{"id":420,"date":"2026-06-13T15:00:05","date_gmt":"2026-06-13T12:00:05","guid":{"rendered":"https:\/\/tatd.org.tr\/sportibbi\/?p=420"},"modified":"2026-06-13T18:32:10","modified_gmt":"2026-06-13T15:32:10","slug":"sporcularda-ani-kardiyak-olum-sahadaki-gorunmez-tehdit","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/sportibbi\/genel\/sporcularda-ani-kardiyak-olum-sahadaki-gorunmez-tehdit\/","title":{"rendered":"Sporcularda Ani Kardiyak \u00d6l\u00fcm: Sahadaki G\u00f6r\u00fcnmez Tehdit"},"content":{"rendered":"
\"\"<\/figure>\n\n\n

Yazar:<\/strong> Uzm. Dr. Hasan Pak\u0131r<\/p>\n\n\n\n

Edit\u00f6r:<\/strong> Dr. \u00d6\u011fr. \u00dcyesi \u00d6mer Yusuf Erdurmu\u015f<\/p>\n\n\n\n

Spor, sa\u011fl\u0131kl\u0131 ya\u015fam\u0131n temel ta\u015f\u0131 olarak kabul edilse de, nadir durumlarda trajik olaylara sahne olabilmektedir. Gen\u00e7 ve sa\u011fl\u0131kl\u0131 g\u00f6r\u00fcnen bir sporcunun antrenman veya m\u00fcsabaka s\u0131ras\u0131nda aniden yere y\u0131\u011f\u0131lmas\u0131, toplumda derin bir \u015fok etkisi yarat\u0131r. Sporda ani kardiyak \u00f6l\u00fcm (AK\u00d6), travma d\u0131\u015f\u0131 nedenlerle geli\u015fen, beklenmeyen kardiyak k\u00f6kenli \u00f6l\u00fcm olarak tan\u0131mlan\u0131r. G\u00fcn\u00fcm\u00fczde bir\u00e7ok \u00e7al\u0131\u015fmada \u00f6l\u00fcm yerine “ani kardiyak arrest” (AKA) kavram\u0131 tercih edilmektedir; \u00e7\u00fcnk\u00fc erken m\u00fcdahale ile baz\u0131 olgular hayatta kalabilmektedir.<\/p>\n\n\n\n

Epidemiyoloji ve G\u00f6r\u00fclme S\u0131kl\u0131\u011f\u0131<\/h2>\n\n\n\n

Sporcularda AK\u00d6 insidans\u0131, ara\u015ft\u0131rmadan ara\u015ft\u0131rmaya farkl\u0131l\u0131k g\u00f6sterse de genel olarak d\u00fc\u015f\u00fck kabul edilir. \u0130statistikler, her y\u0131l 100.000 sporcuda 1-5 aras\u0131nda vaka ya\u015fand\u0131\u011f\u0131n\u0131 g\u00f6stermektedir1<\/sup>. Erkek sporcularda riskin kad\u0131nlara oranla yakla\u015f\u0131k 9 kat daha fazla oldu\u011fu saptanm\u0131\u015ft\u0131r. Ayr\u0131ca siyahi sporcularda, \u00f6zellikle basketbol oyuncular\u0131nda riskin daha y\u00fcksek oldu\u011fu g\u00f6zlemlenmektedir.<\/p>\n\n\n\n

Bu vakalar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu rekabet\u00e7i sporlar s\u0131ras\u0131nda, kalbin elektriksel sistemindeki bozukluk nedeniyle meydana gelir. Kalbin pompalama i\u015flevini yitirdi\u011fi bu duruma genellikle VF (Ventrik\u00fcler Fibrilasyon) e\u015flik eder. Sporun kendisi, do\u011frudan bir \u00f6l\u00fcm nedeni de\u011fil, altta yatan gizli bir kalp hastal\u0131\u011f\u0131n\u0131 tetikleyen unsurdur. Egzersiz s\u0131ras\u0131nda artan adrenalin ve elektrolit de\u011fi\u015fimleri, var olan patolojiyi \u00f6l\u00fcmc\u00fcl bir ritim bozuklu\u011funa d\u00f6n\u00fc\u015ft\u00fcrebilir.<\/p>\n\n\n\n

