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A 20-Year Review

Maj Matthew Phillips, MC; Max Robinowitz, MD; Maj James R. Higgins, MC; Maj Kevin J. Boran, MC; Capt Thomas Reed, MC; Maj Renu Virmani, MC

JAMA. 1986;256(19):2696-2699.

Abstract
We reviewed the clinical and autopsy records of the 19 sudden cardiac deaths that occurred among the 1 606 167 US Air Force healthy, medically screened recruits (90% male; 17 to 28 years old) during a 42-day basic training period between 1965 and 1985. Sixteen (all male) died suddenly of underlying structural heart disease, whereas no anatomic cause of death was identified in the remaining three. Thirty-two nonsudden, noncardiac deaths occurred during the same period, and only two had structural heart disease. Strenuous physical exertion was associated with sudden death in 17 of 19 cases (0.017 deaths per 50 000 exercise-hours), and the most frequent underlying etiology was myocarditis. Sudden cardiac death, a rare event in healthy young adults, is usually associated with exertion.

(JAMA 1986;256:2696-2699)

Author Affiliations
USAF; USAF; USAF; USAF; USAR

From the Department of Cardiology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Tex (Drs Phillips, Higgins, Boran, and Reed); and the Department of Carciovascular Pathology, Armed Forces Institute of Pathology, Washington, DC (Drs Robinowitz and Virmani).

Footnotes
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Departments of the Air Force and Army, or the Department of Defense.

Reprint requests to Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 (Dr Virmani).

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