gms | German Medical Science

Objective: Isolated ventricular septal defect (VSD) have a number of anatomic malformations, and each has a distinctive natural history and decision-making issue. Studies have showed that there are five types of VSD’s (Perimembranous, Inlet, Apical Muscular, Mid Muscular and Outlet). From the other hand sudden cardiac death remains a common mode of death in adult congenital heart diseases (ACHD) and so high mortality rate can reflect VSD’s who didn’t underwent surgical closure.

Material/Methods: At the present study we report the case of a 20-year-old athlete who died suddenly while sleeping. Because his was an active, healthy and symptom free football player without known family history an autopsy has been performed in order to investigate the cause of death.

Results: The autopsy showed significant degree of left and right ventricular hypertrophy (1,8cm left and 0,9cm right) with a total heart weight of 473gr and also an atrioventricular septal defect of maximum diameter 1,1cm. It also showed emphysema and mild lung edema. The histopathological examination of the heart and lungs verified the hypertrophy and the emphysema. No other significant autopsy and histopathological findings were found, such as heart attack, intramural coronary arteries (myocardial bridging) or other congenital malformations. The toxicological analysis have shown no traces of alcohol or of drugs of abuse.

Conclusion: Risk factors for death in adult patients with VSD’s are clearly related to the size of the defect and the absence or presence of pulmonary artery hypertension that can lead to malignant arrhythmias and sudden death.