Abstract

On 6th of June 1997 Ferenc N., 17 years old boxer died suddenly during running training. In the preclinical history WPW' syndrome was verified, the immediate cause of death was malignant arrhythmia and cardiac arrest according to the autopsy report. Endocardial fibrosis, ectasia ventriculi sinistri cordis med. gravis and acute tracheobronchitis were denoted as concomitant diseases. The athlete was signed on as boxer from 1995, in that time he was free of complaints. The arrhythmia was revealed in June 1996 by the sports physician and the boxer was sent for further examinations to the regional cardiologic center. The specialist's examination verified mitral prolapse, insufficiency valv. bicusp gr. II, incomplete WPW's syndrome, ventricular extrasystolia and perfusion disorder of the coronary vessels. Regular medication by Concor tablets was suggested and the practice of competitive sports was contraindicated. On 6th of September 1996 during a check inspection the athlete collapsed and was admitted to Hospital, where the above diagnoses were reaffirmed by further cardiological examinations. Because of the suspected anomaly of the coronaries the boxer was sent for further invasive examinations to the local hemodynamic laboratory. In November 1996 after the check up the anomaly of the coronary vessels was excluded, the final diagnosis was mitral prolapse min. gr. and WPW's syndrome. The practice of competitive sport was thus allowed on condition that echocardiography and ECG stress-test should be done every day. Consequently the boxer continued the training activity and one year after the observation of the arrhythmia he suddenly died during a running training. Because of the contradictory medical reports it should have been practical to send the boxer for final diagnosis to the Cardiology of the National Institute for Sports Medicine. In the future it should be indispensable to develop a guideline considering the relatively frequent arrhythmias and mitral prolaps as well. Verf.-Referat