Sudden cardiac deaths during exercise in school (1986-1995)

In order to elucidate factors associated with sudden cardiac death during exercise in school from 1986 to 1995, the frequency and characteristics of death were investigated. The authors collected data from the booklet "Deaths and injuries under school supervision" published by the National Stadium and School Health Center of Japan. There were 480 cases of sudden cardiac death during exercise from 1986 to 1995, and boys accounted for 74% of these cases. In more recent years, the incidence per one hundred thousand persons has decreased in elementary and senior high schools; whereas it has increased in junior high school. Regarding activity at the time of occurrence, 251 cases (52%) occurred during physical education; 144 cases (30%) during sports club training; and 85 cases (18%) during school events. Incidence during sports club training in elementary school was significantly lower than that in junior and senior high school. Regarding past history, in most case, there was no past history of heart disease. Regarding types of exercise, incidence while running was highest (48%). Among "running" cases, most occurred during training. Regarding past history, the incidence of cases showing a past history was high for light intensity running, and the incidence of cases without a past history was high during running that involved upper light intensity running. Regarding the stages of running, incidence was markedly higher in the first half of the running period among cases showing a past history, and during training and for light exertion, while the incidence was high in the latter half of the running period among cases without a past history, and also high during timed races and for upper light exertion. Among causes of death, acute heart failure was the most frequent cause. As a result, more attention should be paid to circumstances related to a high incidence of death and the necessity of teaching health care and the prevention of sudden death at school and at home.