Dataset Information

Sudden cardiac death risk in contact sports increased by myocarditis: a case series.

ABSTRACT:

Background

Myocarditis is a known cause of sudden cardiac death of the athlete. The impact of direct chest trauma in at-risk sports or activities in patients with a history of myocarditis has never been demonstrated or studied. We report herein two cases of life-threatening ventricular arrhythmia secondary to non-penetrating blunt chest trauma while playing contact sports.

Case summary

The first patient, a 26-year-old man described a brief loss of consciousness after having received blunt impact to the chest (typical intensity) while playing a rugby match. The loss of consciousness was total and proceeded by rapid and regular palpitations. He had a history of viral myocarditis 10 years prior with a fibrotic sequalae in the inferolateral wall on cardiac magnetic resonance imaging (left ventricular ejection fraction 71%). Right apical ventricular pacing induced a sustained monomorphic ventricular tachycardia reproducing the patient's symptoms. A subcutaneous implantable cardioverter-defibrillator was implanted. The second patient is a 22-year-old professional rugby player with no known notable history. During a match, a direct blow to the chest wall was followed by a cardiac arrest. A ventricular fibrillation was cardioverted to pulseless electrical activity. Patient died despite cardiopulmonary resuscitation. An autopsy identified a myocardial sequela of fibrosis with no acute inflammatory remodelling compatible with a previous myocarditis.

Discussion

Myocarditis may increase the risk of life-threatening ventricular arrhythmias caused by blunt impact to the chest, particularly in contact sports. Screening and prevention measures should be considered to reduce this risk.

SUBMITTER: Massoullie G

PROVIDER: S-EPMC8185879 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Sudden cardiac death risk in contact sports increased by myocarditis: a case series.

Massoullié Grégoire G Boyer Baptiste B Sapin Vincent V Jean Frédéric F Andronache Marius M Peoc'h Michel M Clerfond Guillaume G Eschalier Romain R

European heart journal. Case reports 20210301 3

<h4>Background</h4>Myocarditis is a known cause of sudden cardiac death of the athlete. The impact of direct chest trauma in at-risk sports or activities in patients with a history of myocarditis has never been demonstrated or studied. We report herein two cases of life-threatening ventricular arrhythmia secondary to non-penetrating blunt chest trauma while playing contact sports.<h4>Case summary</h4>The first patient, a 26-year-old man described a brief loss of consciousness after having receiv ...[more]

PMID: 34113757

Similar Datasets

Project description:BackgroundVentricular arrhythmias (VAs) frequently occur in the acute phase of myocarditis. Possible arrhythmic recurrences and the risk of sudden cardiac death (SCD) in this setting are reasons for concern, and limited data have been published to guide clinical management of these patients. The aim of the present paper is to report the incidence of major arrhythmic events, defined as sustained VA, SCD and appropriate implantable cardiac-defibrillator (ICD) treatment, in patients with acute myocarditis and ventricular arrhythmic phenotype.MethodsWe conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to evaluate studies reporting long-term outcomes in patients with acute myocarditis and arrhythmic presentation. We systematically searched PubMed, EMBASE and Scopus databases for relevant studies up to 2 August 2024. Study quality was assessed by the Newcastle-Ottawa Scale. The primary outcome was a composite of SCD, VA recurrence and appropriate ICD therapy. Random-effect models were used to calculate pooled ORs and CIs.ResultsFive observational studies enrolling 322 patients were identified. The pooled proportion of patients who experienced VA recurrence was 0.41 (95% CI 0.30 to 0.53, p=0.13). An increased risk of adverse outcomes during follow-up was observed in patients presenting with monomorphic ventricular tachycardia (OR 3.77, 95% CI 1.23 to 11.53) and left ventricular ejection fraction (LVEF) <50% (OR 2.74, 95% CI 0.78 to 9.63). Gender and anteroseptal late gadolinium enhancement were not found as potential risk factors in this analysis.ConclusionsPatients with myocarditis with arrhythmic ventricular presentation have a high recurrence rate of VA, underscoring the importance of careful monitoring and management in this patient population. Risk stratification for SCD during follow-up should be individualised, and monomorphic VA at presentation or a reduced LVEF may be markers of poor prognosis. In these cases, an ICD implantation may be cautious pending further dedicated studies.

Dataset Information

Sudden cardiac death risk in contact sports increased by myocarditis: a case series.

Background

Case summary

Discussion

Publications

Sudden cardiac death risk in contact sports increased by myocarditis: a case series.

Similar Datasets

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