About a third of sudden cardiac deaths affect young and apparently healthy people, whose hearts are structurally intact and free of visible anomalies. A worrying phenomenon that has pushed the University Hospital of Padua, for decades a national reference center for the study and prevention of these dramatic events, to focus on the most hidden causes of these deaths.

In the laboratory of Professor Cristina Basso, director of the UOC of Cardiovascular Pathology and coordinator of the Regional Center for Sudden Juvenile Death, over a thousand cases of sudden deaths in subjects under 40 have been analyzed since the 1990s. These are hearts which, despite appearing normal on tests, hid electrical alterations or genetic defects not detectable with classical methods. Among the hypotheses under study: disturbances in the heart’s electrical conduction network and problems with ion channels.

Thanks to advances in investigation techniques, in particular cardiac magnetic resonance imaging, it is now possible to identify previously invisible myocardial scars, linked to previous inflammation or hereditary mutations.

Professor Domenico Corrado, director of the Cardiology Clinic and pioneer of sports screening, underlines how simple but targeted tests – such as an electrocardiogram with exercise test and echocardiogram – are fundamental for detecting risk signals, such as arrhythmias under stress. The incidence of sudden death among athletes is estimated at 4 cases per 100 thousand, but thanks to systematic checks in Veneto, mortality among young people between 12 and 35 years old has been reduced by 90%.

Despite progress, survival from cardiac arrest remains less than 10%. Hence the proposal for a national research project that would allow advanced tests such as cardiac resonance to be offered to all athletes, even non-professionals. The objective is ambitious but clear: to prevent even that 10% of cases that are still elusive today and to save lives that seemed safe.