Life-threatening and major cardiac events during long-distance races: updates from the prospective RACE PARIS registry with a systematic review and meta-analysis

2020 ◽  
pp. 204748732094300
Author(s):  
Benoît Gerardin ◽  
Paul Guedeney ◽  
Anne Bellemain-Appaix ◽  
Thomas Levasseur ◽  
Hazrije Mustafic ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Heat Stroke ◽  
Sudden Cardiac Arrest ◽  
Cardiac Events ◽  
Long Distance ◽  
Exertional Heat Stroke ◽  
Life Threatening ◽  
Long Distance Race

Aims Limited data exist regarding the incidence and aetiology of life-threatening events such as major cardiac events or exertional heat stroke during long-distance races. We aimed to provide an updated incidence, etiology and prognosis of life-threatening events during long-distance races. Methods The prospective RACE PARIS registry recorded all life-threatening events/fatal events occurring during 46 marathons, half-marathons and other long-distance races in the Paris area between 2006 and 2016, comprising 1,073,722 runners. Event characteristics were determined by review of medical records and interviews with survivors. Results The incidence of life-threatening events, exertional heat stroke and major cardiac events was 3.35 per 100,000, 1.02 per 100,000 and 2.33 per 100,000, respectively, including 18 sudden cardiac arrests (1.67 per 100,000). The main aetiology of sudden cardiac arrest was myocardial ischaemia (11/18), due to acute coronary thrombosis (6/11), stable atherosclerotic coronary artery disease (2/11), coronary dissection (1/11), anomalous connection (1/11) or myocardial bridging (1/11). A third of participants with ischaemia-related major cardiac events presented with pre-race clinical symptoms. Major cardiac events were more frequent in the case of a high pollution index (6.78 per 100,000 vs. 2.07 per 100,000, odds ratio 3.27, 95% confidence interval 1.12–9.54). Case fatality was low (0.19 per 100,000). Similarly, we report in a meta-analysis of eight long-distance race registries comprising 16,223,866 runners a low incidence of long-distance race-related sudden cardiac arrest (0.82 per 100,000) and fatality (0.39 per 100,000). Death following sudden cardiac arrest was strongly associated with initial asystole or pulseless rhythm. Conclusion Long-distance race-related life-threatening events remain rare although serious events. Better information for runners on the risk of pre-race clinical symptoms, outside air pollution and temperature may reduce their incidence.

scholarly journals A Case of Exertional Heat Stroke Complicated by Hypoxic Hepatitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bertram K. Woitok ◽  
Shawki Bahmad ◽  
Gregor Lindner
Keyword(s):  
Supportive Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Multiorgan Failure ◽  
Heat Stroke ◽  
Exertional Heat Stroke ◽  
Hypoxic Hepatitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Delayed Referral

Background.Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10  km run in 28°C outside temperature who developed acute liver failure. Case Presentation. Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care. Conclusions. Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.

scholarly journals Sudden Cardiac Arrest in Long Distance Races

2015 ◽  
Vol 65 (4) ◽  
pp. 407-408 ◽  
Author(s):  
William J. Strimel ◽  
Martin J. O’Riordan
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Long Distance

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals Cardiac Arrest in the Airport Revealing Cocaine Body Packing: A Case Report

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Dabor Resiere ◽  
Hossein Mehdaoui ◽  
Bruno Megarbane
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Flight Attendants ◽  
Emergency Physicians ◽  
Body Packing ◽  
Charles De Gaulle ◽  
Cross Border ◽  
Cardiac Symptoms ◽  
Life Threatening ◽  
De Gaulle

Ingestion of large amounts of cocaine packages is a well-known method for cross-border transportation. Intestinal obstruction and life-threatening sympathomimetic toxidrome including seizures, ventricular dysrhythmia, and cardiac arrest resulting from the rupture of cocaine packages may occur. Here, we report a case of a 34-year-old pregnant woman who had a sudden cardiac arrest while waiting for her bags at Paris-Charles de Gaulle Airport, France. According to the flight attendants, the patient travelled from Brazil and complained of abdominal pain during the flight. After resuscitation, the patient presented sustained tachycardia and convulsions suggesting cocaine overdose caused by body packing. Once admitted to the hospital, laparotomy was performed allowing the extraction of 50 cocaine packages. Cardiac symptoms were attributed to the rupture of five of the packages. Prehospital and emergency physicians need to be aware of the possibility of cocaine overdose by body packing in patients presenting sudden cardiac arrest in airports.

