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Sudden death and sickle cell trait: medicolegal considerations and implications.

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      Abstract

      Sickle cell trait, which affects approximately 8% of American blacks, is generally felt to be a benign condition. Exercise-related collapse in persons with sickle cell trait is a rare but serious complication. It occurs most often in military recruits and deconditioned athletes undergoing intense physical training, but can also occur in other situations in which an individual exerts himself beyond his limits of endurance. Local hypoxia causes intravascular sickling, in turn causing vascular occlusion and organ and tissue damage. This can result in rhabdomyolysis, myocardial ischemia, arrhythmias and sudden death. Risk factors include poor physical conditioning, inadequate hydration, excess heat and/or altitude, heat-retaining clothing and febrile illness. Seven cases are presented, and the implications of the diagnosis of sickle trait-associated collapse and sudden death are discussed.

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      Author and article information

      Affiliations
      [1 ] Los Angeles Department of Coroner, University of Southern California, USA.
      Journal
      Am J Forensic Med Pathol
      The American journal of forensic medicine and pathology
      Ovid Technologies (Wolters Kluwer Health)
      1533-404X
      0195-7910
      Jun 2009
      : 30
      : 2
      19465821
      10.1097/PAF.0b013e318187dfcd
      00000433-200906000-00023

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