Skip to main content
SpringerLink
Log in

Plötzlicher natürlicher Tod beim Sport

Häufigkeit im Obduktionsgut in den Jahren 1972–2007

Sudden unexpected death associated with sports

Frequency in autopsies between 1972 and 2007

  • Leitthema
  • Published:
Rechtsmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Der plötzliche natürliche Tod beim Sport stellt häufig ein dramatisches Ereignis dar und kann eine aufwendige straf- und zivilrechtliche Klärung nach sich ziehen.

Material und Methoden

Zirka 33.000 Sektionen aus den Jahren 1972–2007 des Zentrums der Rechtsmedizin der Universität Frankfurt/Main wurden teils prospektiv, teils retrospektiv auf plötzliche natürliche Todesfälle beim Sport untersucht und ein Vergleich dieser Fälle mit einer Kontrollgruppe durchgeführt.

Ergebnisse

Von 120 Betroffenen (0,36% der Obduktionen) waren 114 männlich (95,0%, Alter zwischen 6 und 83 Jahren, Durchschnittsalter: 53,0 Jahre) und 6 weiblich (5,0%, Alter zwischen 15 und 59 Jahren, Durchschnittsalter: 38,2 Jahre). Die Altersklassen von 50–59 Jahren (31 Fälle) und von 60–69 Jahren (25 Fälle) waren am häufigsten betroffen. Bei älteren Sportlern ab 36 Jahren überwogen deutlich kardiovaskuläre Todesursachen (91 Fälle; 90,1%), bei jüngeren Athleten waren todesursächliche kardiovaskuläre und entzündliche Herzerkrankungen gleich häufig (n=5; 26,3%).

Schlussfolgerung

Plötzliche natürliche Todesfälle beim Sport sind seltene, aber dramatische Ereignisse. Neben der Obduktion sollten auch histologische, mikrobiologische und chemisch-toxikologische Untersuchungen durchgeführt werden.

Abstract

Background

Sudden, unexpected death during sports is often dramatic and may be relevant to criminal and civil law.

Methods

Approximately 33,000 autopsies carried out at the Centre of Legal Medicine at the University of Frankfurt/Main from 1972 to 2007 were analyzed concerning sudden unexpected deaths connected with sports and the results were compared with a control group.

Results

Among 120 fatalities connected with sports (0.36% of all autopsies) there were 114 men (95.0%, average age 53.0 years, range 6 to 83 years) and 6 women (5.0%, average age 38.2 years, range 15 to 59 years). The age groups between 50 and 59 years (31 cases) and between 60 and 69 years (25 cases) were the most affected. In older athletes over 35 years of age cardiovascular diseases were the most frequent cause of death (91 cases; 90.1%). In younger athletes fatal cardiovascular diseases were more seldom, but as frequent as inflammatory cardiac diseases (n=5; 26.3%)

Conclusions

Sudden unexpected death associated with sports is seldom but dramatic. In addition to the autopsy, histological, microbiological and toxicological testing should also be carried out.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Aretz HT (1987) Myocarditis: the Dallas criteria. Hum Pathol 18: 619–624

    Article  PubMed  CAS  Google Scholar 

  2. Aretz HT, Billingham ME, Edwards WD et al. (1987) Myocarditis. A histopathologic definition and classification. Am J Cardiovasc Pathol 1: 3–4

    PubMed  CAS  Google Scholar 

  3. Baron DA, Martin DM, Abol Magd S (2007) Doping in sports and its spread to at-risk populations: an international review. World Psychiatry 6: 54–59

    Google Scholar 

  4. Bux R, Herzog C (2004) Vergleich der radiologischen und histologischen Beurteilung von Zusammensetzung und Stabilität atherosklerotischer Plaques in Aorten von hereditär hyperlipidämischen Watanabe-Hasen. Rechtsmedizin 14: 326

    Google Scholar 

  5. Bux R, Parzeller M, Raschka C, Bratzke H (2004) Early symptoms and causes of sudden death related to sports activities. Dtsch Med Wochenschr 129: 997–1001

    Article  PubMed  CAS  Google Scholar 

  6. Chimenti C, Pieroni M, Frustaci A (2006) Myocarditis: when to suspect and how to diagnose it in athletes. J Cardiovasc Med 7: 301–306

    Google Scholar 

  7. Ciampricotti R, el-Gamal M, Relik T et al. (1990) Clinical characteristics and coronary angiographic findings of patients with unstable angina, acute myocardial infarction, and survivors of sudden ischemic death occurring during and after sport. Am Heart J 120: 1267–1278

    Article  PubMed  CAS  Google Scholar 

  8. Corrado D, Basso C, Schiavon M, Thiene G (2006) Does sports activity enhance the risk of sudden cardiac death? J Cardiovasc Med 7: 228–233

    Google Scholar 

  9. Corrado D, Basso C, Schiavon M, Thiene G (1998) Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med 339: 364–369

    Article  PubMed  CAS  Google Scholar 

  10. Corrado D, Thiene G, Nava A et al. (1990) Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases. Am J Med 89: 588–596

    Article  PubMed  CAS  Google Scholar 

  11. Fineschi V, Riezzo I, Centini F et al. (2007) Sudden cardiac death during anabolic steroid abuse: morphologic and toxicologic findings in two fatal cases of bodybuilders. Int J Legal Med 121: 48–53