Biocompatible implantable antimicrobial release for necrotizing external otitis

1991 ◽  
Vol 105 (4) ◽  
pp. 252-256
Author(s):  
E. J. Ostfeld ◽  
A. Kupferberg
Keyword(s):  
Cardiac Arrest ◽  
Clinical Symptoms ◽  
Sudden Cardiac Arrest ◽  
The Other ◽  
External Otitis ◽  
Therapeutic Modality ◽  
Antibiotic Administration ◽  
Post Implantation ◽  
Necrotizing External Otitis

AbstractThe efficacy of a biocompatible, surgically implantable, antimicrobial release system (IARS) as the exclusive antimicrobial therapy of necrotizing external otitis (NEO) was evaluated in six NEO patients. Gentamicin incorporated polymethyl-methacrylate beads were implanted, following surgical debridement and were removed two months later. Post-implantation alleviation of clinical symptoms: pain, periauricular tissue swelling, otorrhoea, eradication of pseudomonal infection (100 per cent) and substantially shortened hospitalization (4–15 days) were the salient results of this therapeutic modality. Three patients recovered. Two patients who died, one of sudden cardiac arrest and the other of paralytic ileus, 15 and 60 days postoperatively while the beads were still implanted, were symptomless. Recurrence was seen in one patient with early bead extrusion. Ipsilateral sensorineural hearing loss (one patient) and external meatal stenosis were the main complications. IARS appears to offer an effective alternative to long-term systemic antibiotic administration for the eradication of NEO-pseudomonal infection in patients who are sensitive, develop resistance, or when quinolone medical treatment has failed or is contra-indicated.

scholarly journals Incidence of sudden cardiac arrest and death in young athletes and military members: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Aaron Lear ◽  
Niraj Patel ◽  
Chanda Mullen ◽  
Marian Simonson ◽  
Vince Leone ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Incidence Rate ◽  
Meta Analysis ◽  
National Level ◽  
Sudden Cardiac Arrest ◽  
Rare Event ◽  
Risk Of Bias ◽  
Low Risk ◽  
Military Members

Abstract Objectives: The goals of this review are to evaluate the quality of the evidence on the incidence of sudden cardiac arrest and death (SCA/D) in athletes and military members; and to estimate annual incidence of SCA/D. Data Sources: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19–7/29/19. Study Selection: Studies which reported incidence of SCA/D or both in athletes, or military members under age 40 were eligible for inclusion. 40 studies were identified for inclusion Data Extraction: Risk of bias was assessed using a validated, customized tool for prevalence studies in all included studies. 12 were found to be low ROB, with the remaining 28 moderate or high ROB. Data was extracted for narrative review, and meta-analysis. Data Synthesis: Random-effects meta-analysis was performed in studies judged to be low risk of bias in two separate categories: 5 studies on regional or national level data including athletes at all levels, and both sexes included 130 events of SCD, with a total of 11,272,560 athlete years showing a cumulative incidence rate of 0.98 [95%CI: 0.62, 1.53] per 100,000 athlete years, with high heterogeneity with I2 of 78%; 3 Studies on competitive athletes aged 14 to 25 were combined, and included 183 events, and 17,798758 athlete years showing an incidence rate of 1.91[95%CI: 0.71; 5.14] per 100,000 athlete years with high heterogeneity with I2 of 97%. The remaining low risk of bias studies were in military members, and were not synthesized. Conclusion: The worldwide incidence of SCD is a rare event. Low risk of bias studies indicate incidence to be below 2 per 100,000 athlete years. Overall, the quality of the evidence available is low, but there are high quality individual studies to inform the question of incidence levels. PROSPERO Registration: CRD42019125560

scholarly journals Successful Treatment of a Patient with Cardiac Arrest Due to Hyperkalemia by Prolonged Cardiopulmonary Resuscitation along with Hemodialysis: A Case Report and Review of the Literature

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 810
Author(s):  
Nuri Kose ◽  
Ferruh Bilgin
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Conventional Treatment ◽  
Femoral Vein ◽  
Sudden Cardiac Arrest ◽  
Review Of The Literature ◽  
Life Threatening ◽  
Severe Hyperkalemia ◽  
The Right ◽  
Cardiac Emergency

Severe hyperkalemia is a potentially life threatening cardiac emergency, especially in patients with renal failure, and can lead to fatal arrhythmias such as ventricular fibrillation or asystole, leading to cardiac arrest. We report a case of a 39-year-old woman who developed sudden cardiac arrest secondary to hyperkalemia (9.95 mEq/L) with renal insufficiency. Despite 20 min of cardiopulmonary resuscitation (CPR) and conventional treatment for hyperkalemia, the cardiac arrest persisted. Hemodialysis was then initiated via the right femoral vein during CPR, and the patient restored spontaneous heartbeat 40 min later. Hemodialysis should be considered in the course of CPR in severe hyperkalemia induced cardiac arrest if conventional therapies fail.

