This report is a case history of a 16-year-old highly trained athlete who suffered
from ventricular fibrillation during exhaustive physical activity. After resuscitation
and admission into hospital ECG revealed posterior wall infarction. Thrombolytic therapy
was advised and ST-segment elevation reversed. Within 48 h cerebral edema evolved
due to hypoxic brain damage and the subject deceased after 16 days despite prolonged
maximum antiedematous therapy. Autopsy confirmed the diagnosis of concentric myocardial
hypertrophy (total heart weight 568 g) without signs of coronary artery disease. Systemic
inflammatory diseases and drug abuse were ruled out by lab studies, evidence for viral
infection was not found. Thus, relative coronary insufficiency in regard to myocardial
hypertrophy during excessive athletic activity must be viewed as cause for the fatal
arrhythmia.
Sudden cardiac death, athlete's heart, myocardial infarction, left ventricular hypertrophy,
rhabdomyolysis.
