[S1129]Sudden Death In Athletes

People die suddenly are mostly caused by heart conditions, though people can also die in their sleep from an asthmatic attack, a stroke, the rupture of an enlarged blood vessel or sleep apnea. Sleep apnea is a condition when one's breathing stops due to an obstruction in the airway. For a very small portion of these cases, the cause of death cannot be identified.

While unexplained sudden death of apparently healthy young men in their sleep is rare in the West, it is more common in South-East Asian countries and Japan. These men are called ?lai tai? in Thailand, ?bangungut? in Philippines and ?pokkuri? in Japan.

Back in late 1980s and early 1990s, doctors cannot find out the cause of these deaths. They postulated various causes of death, such as heart rhythms going awry in some unspecified way, and they identified these as cases of Brugada syndrome, a mysterious condition that kills victims in their sleep because of spontaneous abnormal heart rhythms.

Nevertheless, it seemed that most of these populations were quite inaccurate.

The cause, as confirmed by different groups of experts in various countries, has now been identified as mutations in 7 particular genes, which are specific segments of our DNA code. As such, Brugada syndrome is now regarded as an inheritable heart condition.

These mutations affect ?ion channels? that are found in the living membrane that covers the heart muscle cell. These channels are protein complexes structured like tubes running through the thickness of a cell membrane. Their function is to permit or restrict the movement in and out of the heart cells of positively charged atoms, or ions, of potassium and sodium.

Through the movement of ions in and out of cells, a voltage difference is generated between the inside and outside of the cell. The voltage difference then gives rise to electric signals in the membrane that go around the heart, causing the organ to beat rhythmically.

These electrical signals stimulate the heart chambers to contract regularly and continuously in the correct order, pumping blood throughout the body.

If this electric activity is disrupted, the heart may fail to be effective as a pump, and one could suffer a blackout, notice palpitations and even die if his or her heart stops beating and pumping. This is what happens in Brugada syndrome.

This condition can be summarized as a case which sees abnormal channels letting potassium ions in too slowly or sodium ions too quickly. However, potassium channel problems are associated with sudden death that is usually caused by exercise or if the person is startled or awoken suddenly. Sodium channel problems are more likely to be associated with death while one is asleep.

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