What are the causes of sudden death during exercise?

Sudden cardiac death during exercise generally refers to the occurrence of symptoms during or immediately after physical activity, followed by non-traumatic death within six hours. It is primarily caused by severe heart diseases such as coronary heart disease, angina pectoris, and hypertrophic cardiomyopathy. Individuals with these conditions should avoid strenuous exercise.

1. Coronary Heart Disease: Coronary heart disease results from atherosclerosis of the coronary arteries, leading to myocardial ischemia, hypoxia, and even necrosis. This often causes discomfort such as chest pain, palpitations, and shortness of breath. During exercise, the condition may worsen, increasing the risk of structural damage to the heart and resulting in sudden cardiac death. If an acute episode occurs, physical activity should be stopped immediately and rest initiated. If symptoms persist, fast-acting nitrate medications—such as nitroglycerin tablets or isosorbide dinitrate tablets—may be taken under medical guidance for relief.

2. Angina Pectoris: Angina is a clinical syndrome caused by a temporary imbalance between myocardial oxygen supply and demand, resulting in myocardial ischemia. It commonly occurs during exertion or exercise. Mild episodes may present as chest pain or tightness; if left untreated, it can progress to heart failure, acute myocardial infarction, or sudden cardiac death. During acute attacks, medications such as nitroglycerin tablets or isosorbide dinitrate tablets can be taken as directed by a physician. In some cases, timely interventional procedures or coronary artery bypass surgery may be required. Strenuous exercise should be avoided.

3. Hypertrophic Cardiomyopathy: This is a type of heart disease characterized by asymmetric thickening of the ventricular walls, often due to genetic mutations in sarcomere protein-coding genes. Symptoms include shortness of breath, chest pain, and palpitations. Exercise may exacerbate the condition and even trigger sudden death. Under medical supervision, beta-blockers such as metoprolol tartrate tablets or propranolol hydrochloride tablets may be used to manage symptoms. In severe cases, surgical interventions such as septal myectomy or heart transplantation may be necessary. Patients should avoid intense physical activity.

In addition, severe aortic stenosis, acute myocardial infarction, and similar conditions may lead to sudden death during exercise if not promptly treated. It is important to seek timely medical evaluation and treatment.