Elsevier

Human Pathology

Volume 14, Issue 8, August 1983, Pages 704-709
Human Pathology

Cardiac conduction system abnormalities as a possible cause of sudden death in young athletes

https://doi.org/10.1016/S0046-8177(83)80143-9Get rights and content

Histologic examination of serial sections of the conduction system of the hearts of three young persons who died suddenly white engaged in active sports was performed. In no case were electrocardiogram tracings available. One patient, an 11-year-old girl, had micro-Ebstein's anomaly of the tricuspid valve associated with a septoseptal Kent fascicle through a wide gap of the central fibrous annulus and upper Mahaim fibers. Another patient, a 24-year-old football player, had a focal, 75 per cent obstructing atherosclerotic plaque in the proximal descending coronary artery, with scattered band necrosis and patchy myocardial fibrosis; upper and lower Mahaim fibers joined the atrioventricular node and the left bundle branch with the crest of the interventricular septum. The third patient, a 26-year-old cycling champion, had a conspicuous atrial fascicle of ordinary and transitional myocardium bypassing the atrioventricular node to anastomose with the His bundle (James accessory atrioventricular pathway). These findings indicate that atrioventricular conduction system abnormalities may play a fatal arrhythmogenic role in sudden death and raise questions regarding the prevention of electrical instability in young people engaged in active sports.

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    *

    Department of Pathology, University of Padua

    Laboratory of Histopathology, Milan, Italy.

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