LAUSR

Sudden cardiac death (SCD) in the young and the athletes is a devastating event. It occurs unexpectedly in apparently healthy people, often during maximal, vigorous cardiac performance. In 1980 we observed a series of cases and perceived that an investigation covering all the victims in the Veneto Region of Italy might help to clarify the puzzle. Since then, in the time interval 1980–2013 we studied 650 consecutive sudden death (SD) cases in the young and athletes.1,2 Collaboration with pathologists and forensic doctors was crucial. The aim was clear: to assess the epidemiology of the phenomenon and to identify the ‘killer’ diseases – in particular, to identify morbid conditions which could be genetically transmissible, ie hereditary. Is this catastrophe predictable because written in our DNA? Is it possible to identify subjects at risk? The method of investigation was autopsy with gross, histologic and, latterly, molecular investigation, together with clinical correlations. Since in Italy eligibility for sport activity requires ECG, the review of ECG records played a fundamental role by detecting even subtle abnormalities which could be of help to improve sensitivity and specificity of in vivo diagnosis and disqualify the subjects from strenuous sport activity. As far as definition of SD, we adopted the old definition of Morgagni ‘…and here with the name of sudden death we mean the death that, expected or unexpected, kills the man abruptly.’3