Exercise-induced intraventricular pressure gradient may be the cause of sudden cardiac death in patients with unknown cardiac disease

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses Pub Date : 2025-02-01 DOI:10.1016/j.mehy.2024.111552

Nuno Cotrim , Hugo Café , Pedro Cordeiro , Jorge Guardado , Luís Baquero , Carlos Cotrim

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Abstract

Sudden cardiac death (SCD) is a tragedy at any age and under any circumstances, but it is especially poignant, and fortunately very rare, when it takes the life of an athlete, a person who represents health and a healthy lifestyle. Sports cardiologists worldwide have worked to quantify the incidence of SCD in athletes, identify risk factors, develop pre-participation screening tools, and formulate plans to address on-field SCD. While progress has been made, there is still much to do to make both competitive and recreational sports safer for individuals with known cardiac disease and athletes without known or suspected cardiac abnormalities.

We recently published the case of an athlete who practices triathlon and underwent medical evaluation after an episode of aborted sudden death. The complete diagnostic workup including a complete genetic study for myocardiopathy had normal results. An exercise stress echocardiogram (ESE) was finally performed during which he developed a significant intraventricular pressure gradient (IVPG) − a possible cause of ischemia − over 100 mmHg with an end-systolic peak at the end of exercise that was associated with frequent premature ventricular complexes.

We hypothesize the possible role of ESE for IVPG assessment in athletes who have unexplained symptoms related to exercise or aborted sudden death. In our opinion, it should be considered useful and used by routine to improve the clinical approach of this group of patients, detecting possible high-risk athletes.

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来源期刊

Medical hypotheses 医学-医学：研究与实验

CiteScore

10.60

自引率

2.10%

发文量

167

审稿时长

60 days

期刊介绍： Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.