Temel Nedenler: Ya\u015f Grup<\/strong>lar\u0131na G\u00f6re Farkl\u0131l\u0131klar<\/strong><\/h2>\n\n\n\n

Sporcularda ani \u00f6l\u00fcm nedenleri ya\u015fa ba\u011fl\u0131 olarak iki ana gruba ayr\u0131l\u0131r. 35 ya\u015f alt\u0131ndaki gen\u00e7 sporcularda nedenler genellikle genetiktir veya do\u011fu\u015ftan gelen yap\u0131sal anomalilere dayan\u0131r. Bu grupta en s\u0131k kar\u015f\u0131la\u015f\u0131lan neden\u00a0Hipertrofik Kardiyomiyopati (HKM)\u00a0olarak bilinen kalp kas\u0131 kal\u0131nla\u015fmas\u0131d\u0131r2<\/sup>. HKM, d\u00fcnya genelinde gen\u00e7 sporcu \u00f6l\u00fcmlerinin yakla\u015f\u0131k %30’undan sorumludur. Ancak g\u00fcncel literat\u00fcrde nedenlerin \u00fclkeler ve pop\u00fclasyonlar aras\u0131nda de\u011fi\u015fiklik g\u00f6sterebildi\u011fini ortaya koymaktad\u0131r. \u00d6zellikle otopsi negatif \u00f6l\u00fcmler, koroner anomaliler, miyokardit ve aritmojenik kardiyomyopati di\u011fer s\u0131k g\u00f6r\u00fclen nedenler aras\u0131ndad\u0131r.<\/p>\n\n\n\n

Di\u011fer \u00f6nemli nedenler aras\u0131nda koroner arter anomalileri ve Aritmojenik Sa\u011f Ventrik\u00fcl Kardiyomiyopatisi (ASVK) yer al\u0131r. \u0130yon kanal\u0131 hastal\u0131klar\u0131 (Ritim bozukluklar\u0131) da yap\u0131sal bir bozukluk olmasa bile kalbin durmas\u0131na yol a\u00e7abilir. 35 ya\u015f \u00fcst\u00fc “veteran” sporcularda ise durum tamamen de\u011fi\u015fir. Bu ya\u015f grubundaki AK\u00d6 vakalar\u0131n\u0131n %80’inden fazlas\u0131\u00a0Koroner Arter Hastal\u0131\u011f\u0131 (KAH)\u00a0nedeniyle ger\u00e7ekle\u015fmektedir3<\/sup>.<\/p>\n\n\n\n

Tan\u0131 ve Tarama Y\u00f6ntemleri<\/h2>\n\n\n\n

Sporcular\u0131n sahaya \u00e7\u0131kmadan \u00f6nce de\u011ferlendirilmesi, riskli bireylerin saptanmas\u0131 a\u00e7\u0131s\u0131ndan hayati \u00f6nem ta\u015f\u0131r. Avrupa Kardiyoloji Toplulu\u011fu (ESC), t\u00fcm sporcular i\u00e7in detayl\u0131 bir anamnez ve fizik muayene \u00f6nermektedir. Bunun yan\u0131nda 12 derivasyonlu\u00a0Elektrokardiyogram (EKG)\u00a0\u00e7ekilmesi, gizli ritim bozukluklar\u0131n\u0131n saptanmas\u0131nda kritik rol oynar. \u0130talya\u2019da yap\u0131lan bir \u00e7al\u0131\u015fmada EKG \u00e7ekilmesinin, sporcu \u00f6l\u00fcmlerini %90 oran\u0131nda azaltt\u0131\u011f\u0131n\u0131 ve \u00f6nceden tan\u0131 ile ani kardiyak \u00f6l\u00fcm\u00fcn \u00f6n\u00fcne ge\u00e7ildi\u011fini g\u00f6stermi\u015ftir4<\/sup>. \u0130talya’da ger\u00e7ekle\u015ftirilen geni\u015f kapsaml\u0131 bir tarama program\u0131nda ani kardiyak \u00f6l\u00fcm oranlar\u0131nda belirgin azalma g\u00f6sterilmi\u015f olsa da, EKG taramas\u0131n\u0131n t\u00fcm pop\u00fclasyonlarda ayn\u0131 fayday\u0131 sa\u011flay\u0131p sa\u011flamad\u0131\u011f\u0131 halen tart\u0131\u015f\u0131lmaktad\u0131r.<\/p>\n\n\n\n