    Article  PubMed  Google Scholar 

  12. Fornes P, Lecomte D (2001) Sudden death and physical activity and sports. Rev Prat 51: S31–S35

    PubMed  CAS  Google Scholar 

  13. Hipp AA, Heitkamp HC, Rocker K, Dickhuth HH (2004) Hypertrophic cardiomyopathy – sports-related aspects of diagnosis, therapy, and sports eligibility. Int J Sports Med 25: 20–26

    Article  PubMed  CAS  Google Scholar 

  14. Hollmann W, Hettinger T (1990) Sportmedizin: Arbeits- und Trainingsgrundlagen. Schattauer, Stuttgart New York

  15. Kierzkowska B, Stanczyk J, Kasprzak JD (2005) Myocardial infarction in a 17-year-old body builder using clenbuterol. Circ J 69: 1144–1146

    Article  PubMed  Google Scholar 

  16. Laure P, Binsinger C (2007) Doping prevalence among preadolescent athletes: a 4-year follow-up. Br J Sports Med 41: 660–663

    Article  PubMed  CAS  Google Scholar 

  17. Maisch B, Portig I, Ristic A et al. (2000) Definition of inflammatory cardiomyopathy (myocarditis): on the way to consensus. A status report. Herz 25: 200–209

    Article  PubMed  CAS  Google Scholar 

  18. Maron BJ (2005) Distinguishing hypertrophic cardiomyopathy from athlete’s heart: a clinical problem of increasing magnitude and significance. Heart 91: 1380–1382

    Article  PubMed  CAS  Google Scholar 

  19. Maron BJ (2004) Hypertrophic cardiomyopathy: an important global disease. Am J Med 116: 63–65

    Article  PubMed  Google Scholar 

  20. Maron BJ (2002) The young competitive athlete with cardiovascular abnormalities: causes of sudden death, detection by preparticipation screening, and standards for disqualification. Card Electrophysiol Rev 6: 100–103

    Article  PubMed  Google Scholar 

  21. Maron BJ, Olivotto I, Maron MS (2006) The dilemma of left ventricular outflow tract obstruction and sudden death in hypertrophic cardiomyopathy: do patients with gradients really deserve prophylactic defibrillators? Eur Heart J 27: 1895–1897

    Article  PubMed  Google Scholar 

  22. Maron BJ, Pelliccia A (2006) The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation 114: 1633–1644

    Article  PubMed  Google Scholar 

  23. Maron BJ, Shirani J, Poliac LC et al. (1996) Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 276: 199–204

    Article  PubMed  CAS  Google Scholar 

  24. Mund M, Hailemariam S, Cathomas G (2002) Die arrhythmogene rechtsventrikuläre Kardiomyopathie als Ursache des plötzlichen Herztodes. Rechtsmedizin 12: 371–374

    Article  Google Scholar 

  25. Northcote RJ, Flannigan C, Ballantyne D (1986) Sudden death and vigorous exercise – a study of 60 deaths associated with squash. Br Heart J 55: 198–203

    Article  PubMed  CAS  Google Scholar 

  26. Quigley F (2000) A survey of the causes of sudden death in sport in the Republic of Ireland. Br J Sports Med 34: 258–261

    Article  PubMed  CAS  Google Scholar 

  27. Schanzer W, Thevis M (2007) Doping in sport. Med Klin 102: 631–646

    Article  CAS  Google Scholar 

  28. Shanes JG, Ghali J, Billingham ME et al. (1987) Interobserver variability in the pathologic interpretation of endomyocardial biopsy results. Circulation 75: 401–405

    PubMed  CAS  Google Scholar 

  29. Simon P, Striegel H, Aust F et al. (2006) Doping in fitness sports: estimated number of unreported cases and individual probability of doping. Addiction 101:1640–1644

    Article  PubMed  Google Scholar 

  30. Suarez-Mier MP, Aguilera B (2002) Causes of sudden death during sports activities in Spain. Rev Esp Cardiol 55: 347–358

    PubMed  Google Scholar 

  31. Tabib A, Miras A, Taniere P, Loire R (1999) Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity. A report of 80 cases. Eur Heart J 20: 900–903

    Article  PubMed  CAS  Google Scholar 

  32. Tanasescu M, Leitzmann MF, Rimm EB et al. (2002) Exercise type and intensity in relation to coronary heart disease in men. JAMA 288: 1994–2000

    Article  PubMed  Google Scholar 

  33. Weiner HR (1999) Preventing sudden death in student athletes. Compr Ther 25: 151–154

    Article  PubMed  CAS  Google Scholar 

  34. Young MC, Fricker PA, Thomson NJ, Lee KA (1999) Sudden death due to ischaemic heart disease in young aboriginal sportsmen in the Northern Territory, 1982–1996. Med J Aust 170: 425–428

    PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Institut für Forensische Medizin, Universitätsklinikum, Johann Wolfgang Goethe-Universität, Kennedyallee 104, 60596, Frankfurt a.M., Deutschland

    R. Bux, B. Zedler, P. Schmidt & M. Parzeller

Authors
  1. R. Bux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Zedler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Parzeller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Bux.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bux, R., Zedler, B., Schmidt, P. et al. Plötzlicher natürlicher Tod beim Sport. Rechtsmedizin 18, 155–160 (2008). https://doi.org/10.1007/s00194-008-0519-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00194-008-0519-6

Schlüsselwörter

Keywords

Search

Navigation