Abstract

To evaluate the mechanism of sudden death in childhood and the physical activity levels at the onset of sudden death, we studied the following items: (1) the incidence and the circumstances surrounding sudden death at school in Kanagawa Prefecture, (2) high risk heart diseases detected among healthy school children by heart disease screening, (3) sudden cardiac death or near miss seen in outpatients with heart disease except congential heart disease. Among total 15,156,346 school children, sudden death was observed in 97 subjects (M:77, F:20). Annual incidence of sudden death was 6.4 per mill. Of the 97 subjects, acute heart failure of unknown etiology was found in 60 (62), cardiovascular disease in 18 (19), cerebral vascular accidents in 14 (14) and heat stroke in 5 (5). Of the 78 subjects (M:64, F:14) considered as sudden cardiac death, 62 (79) died during sports activities, and 16 (21) died at rest. Of the 62 subjects, 29 died during track and field activities and 7 while swimming, both in physical education classes. Eighteen died during athletic club activities and 8 during extracurricular activities. Consequently, 54 subjects (87) died in the presence of a school teacher. Of the 18 subjects with cardiovascular disease, 9 (hyperthrophic cardiomyopathy in 3, myocarditis in 3, Kawasaki disease in 2 and long QT in one) were diagnosed initially by the autopsy study. Latent high risk heart diseases are: hypertrophic cardiomyopathy, long QT syndrome, Kawasaki disease and some arrhythmias. Verf.-Referat (gekuerzt)