Background:
No specific data are available on the prevalence and characteristics of cardiac sudden death (SCD) during sport activities among young women.
Methods and Results:
From a prospective 30-year target project on SCD in the young, involving 695 subjects 1-40 years old who died suddenly in the same geographic areas, 649 were due to SCD (196 female, 30%). A total of 76 young adults were competitive athletes and died during or soon after effort (11%). Only 6 (8%) of such events occurred in women (mean age 23±10 yrs, range 12-38), specifically during jogging (2), and swimming, volley, gymnastic and triathlon (one each). Cause of death seemed more likely to be associated with structurally normal heart in women compared with men (50% versus 7%; P<0.01). In particular, while inherited cardiomyopathies (i.e. arrhythmogenic, hypertrophic and dilated) and coronary atherosclerosis are the leading cause in the overall population of athletes (24/76, 32% and 11/76, 14.5% respectively) and in the male sub-group (24/70, 34% and 11/70, 16%, respectively), they were never observed in female athletes.
Conclusions:
Sports-related SCD in women is dramatically less common compared with men. In the female athletic population, SCD occurs in the setting of a structurally normal heart in half of cases. In a country with obligatory pre-participation screening for sport activity, inherited cardiomyopathies and atherosclerotic coronary artery diseases are almost exclusive of the male athletic population.