[Sudden cardiac death in non-professional athletes]

Sudden death during sports activities in non-professional athletes is a rare occurrence, however it is of great interest in clinical pathology and forensic medicine. We performed chemico-toxicologic and histopathologic investigations in three cases of sudden cardiac death in non-professional athletes, focusing in particular on the cardiac conduction system. Examination of conduction tissue was performed on sections seriated every 150 microns, stained alternately with hematoxylin-eosin and Heidenhain's trichrome (azan). In all three cases diagnostic evidence showed hyperacute myocardial infarction, due to spasm of coronaries with mild atherosclerosis, and myocardial lesions due to reperfusive necrosis. The pathogenesis of sudden death in young athletes is not related only to ischemic-coronary damage that is not exclusively mechanical, but also a dynamic event (spasm and reperfusion), but also to fatal arrhythmias related to abnormal findings in the conduction system. Such findings can therefore be considered the morphologic substrate of sudden cardiac death.