ABSTRACT
It is reported that sport is a multidisciplinary field with multi-dimensional interactions and scientific researches in terms of education, physiology, economy, pharmacology, sociology, psychology, philosophy, medicine, politics, law, communication and technological contents. Sudden death due to sports is defined by the World Health Organization as deaths occurring during or after sports activity, the signs of death appearing within half a minute to six hours and death occuring within 24 hours without any external factor. Athletes’ deaths during matches or training have been encountered with increasing frequency in recent years. Therefore, sudden deaths caused by sports or exercise are met with concern in the society. Most athlete deaths are caused by the cardiovascular system. The most common causes are known as hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, and congenital coronary artery anomalies. However, coronary artery disease deaths are more common among athletes over the age of 35. Recently, with the Coronavirus disease-2019 (COVID-19) pandemic, deaths occurring during sports have also gained different dimensions. In this study, it was aimed to discuss the most common causes of deaths during sports activities, including the COVID-19 pandemic, and what should be done in terms of postmortem forensic medicine.
Keywords: Sport, athlete, death, COVID-19, forensic medicine.
References
1
Felsefe nedir ne değildir? https://www.felsefe.gen.tr/spor-felsefesi-nedir-ne-demektir/ Erişim tarihi 12.08.2022
2
Akarsu, B. Kişi Kavramı ve İnsan Olma Sorunu, İnkılâp Kitabevi, Ankara. 1998, 171.
3
Peters MA. “Critical Philosophy of Sport”, Educational Philosophy and Theory, United Kingdom, 2020;52(8):806.
4
Erdemli, A. İnsan, Spor ve Olimpizm (Spor Felsefesi Yazıları), Sarmal Yayınevi, İstanbul. 1996, 58.
5
Sporcu. https://tr.wikipedia.org/wiki/Sporcu Erişim tarihi 22.08.2022
6
Sermet Koç, Muhammet Can, Ölüm Kavramı ve Ölü Muayenesi. Birinci Basamakta Adli Tıp Kitabı. Editörler Sermet Koç, Muhammet Can. İstanbul Tabip Odası Yayınları. 2. Baskı; 2011, 18-37.
7
Tabib A, Miras A, Taniere P, Loire R. Undetected cardiac lesions cause unexpected sudden cardiac death during occasional sport activity. A report of 80 cases. Eur Heart J. 1999;20(12):900-903. https://doi.org/10.1053/euhj.1998.1403
8
Quigley F. A survey of the causes of sudden death in sport in the Republic of Ireland. Br J Sports Med. 2000;34(4):258-261. https://doi.org/10.1136/bjsm.34.4.258.
9
Suarez-Mier MP, Aguilera B. Causas de muerte su´ bita asociada al deporte en Espan˜a, Rev. Esp. Cardiol. 2002;55:347-358. https://doi.org/10.1016/S0300-8932(02)76614-1
10
Fornes P, Lecomte D. Pathology of sudden death during recreational sports activity: an autopsy study of 31 cases. Am J Forensic Med Pathol. 2003;24(1):9-16. https://doi.org/10.1097/01.PAF.0000052749.51187.AA
11
Turk EE, Riedel A, Püeschel K. Natural and traumatic sports-related fatalities: a 10-year retrospective study. Br J Sports Med. 2008;42(7):604-608; discussion 608. https://doi.org/10.1136/bjsm.2007.038505
12
Solberg EE, Gjertsen F, Haugstad E, Kolsrud L. Sudden death in sports among young adults in Norway. Eur J Cardiovasc Prev Rehabil. 2010;17(3):337-341. https://doi.org/10.1097/HJR.0b013e328332f8f7
13
Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42(11):1959-1963. https://doi.org/10.1016/j.jacc.2003.03.002
14
Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006;296(13):1593-1601. https://doi.org/10.1001/jama.296.13.1593
15
Bille K, Figueiras D, Schamasch P, Kappenberger L, Brenner JI, Meijboom FJ, Meijboom EJ. Sudden cardiac death in athletes: the Lausanne Recommendations. Eur J Cardiovasc Prev Rehabil. 2006;13(6):859-875. https://doi.org/10.1097/01.hjr.0000238397.50341.4a
16
Maron BJ, Haas TS, Doerer JJ, Thompson PD, Hodges JS. Comparison of U.S. and Italian experiences with sudden cardiac deaths in young competitive athletes and implications for preparticipation screening strategies. Am J Cardiol. 2009;104(2):276-280. https://doi.org/10.1016/j.amjcard.2009.03.037
17
Holst AG, Winkel BG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL, et al. Incidence and etiology of sports-related sudden cardiac death in Denmark--implications for preparticipation screening. Heart Rhythm. 2010;7(10):1365-1371. https://doi.org/10.1016/j.hrthm.2010.05.021
18
Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation. 2011;123(15):1594-1600. https://doi.org/10.1161/CIRCULATIONAHA.110.004622
19
Ragosta M, Crabtree J, Sturner WQ, Thompson PD. Death during recreational exercise in the State of Rhode Island. Med Sci Sports Exerc. 1984;16(4):339-342.
