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"Medicina Sportiva" No.14 - 2008 The 15-th Sports Medicine Balkan Congress
SPORTS CARDIOLOGY


MARFAN SYNDROME CAUSING SUDDEN CARDIAC DEATH IN A YOUNG ATHLETE

Asouhidou Irene1, Asteri Theodora2, Natsis Konstantinos3
1Second Department of Anesthesiology, “G.Papanikolaou” Hospital, Exohi, Thessaloniki,
2Department of Cardioanesthesiology, “G.Papanikolaou” Hospital, Exohi, Thessaloniki,
3Department of anatomy, Medical School, Aristotle University of Thessalonili, Greece

Introduction. Sudden death during sports activities is not a rare incident with fatal arrhythmia being the most common cause of death. Marfan syndrome is a relatively common, preventable cause of sudden cardiac death in athletes. It is an autosomal-dominant disorder involving the connective tissue leading to aortic root aneurysm rupture or dissection. Symptoms from the cardiovascular system include hyperventricular arrhythmia, dyspnoia and mitral valve prolapse.
Material. A 26-year-old man, a professional in gymnastics, presented to the Emergency Room complaining of an acute onset of chest pain and back pain and numbness of the left lower extremity. His past medical history included hyperventricular arrhythmia and an incidence of automatic bilateral pneumothorax four years ago.
Results.The contrast enhanced computed tomography revealed dilatation of the aortic root to the level of the renal arteries; a Type I aortic dissection according to the De Bakey Classification. The patient was submitted to the Bental procedure but he unfortunately died during the cardiopulmonary bypass. Marfan syndrome was diagnosed at autopsy. Conclusion. The Marfan syndrome is usually diagnosed in young patients, younger than 35 years, and is associated with a poor prognosis. Early diagnosis of the Marfan syndrome is important so that cardiovascular complications be prevented. Echocardiography is essential to rule out cardiovascular involvement in those suspected of having Marfan syndrome. The significant cost of large population screening should not put a limit to the effort of clarifying the cardiovascular pathology responsible for sudden cardiac death in young athletes.
Key words: Marfan syndrome, athlete, aneurysm, sudden death.






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