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Exertional collapse and sudden death associated with sickle cell trait
1Martin Army Community Hospital, Fort Benning, GA 31905, USA.
Military Medicine
|December 1, 1996
Summary
Sickle cell trait (SCT) can cause sudden death during exertion, often unrecognized in African Americans. A case highlights this risk even in soldiers with years of service during physical tests.
Area of Science:
- Cardiovascular Science
- Genetics
- Sports Medicine
Background:
- Sickle cell trait (SCT) affects 2.5 million African Americans and is often undiagnosed.
- The primary severe complication of SCT is sudden death during strenuous physical exertion.
- Military basic training and athletic preseason training show increased risks.
Observation:
- A soldier with three years of military service experienced sudden death during a physical fitness test.
- This case occurred despite the individual having completed basic training, where risks are typically noted.
- The death was associated with known SCT complications like rhabdomyolysis, heat stroke, and cardiac arrhythmia.
Findings:
- Sudden death in SCT is linked to exertional collapse, rhabdomyolysis, heat stroke, and cardiac arrhythmia.
- There is a 40-fold increased risk of sudden death in SCT-affected individuals during military basic training.
- This case demonstrates that SCT-associated sudden death can occur in soldiers beyond basic training.
Implications:
- Highlights the need for increased awareness and screening for SCT in at-risk populations, including military personnel.
- Suggests that exertional risks associated with SCT may persist beyond initial training phases.
- Underscores the importance of recognizing SCT in the differential diagnosis of exertional collapse and sudden death in athletes and military recruits.