摘要：Cases of sudden cardiac death (SCD) in young athletes during physical exercises are rare. According to the data of prospective population study performed in Veneto (Italy), incidence of SCD is 2.3 cases per year (2.6 among men and 1.1 among women) per 100,000 athletes aged 12 to 35 years for all reasons. Out of them 2.1 cases of SCD were caused by cardiovascular diseases. Coronary artery disease is the most frequent cause of SCD in athletes aged over 35 years. Also there are a number of other pathologies manifested by SCD: hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopaphy/right ventricular dysplasia, congenital abnormalities of coronary arteries, commotio cordis, myocarditis, spontaneous rupture or dissection of ascending aorta, Wolff–Parkinson–White syndrome, Brugada syndrome, catecholaminergic ventricular tachycardia. It is known that in the USA HCM is the main cause of sudden cardiac arrest which accounts for a third of all deaths of athletes during competition. It is also thought that the cause of sudden cardiac arrest in athletes with HCM is the ventricular arrhythmias, in majority of cases caused by dysplastic changes in myocardium. In young athletes suddenly dying from arrhythmogenic cardiomyopathy/right ventricular dysplasia right ventricular dilation and massive fibrous fatty changes of muscles are revealed, significantly increasing the risk of development of life-threatening ventricular arrhythmias. Coronary artery, abnormally originated from aorta, creates the sharp angle with aortic wall. It is thought that fatal myocardium ischemia is caused by aortic root expansion due to physical exercises that constricts the damaged vessel, narrowing its lumen. SCD due to nonpenetrating commotio thoracis in the absence of structural damage to ribs, sternum and heart is known as commotio cordis accompanied by the reflex heart arrest. When detecting one of the above mentioned cardiovascular pathologies one should be guided by recommendations of 36th Bethesda conference regarding the future participation of an athlete in competitions or his/her withdrawal from them. Sports organizations, athletes, coaches, educational institutions and doctors should cooperate and aid each other in organization, development and taking measures for detecting cardiovascular diseases and prevention of SCD in athletes.
