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Exertional collapse and sudden death associated with sickle cell trait
1Martin Army Community Hospital, Fort Benning, Georgia, USA.
American Family Physician
|July 1, 1996
Summary
Sickle cell trait can lead to serious complications like exertional collapse and sudden death in susceptible individuals. Prompt diagnosis and management are crucial for preventing severe outcomes.
Area of Science:
- Sports Medicine
- Hematology
Background:
- Sickle cell trait, while rare, carries risks of exertional collapse and sudden death.
- Environmental and physiological stressors can trigger sickling of abnormal erythrocytes in susceptible individuals.
Purpose of the Study:
- To outline the pathophysiology, diagnosis, and management of exertional complications associated with sickle cell trait.
Main Methods:
- Review of existing literature on exertional collapse in sickle cell trait.
- Analysis of proposed mechanisms including sickling, endothelial damage, and organ-specific effects.
- Summary of diagnostic criteria and differential diagnoses.
- Outline of current management strategies.
Main Results:
- Sickling precipitates endothelial damage, leading to vasoconstriction, DIC, and tissue damage.
- Cardiac effects include ischemia and arrhythmias; muscle damage can cause compartment syndromes and myoglobin release.
- Potential for acute renal failure; diagnosis relies on clinical suspicion and specific lab findings (myoglobinuria, electrolyte imbalances, elevated CK).
Conclusions:
- Exertional collapse in sickle cell trait is a serious condition requiring high index of suspicion for diagnosis.
- Management focuses on stabilization, rehydration, and preventing/treating complications.
- Understanding the pathophysiology is key to effective prevention and treatment strategies.