Just One Collapse During Soccer

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Author(s) A.A.M. Wilde, T.A. Simmers
NHJ edition: 2004; 8, 355
These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.
The ECG can be enlarged twice by clicking on the image and it's first enlargement
Figure 1

A 14-year-old boy died suddenly while playing soccer. He was in the middle of a sprint when he suddenly succumbed. Resuscitation efforts were unsuccessful. His family assured us that he had had no previous symptoms and that his family history was unremarkable. His two-year older brother, however, remembered that he had also collapsed once while playing an exciting soccer match. This occurred at the age 10, after which he experienced no further events. His brother’s death worried him (and his family) and he visited a cardiologist for medical advice. Physical examination was unremarkable; his ECG is shown in figure 1. An echocardiogram was completely normal.

The question now is whether further evaluation is needed.