20
Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H, et al. Sports-related sudden death in the general population. Circulation. 2011;124(6):672-681. https://doi.org/10.1161/CIRCULATIONAHA.110.008979
21
Chevalier L, Hajjar M, Douard H, Cherief A, Dindard JM, Sedze F, et al. Sports-related acute cardiovascular events in a general population: a French prospective study. Eur J Cardiovasc Prev Rehabil. 2009;16(3):365-370. https://doi.org/10.1097/HJR.0b013e3283291417
22
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009;119(8):1085-1092. https://doi.org/10.1161/CIRCULATIONAHA.108.804617
23
Burke AP, Farb A, Virmani R, Goodin J, Smialek JE. Sports-related and non-sports-related sudden cardiac death in young adults. Am Heart J. 1991;121(2 Pt 1):568-575. https://doi.org/10.1016/0002-8703(91)90727-y
24
Virmani R, Burke AP, Farb A, Kark JA. Causes of sudden death in young and middle-aged competitive athletes. Cardiol Clin. 1997;15(3):439-466. https://doi.org/10.1016/s0733-8651(05)70351-9
25
Yanai O, Phillips ED, Hiss J. Sudden cardiac death during sport and recreational activities in Israel. J Clin Forensic Med. 2000;7(2):88-91. https://doi.org/10.1054/jcfm.2000.0374
26
https://dergipark.org.tr/tr/download/article-file/25427 Erişim tarihi 22.08.2022
27
Harmon KG, Asif IM, Maleszewski JJ, Owens DS, Prutkin JM, Salerno JC, et al. Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation. 2015;132(1):10-19. https://doi.org/10.1161/CIRCULATIONAHA.115.015431
28
Compagnucci P, Volpato G, Falanga U, Cipolletta L, Conti MA, Grifoni G, Ciliberti G, Stronati G, Fogante M, Bergonti M, Sommariva E, Guerra F, Giovagnoni A, Dello Russo A, Casella M. Myocardial Inflammation, Sports Practice, and Sudden Cardiac Death: 2021 Update. Medicina (Kaunas). 2021;57(3):277. https://doi.org/10.3390/medicina57030277
29
Clark DE, Parikh A, Dendy JM, Diamond AB, George-Durrett K, Fish FA, Slaughter JC, Fitch W, Hughes SG, Soslow JH. COVID-19 Myocardial Pathology Evaluation in Athletes With Cardiac Magnetic Resonance (COMPETE CMR). Circulation. 2021;143(6):609-612. https://doi.org.10.1161/CIRCULATIONAHA.120.052573. Epub 2020 Dec 17. Erratum in: Circulation. 2021;143(6):e238
30
Morentin B, Suárez-Mier MP, Monzó A, Ballesteros J, Molina P, Lucena J. Sports-related sudden cardiac death in Spain. A multicenter, population-based, forensic study of 288 cases. Rev Esp Cardiol (Engl Ed). 2021;74(3):225-232. English, Spanish. https://doi.org/10.1016/j.rec.2020.05.044
31
Egger F, Scharhag J, Kästner A, Dvořák J, Bohm P, Meyer T. FIFA Sudden Death Registry (FIFA-SDR): a prospective, observational study of sudden death in worldwide football from 2014 to 2018. Br J Sports Med. 2022;56(2):80-87. https://doi.org/10.1136/bjsports-2020-102368
32
Germann CA, Perron AD. Sudden cardiac death in athletes: a guide for emergency physicians. Am J Emerg Med. 2005;23(4):504-509. https://doi.org/10.1016/j.ajem.2004.09.036
33
https://www.trthaber.com/haber/spor/spor-dunyasindaki-sira-disi-olumler-456916. Erişim Tarihi 28.08.2022
34
Lanof JN, Freire FR, Calado Gonçalves VT, Lacerda JR, Coelho F, Veitzman S, et al. Sport-related concussions. Dement Neuropsychol. 2014;8(1):14-19.
35
Winkler EA, Yue JK, Burke JF, Chan AK, Dhall SS, Berger MS, et al. Adult sports-related traumatic brain injury in United States trauma centers. Neurosurg Focus. 2016;40(4):E4. https://doi.org/10.3171/2016.1.FOCUS15613
36
Parent S, Fortier K. Comprehensive overviw of the problem of violence against athletes in sport. Journal of Sport Social Issues. 2018;42(4):227-246.
