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A young athlete experienced sudden collapse and cardiac arrest during sports. Frequent ventricular extrasystoles suggest an underlying arrhythmogenic condition requiring prompt diagnosis.

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Area of Science:

  • Cardiology
  • Sports Medicine
  • Genetics

Background:

  • A 17-year-old male presented with witnessed collapse and respiratory arrest during rugby.
  • He had a history of syncope and a paternal family history of sudden cardiac death.

Observation:

  • The patient was alert on arrival with normal vital signs and physical examination.
  • Paramedics noted frequent ventricular extrasystoles on initial assessment.
  • An initial ECG was recorded (Figure 1).

Findings:

  • The differential diagnosis includes pulmonary embolism, hypertrophic obstructive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and right ventricular outflow tract tachycardia.
  • The presentation suggests a primary electrical abnormality or structural heart disease exacerbated by exertion.

Implications:

  • Early and accurate diagnosis is crucial for preventing recurrent events and sudden cardiac death in young athletes.
  • Genetic counseling and screening may be indicated given the family history.
  • Further diagnostic workup is necessary to determine the definitive cause of the collapse.