Sudden Death Following Exercise Testing Related to Abnormalities of the Cardiac Conduction System and Coronary Artery Pathology

Abstract

A case of sudden death following exercise testing in a 33-year-old man is reported. The forensic autopsy showed atherosclerotic stenosis of the left coronary artery, as well as some changes in the cardiac conduction system, including anomalies of the atrioventricular node and moderate fibrosis and fatty infiltration of the branching bundle. This case demonstrates that cardiac arrest during vigorous exercise may be multifactorial and that abnormalities of the cardiac conduction system may have played some role in the fatal issue.

What is Sudden Cardiac Death?

“…Aside from the myocardium, the SA and AV node and bundle of His are the major components of the conduction system of the heart. Ischemia (nodal artery dysplasia) or myocardial lesions (e.g., sarcoidosis) may interfere with the signal transmission (26,(65)(66)(67)(68)(69). By-pass tracts also may cause re-entrant arrhythmias.…”