37
Schmidt Ralph E, Schneeberger Andres R, Clussen MC. Interpersonal violence against athletes. What we know, what we need to know, and what we should do. Sports Psychiatry, 2022;1-7.
38
World Anti-Doping Code International Standard Prohibited List (https://www.wada-ama.org/sites/default/files/2022-01/2022list_final_en_0.pdf Son Erişim Tarihi: 28.08.2002)
39
Lehmann S, Thomas A, Bochat-Schiwy KH, Geyer H, Thevis M, Glenewinkel F, et al. Death after of anabolic substances (clenbutol, stanozolol and metandienone). Forensic Sci Int. 2019;303;1-7. https//doi.org/10.1016/j.forsciint.2019.109925.
40
Sanghera AS, Singh N, Popkave A. Running Marathons with Blocked Coronary Arteries and Runners' Risk of Sudden Cardiac Death-Case Report and Review. Curr Sports Med Rep. 2020;19(3):107-109. https://doi.org/10.1249/JSR.0000000000000694
41
Williams Gemma P, Sharma S. The ffects of endurance exercise on the heart: panacea of poison? Nat Rev Cardiol. 2020;17(7);402-417. https://doi.org/10.1038/s41569-020-0354-3
42
Lee DC, Pate RR, Lavie CJ, Sui X, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64(5):472-481. https://doi.org/10.1016/j.jacc.2014.04.058. Erratum in: J Am Coll Cardiol. 2014;64(14):1537.
43
Quattrone RD, Eichner ER, Beutler A, Adams WB, O'Connor FG. Exercise collapse associated with sickle cell trait (ECAST): case report and literature review. Curr Sports Med Rep. 2015;14(2):110-116. https://doi.org/10.1249/JSR.0000000000000137
44
Cina SJ. Sports-related fatalities. In: Froede CR (Editor). Handbook of Forensic Pathology. 2st Edition, U.S.A: College of American Pathologists. 2003:265-274.
45
Denton JS, Fusaro AJ, Donoghue ER. Deaths due to Heat and Cold Exposure. In: Froede CR (Editor). Handbook of Forensic Pathology. 2st Edition, Northfield, U.S.A: College of American Pathologists, 2003:225-230.
46
Suárez-Mier MP, Aguilera B, Mosquera RM, Sánchez-de-León MS. Pathology of sudden death during recreational sports in Spain. Forensic Sci Int. 2013;226(1-3):188-196. https://doi.org/10.1016/j.forsciint.2013.01.016
47
https://www.trtspor.com.tr/haber/diger-sporlar/uzakdogu-sporlari/turk-tekvandocu-hayatini-kaybetti-64958.html Erişim Tarihi: 22.08.2022
48
https://www.hurriyet.com.tr/emrah-kandemirin-cocuklarina-tff-sahip-cikacak-27886735 Erişim tarihi 22.08.2022
49
Mutlu Öner, Turgut KAPLAN, Alpaslan İNCE, Hüseyin ÜNLÜ. Okullarda Sportif Aktivitelerde Ortaya Çıkan Ani Ölümler. Milli Eğitim; Bahar; 2008:178;247-257.
50
https://sporhekimleridernegi.org/sporda-ani-olum Erişim Tarihi: 22.08.2022
51
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet.
52
Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and Cardiovascular Disease. Circulation. 2020;141(20):1648-1655. https://doi.org/10.1161/CIRCULATIONAHA.120.046941
53
Huang L, Zhao P, Tang D, Zhu T, Han R, Zhan C, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. JACC Cardiovasc Imaging. 2020;13(11):2330-2339. https://doi.org/10.1016/j.jcmg.2020.05.004.
54
Gleeson S-UT. Former Florida State basketball center Michael Ojo died on Friday from a heart attack he suffered during practice overseas, the university’s athletic department confirmed [Internet]; 2020 [cited 2021 Jan 11]. Available from: https://eu.usatoday.com/story/sports/ncaab/2020/08/07/mic Erişim tarihi 22.08.2022
55
Daniels Curt J, Rajpal Saurabh, Greenshields Joel T, Rosenthal GL, Chung EH, Terrin M, Jeudy J, et al., Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection. JAMA Cardiol. 2021;6(9):1078-1087.
56
Bingöl H, Bingöl Ş, Öner İ. COVID-19’un E-Spor Sektörü Üzerindeki Etkisi. Journal of ROL Sport Sciences. 2021;2(1);119-131.
57
Akçan R, Hilal A. Spor Aktivitelerinde Ani Ölüm. Arşiv Kaynak Tarama Dergisi, 2007;16(1):16-34.
58
Saukko P, Knight B. Knight’s Forensic Pathology, The pathology of sudden death. Third Edition. Arnold Publishing, London, 2004:492-509.
