Resumen

VALERIO HERNANDEZ, Mayela; REYES GUZMAN, Alma  y  ESCOBAR YANES, Lempira. Estudio sobre muerte súbita en deportistas, 1985-1995. Med. leg. Costa Rica [online]. 1998, vol.15, n.1-2, pp.44-51. ISSN 2215-5287.

The relationship between the heart and its changes caused by exercise have been studied since 19th century, and since then various authors like Niemela, Kirsh and Linzbach have analized the death in this particular group of people and found in the mayority alterations of the heart, coronary arteries with an important atherosclerotic component. This gave birth to the Sportsman Heart Syndrome, wich is the physiologic adaptation of the cardiac muscle secondary to exercise, and it reflects in a global hipertrophy and bradicardial with normal arterial pressure. The sudden death on sportsmen is the one that occurs instantly during or a few minutes after doing exercise. Filipides was the first person to die after running a marathon in Athens in the year 490 B.C.. It was shown that sportsmen under 30 generally have a cardiovascular problem of congenital character  and in persons above 30 years old have a severe atherosclerotic component.  With this concepts in mind Doctors Valerio Hernández, Reyes Guzmán and Escobar Yanes, analized 10 years of autopsies between january 1985 and july 1995, they analized over 19.359 autopsies, in wich 33 of the cases were due to sudden death on sportsmen. In all the cases it was put aside the trauma and it was done a histology study of the tissues.  The year that presents more cases is 1994, and the mayority of them were from San José. Of  these 33 cases, 32 were men, just one woman, 31 were white, and 2 were black. The major age group was between 26 and 30 years old. The youngest of all was a 12-year-old and the eldest was a 62-year-old, to a average age of 29. The most commo sport was soccer, due mainly to our culture, followed by athletism, swimming, bike raiding, basketball and motocross. According to the cause of death, 26 cases were from a cardiac origin (72%), 5 from cerebral origin (15%), and 2 from vascular origin (6%). Confirming the literature facts about it, in the cases lower to 30 years old (11 cases), it was found a common death in decreasing order: ischemic cardiomyopathy, hypertrophic vasculopathy, myocarditis, Inter atrial communication, idiopathic cardiomyopathy, fibromuscular dysplasia, coronary arteries anomalies with associated thrombosis in  7 cases and 7 persons had a smoking and alcohol record. The coronary atheroclerosis was shown in 10 cases of severe character (IIIC-IIIB). In the cerebral origin cases it was shown a subarachnoid hemorrhage, brain hemorrhage, with only 2 cases of congenital aneurisms, one A-V malformation, and one of cerebral shock with emboli. Just one person had 38 years old and all the others were under 30. In the 2 cases wich the caused of death was a vascular disease, this was due to a  aneurism in the aorta and the other one was an A-V malformation of the mediatinal vessels. Their ages were 30 and 16 years old, and weren't using drugs. In some cases sudden death is not exactly the organic cause of the death and you must have in mind that arritmias are an important element speacially in children. This indicated the importance of a check-up specially of the heart before exercising.

Palabras clave : sport; adult; young; congenital cardiomiopathy; atherosclerosis; stroke.