Sudden Death and Physical Activity

Abstract
The circumstances surrounding 2,606 sudden deaths were studied by reviewing the death certificates and autopsy reports to establish correlations with the type and intensity of physical activity preceding death. 73% of the deaths were caused by acute or chronic ischemic heart disease. Physical activity was more commonly associated with death in men than in women and in subjects under 50 years of age than in older people. Instantaneous cardiac death was observed only with coexisting activity. There was no relationship between the intensity of the effort and the number of cardiac deaths. Sudden deaths in connection with sporting activities were rare. There were, however, 67 nonaccidental deaths during or following sauna bath. In the second part of the study, 10 sudden deaths are described in connection with day-long ski hikes. Strenuous physical exercise seems to have played an important role in these cases. However, most of the subjects had serious cardiovascular risk factors which were known in advance or could have been identified by medical examination. In conclusion, daily physical activities or sports cannot be incriminated as an important contributory factor in sudden death in the general population. However, there is a risk of cardiac complications in connection with strenuous physical exercise in subjects with manifest or latent cardiac disease.