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- Börjesson, Erik, et al.
(författare)
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Symptoms and ECG changes precede sudden cardiac death in hypertrophic cardiomyopathy-A nationwide study among the young in Sweden.
- 2022
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
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Tidskriftsartikel (refereegranskat)abstract
- Hypertrophic cardiomyopathy (HCM) is a major cause of sudden cardiac death (SCD) in the young. We aimed to characterize detailed family history, symptoms, hospital utilization and ECG changes before SCD.We extracted all cases suffering SCD with HCM from the SUDDY cohort, which includes all cases of SCD between 2000-2010 in Sweden among individuals aged 0-35 years along with their controls. We gathered data from mandatory national registries, autopsy reports, medical records, ECGs (including military conscripts), and detailed family history from an interview-based questionnaire (with relatives, post-mortem).Thirty-eight cases (7 female), mean age 22 years, with HCM were identified. Among these, 71% presented with possible cardiac symptoms (chest pain [26%], syncope [22%], palpitations [37%]), before death; 69% received medical care (vs 21% in controls) within 180 days before death. The majority (68%) died during recreational activity (n = 14) or exercise/competitive sports (n = 12). Fifteen (39%) had a known cardiac disorder prior to death, with HCM being diagnosed pre-mortem in nine cases. 58% presented with abnormal ECG recordings pre-mortem, and 50% had a positive family history (1st-3rd generation) for heart disease.In this comprehensive, nationwide study of SCD due to HCM, 87% (33/38) of cases had one or more abnormality prior to death, including cardiac symptoms, a positive family history, known cardiac disease or ECG abnormalities. They sought medical care prior death, to a larger extent than controls. These findings suggest that cardiac screening should be expanded beyond competitive athletes to aid SCD prevention in the young population with HCM.
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| 2. |
- Börjesson, Mats, 1965, et al.
(författare)
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Hjärtstopp bland unga och idrottare särskiljer sig
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112:14-15
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Dödsfall till följd av hjärtstopp av kardiella orsaker, sk plötslig hjärtdöd, hos unga och inom idrotten skiljer sig på flera sätt från plötslig hjärtdöd i högre åldrar. Drabbade kan sakna symtom, men de har vanligen en bakomliggande, ofta okänd, hjärtsjukdom. Flera olika hjärtsjukdomar har visats kunna ligga bakom plötsligt hjärtstopp bland unga och inom idrotten. Vanligen är de ärftliga och svårdiagnostiserade. Idrottande unga löper större risk att drabbas av plötsligt hjärtstopp än icke-idrottande. Screening av tävlingsidrottare rekommenderas internationellt, i Sverige också av Socialstyrelsen och Riksidrottsförbundet, för riskgrupper som elitidrottare från 16 års ålder. Vid hjärtstopp är tidig insats avgörande för utfallet. Det är därför viktigt att adekvat beredskap och kompetens finns på plats vid idrottsevenemang.
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| 3. |
- Börjesson, Mats, et al.
(författare)
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Hjärtstopp bland unga och idrottare särskiljer sig
- 2015
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 112:14-15
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Tidskriftsartikel (refereegranskat)abstract
- Vi diskuterar i denna artikel hjärtstopp av kardiella orsaker, s k plötslig hjärtdöd, hos unga och inom idrotten. Sådana dödsfall röner alltid stor uppmärksamhet, såväl inom den närmaste kretsen som i medier. Detta är naturligt, eftersom det drabbar en ung individ och/eller en idrottare, som i samhället är en symbol för »friskhet«. På flera sätt skiljer sig dessa dödsfall från plötslig hjärtdöd i högre åldrar. Drabbade är vanligen till synes helt friska personer, dödsfallen är sällsynt förekommande och de orsakas av ett flertal olika hjärtsjukdomar, oftast ärftliga och svårdiagnostiserade.
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| 4. |
- Stattin, Eva-Lena, et al.
(författare)
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Cohort profile : the Swedish study of SUDden cardiac Death in the Young (SUDDY) 2000-2010
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The rationale behind the SUDden cardiac Death in the Young (SUDDY) cohort was to provide a complete nationwide, high-quality platform with integrated multisource data, for clinical and genetic research on sudden cardiac death (SCD) in the young, with the ultimate goal to predict and prevent SCD.PARTICIPANTS: The cohort contains all SCD victims <36 years, in Sweden during the period 2000-2010. We assigned five population-based controls per case, together with parents of cases and controls, in total 15 633 individuals. Data of all individuals were extracted from multiple mandatory registries; the National Patient Registry, the Medical Birth Registry, the Prescribed Drug registry, the Cause of Death registry, the Multigeneration Registry, combined with socioeconomic data from Statistics Sweden. From SCD victims, the autopsy report, medical records, ECGs, parental information and biological samples were gathered.FINDINGS TO DATE: We identified 903 individuals diagnosed with SCD (67% men, 33% women). The cases comprised 236 infants <1 year of age (26%), 90 individuals aged 1-15 years (10%), 186 individuals aged 15-25 years (21%) and 391 aged 25-35 years (43%). Hospitalisations and outpatient clinic visits due to syncope were significantly more common among cases than controls. DNA obtained from dried blood spots tests (DBS) stored from birth was equally suitable as venous blood samples for high-throughput genetic analysis of SCD cases.FUTURE PLANS: We will explore the SUDDY cohort for symptoms and healthcare consumption, socioeconomic variables and family history of SCD. Furthermore, we will perform whole exome sequencing analysis on DNA of cases obtained from DBS or postmortem samples together with parental blood samples in search for gene variants associated with cardiac disease. The genetic analysis together with data compiled in the nationwide cohort is expected to improve current knowledge on the incidence, aetiology, clinical characteristics and family history of SCD.
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| 6. |
- Wisten, Aase, et al.
(författare)
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Exercise related sudden cardiac death (SCD) in the young — Pre-mortal characterization of a Swedish nationwide cohort, showing a decline in SCD among athletes
- 2019
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 144, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To study the frequency, etiology, and premortal abnormalities in exercise-related sudden cardiac death (SCD) in the young in Sweden. Methods: All subjects with SCD in 10–35-year olds in Sweden during 2000–10, were included (n = 514). Information about each case was retrieved from death certifications, autopsy- and medical records. The number of SCD in athletes was compared to national figures from 1992-99. Results: Exercise-related SCD occurred in 12% (62/514) of the SCD-population, a majority being men (56/62; 90%). Cardiopulmonary resuscitation (CPR) was started in 87% (54/62). In total, 48% (30/62), had a cardiac diagnosis, symptoms, family history and/or ECG-changes, before the fatal event. The most prevalent autopsy diagnosis was sudden arrhythmic death syndrome (15/62; 24%). The frequency of hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC) was significantly higher in exercise-related SCD compared to non-exertional SCD. Exercise-related SCD was more common in athletes (21/29) than in non-athletes (41/485) (P < 0.0001). The total number of SCDs/year in athletes 15–35 years old, are approximately halved in 2000-10 compared to the years 1992–99. Conclusion: The increased risk of exercise-related SCD in HCM and ARVC underlines the importance of early detection and eligibility recommendations. There is a major reduction in deaths among athletes in the 2000s, compared to the previous decade. These results may partly be explained by improved acute preparedness for sudden cardiac arrest (CPR, defibrillation), but as a substantial percentage have preceding risk factors, such as symptoms and ECG-abnormalities, increased cardiac screening and increased general awareness, may also play a role.
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