[Acute myocardial infarct during sports practice: a preventive approach based on 40 cases with a non-fatal outcome in a military environment].

A retrospective study of 40 non-lethal myocardial infarctions occurring during physical exercise (average age 38 years) compared with 100 controls (average age 41 years) showed that the coronary artery disease which was identical after 40 years of age, differed in the youngest age subgroups. Juvenile exercise-induced infarction (N = 20) was characterised by a high incidence of normal coronary vessels (N = 8 compared with 6 in 39 controls of comparable age). The cardiovascular risk factors were qualitatively and quantitatively the same with a high incidence of smoking (85 to 95 p. 100) in the juvenile groups, especially with normal coronary arteries. Premonitory chest pain was sporadic and atypical before the age of 40 but was typical and recurrent in half of the older men, though generally unrecognised. Analysis of the circumstances surrounding infarction showed that in 90 p. 100 of cases (and in all juvenile cases) there were several factors in common related to the conditions under which the exercise was performed: external conditions (particularly the weather) or individual conditions (fatigue, dietary error, etc.) which probably played a contributory role. These observations suggest that a preventive strategy may be possible based on an anti-smoking campaign, on the identification of high risk subjects and on the adoption of adequate conditions of surveillance and performance of physical training.