School Nurses on the Front Lines of Healthcare: Emergencies Associated With Sport and Physical Activities (Part 2): Sudden Cardiac Arrest, Hypovolemic Shock, and Spinal Cord Injury

2021 ◽  
pp. 1942602X2110460
Author(s):  
Thomas P. Swaffield ◽  
Robert P. Olympia
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Hypovolemic Shock ◽  
The United States ◽  
Physical Activities ◽  
Cord Injury ◽  
Life Threatening

Sport participation is an important part of the development, both physically and mentally, of children and adolescents in the United States. Illness and injury associated with sport and physical activities may occur in the school setting. Although most sport-related illness and injury in students are considered minor emergencies, life-threatening illnesses or injuries may occur. It is important for the school nurse to recognize potential life-threatening emergencies associated with sport and physical activity, to initiate stabilization of the student with life-threatening symptoms, and to triage these students to an appropriate level of care (back to the classroom, home with their guardian with follow up at their primary healthcare provider’s office, or directly to the closest emergency department via Emergency Medical Services). This article specifically describes the initial assessment and management of three potentially life-threatening conditions associated with sport and physical activity, namely sudden cardiac arrest, hypovolemic shock, and spinal cord injury.

Abstract 347: Sudden Cardiac Arrest Caused by Coronary Artery Disease in School Students

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Mamoru Ayusawa ◽  
Masataka Kato ◽  
Akiko Komori ◽  
Yuriko Abe ◽  
Rie Ichikawa
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Arrest ◽  
Coronary Artery ◽  
Junior High ◽  
Sudden Cardiac Arrest ◽  
Intensity Level ◽  
Mutual Aid ◽  
School Students ◽  
Long Distance ◽  
Artery Disease

Background: To disclose coronary artery disease (CAD) in the young is difficult by electrocardiogram screening for school students before their first events. Methods: By reviewing all reports submitted to the Mutual Aid System for Schools between 1989 and 2015, we listed all cases of sudden cardiac arrest which were considered to be caused by CAD. Kawasaki disease sequela was excluded. Epidemiology, type of CAD, symptom before onset, the intensity of the exercise at onset were investigated. Results: Thirty cases were enrolled and 26 resulted in sudden deaths, 4 were resuscitated without unfavorable sequelae. Cardioverter-defibrillator were implanted in 2 cases. Twenty-eight were male. One student was in 6th grader of primary, 11 in junior high, 15 cases in high, and 3 cases in nursing schools. Before onset, 12 cases were diagnosed as normal by ECG screening, 1 case for each was diagnosed as premature ventricular contraction, Wolff-Parkinson-White syndrome, and past history of atrial flutter. Diagnosis of 15 cases was unknown. Types based on hospital or post-mortem records: Left coronary artery (LCA); LCA of two cases were originated from the pulmonary artery, 4 cases from right coronary cuspid (RCC), and 1 from an unknown site. Two cases with LCA malformation without detail description, 3 with left ostium stenosis, and 1 with a myocardial bridge. Right coronary artery (RCA); RCA of a student was from left coronary cuspid (LCC), 1 from unknown site, 4 cases were diagnosed as hypoplastic RCA. Three cases complicated with atherosclerotic stenosis, 2 with hypoplastic CA, a case with single CA, and 4 with vasospastic angina.The school grader at onset: All of 4 cases with LCA from RCC, 2/3 with the LCA ostium stenosis and 3/4 with RCA hypoplasia were junior high school cases. Exercise intensity (level 1 to 5: most strenuous): At the onset, 19 cases were at level 5, 7 at level 4, 1 at level 3, 3 at an unknown level. Exercise at onset; soccer in 6 cases, basketball in 5, long distance running in 4, swimming, baseball, tennis, rugby, kendo, and on the way to school were in 2 for each. Conclusion: Anomalous ostium and origin of CA from the opposite side cusp tend to cause cardiac arrest in younger cases. CA evaluation by CT angiogram, MRI, or myocardial perfusion imaging is desirable.

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