Cardiac arrest in a young athlete

3 December 2014

Organised by:

The case

Description

20-year-old black football player collapsed during a football match on the pitch.
He did not have any previous sinister cardiac symptoms.
He was not on any regular medications and there was no family history of premature sudden cardiac death or cardiomyopathy.
Bystander CPR was commenced immediately.
Paramedics arrived within 7 minutes and found the patient in ventricular fibrillation.
Sinus rhythm was restored after a single shock by automated external defibrillator.
On arrival at the hospital his GCS was 14, maximum Troponin I was 139 ug/l (normal <0.05 ug/l)

His 12-lead ECG is presented below.

References

[*1] Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association.
Maron BJ, Thompson PD, Puffer JC, McGrew CA, Strong WB, Douglas PS, Clark LT, Mitten MJ, Crawford MH, Atkins DL, Driscoll DJ, Epstein AE. Circulation. 1996 Aug 15;94:850-6
[*2] Coronary artery anomalies: an entity in search of an identity.
Angelini P. Circulation. 2007 Mar 13;115:1296-305
[*3] Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes.
Basso C, Maron BJ, Corrado D, Thiene G. J Am Coll Cardiol. 2000 May;35:1493-501
[*4] Surgical management of coronary artery arising from the wrong coronary sinus, using standard and novel approaches.
Gulati R, Reddy VM, Culbertson C, Helton G, Suleman S, Reinhartz O, Silverman N, Hanley FL. J Thorac Cardiovasc Surg. 2007 Nov;134:1171-8

Notes to editor

Dr Vincent Gabus, SpR in Cardiology, St George’s university of London
Dr Michael Papadakis, Lecturer in cardiology, St George’s university of London
Prof Sanjay Sharma, Professor of clinical cardiology, St George’s university of London

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Contributors

Professor Sanjay Sharma

Doctor Michael Papadakis

Doctor Vincent Gabus

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