.