Sudden cardiac death in a young athlete due to anomalous origin of both coronaries from a common ostium
Stefania Zerbo1, Giuseppe Davide Albano2, Ginevra Malta2
1Section of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, 90129, Italy. stefania.zerbo@unipa.it.
Insights
Sudden cardiac death (SCD) in young athletes is a critical public health concern. A rare congenital coronary artery anomaly combined with hypertrophic cardiomyopathy (HCM) was identified as the cause of SCD in a young athlete.
Area of Science:
- Cardiology
- Pathology
- Sports Medicine
Background:
- Sudden cardiac death (SCD) is a significant cause of mortality in young individuals, particularly athletes.
- Congenital cardiac disorders, including cardiomyopathies and coronary anomalies, are frequently implicated in SCD.
- Identifying underlying causes is crucial for prevention strategies.
Purpose of the Study:
- To report a rare case of SCD in a young athlete.
- To investigate the contributing cardiac abnormalities.
- To emphasize the association between coronary anomalies, hypertrophic cardiomyopathy (HCM), and SCD risk.
Main Methods:
- Case report of a 14-year-old male athlete who experienced SCD during a football game.
- Autopsy examination to identify cardiac abnormalities.
- Toxicological analysis to rule out substance abuse.
Main Results:
- Autopsy revealed a congenital anomalous origin of both coronary arteries from a single aortic ostium.
- Concomitant hypertrophic cardiomyopathy (HCM) was diagnosed.
- Toxicology was negative for common drugs.
Conclusions:
- The SCD was attributed to hyperkinetic ventricular arrhythmia secondary to myocardial ischemia.
- A rare congenital coronary artery anomaly coupled with HCM poses a high risk for SCD in young athletes.
- This case underscores the importance of recognizing these rare conditions in athletes.
Abstract:
Sudden cardiac death (SCD) in young people is a tragic event and a worldwide public health issue. SCD is the most common cause of death in young athletes and is related to acquired/congenital cardiac disorders, such as cardiomyopathies, congenital coronary anomalies and ion channelopathies. We report the case of a 14-year-old male non professional athlete who was apparently healthy but suddenly died during a football game. His clinical history was negative for any significant medical illness. At autopsy, a congenital anomalous origin of both the right and left coronary arteries from a single aortic ostium above the aortic cusp was observed with a concomitant hypertophic cardiomyopathy (HCM) The toxicological analysis was negative for common drugs of abuse. The death was attributed to SCD due to hyperkinetic ventricular arrhythmia secondary to myocardial ischemia in a subject with an anomalous origin of both coronary arteries and underlying hypertrophic cardiomyopathy. This report highlights a rare congenital anomalous origin of the coronary arteries associated with a high risk of SCD, particularly in young athletes.
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