Tarama s\u00fcrecinde sporcunun ailesinde erken ya\u015fta ani \u00f6l\u00fcm \u00f6yk\u00fcs\u00fc olup olmad\u0131\u011f\u0131 titizlikle sorgulanmal\u0131d\u0131r. G\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, egzersizle gelen bay\u0131lma (senkop) veya \u00e7arp\u0131nt\u0131 gibi belirtiler “k\u0131rm\u0131z\u0131 bayrak” olarak kabul edilir. E\u011fer EKG veya muayenede \u015f\u00fcpheli bir durum saptan\u0131rsa, daha ileri tetkikler olan Ekokardiyografi veya Kardiyak MR y\u00f6ntemlerine ba\u015fvurulur. Ancak her tarama testi %100 sonu\u00e7 vermez; baz\u0131 patolojiler maalesef ilk belirtisini AK\u00d6 ile verebilir.<\/p>\n\n\n\n

Commotio Cordis: Darbeye Ba\u011fl\u0131 Durmalar<\/h2>\n\n\n\n

Yap\u0131sal bir kalp hastal\u0131\u011f\u0131 olmayan sporcularda da ani \u00f6l\u00fcm g\u00f6r\u00fclebilir. Commotio Cordis<\/strong>, g\u00f6\u011f\u00fcs duvar\u0131na gelen sert ve k\u00fct bir darbe sonucu kalbin durmas\u0131 olay\u0131d\u0131r. Genellikle beyzbol, hokey veya karate gibi sporlarda, topun veya darbenin kalbin tam \u00fczerine isabet etmesiyle olu\u015fur. Darbenin, kalp d\u00f6ng\u00fcs\u00fcn\u00fcn (T dalgas\u0131n\u0131n ba\u015flang\u0131c\u0131) \u00e7ok dar bir zaman dilimine denk gelmesi gerekir5<\/sup>.<\/p>\n\n\n\n

Bu durum, kalbin normal ritmini bozarak ventrik\u00fcler fibrilasyona girmesine neden olur. Commotio cordis vakalar\u0131nda koruyucu ekipman kullan\u0131m\u0131 \u00f6nemli olsa da, tam koruma sa\u011flamayabilir. Bu nedenle, spor sahalar\u0131nda acil m\u00fcdahale ekipmanlar\u0131n\u0131n haz\u0131r bulunmas\u0131 tek kurtulu\u015f yoludur. Gen\u00e7 sporcular\u0131n g\u00f6\u011f\u00fcs duvar\u0131 daha esnek oldu\u011fu i\u00e7in bu riske kar\u015f\u0131 daha savunmas\u0131zd\u0131rlar.<\/p>\n\n\n\n

Sahada Acil M\u00fcdahale ve AED Kullan\u0131m\u0131<\/h2>\n\n\n\n

Erken defibrilasyon uygulanmayan ventrik\u00fcler fibrilasyon olgular\u0131nda hayatta kalma olas\u0131l\u0131\u011f\u0131 her ge\u00e7en dakika belirgin \u015fekilde azal\u0131r ve yakla\u015f\u0131k %7-10 oran\u0131nda d\u00fc\u015febilir. \u00a0Otomatik Eksternal Defibrilat\u00f6r (AED)<\/strong>\u00a0cihazlar\u0131n\u0131n \u00f6nemi bu noktada ortaya \u00e7\u0131kmaktad\u0131r. AED, kalbin ritmini analiz eden ve gerekliyse \u015fok veren, t\u0131p e\u011fitimi almam\u0131\u015f ki\u015filerin bile kullanabilece\u011fi bir cihazd\u0131r. Erken defibrilasyon, hayatta kalma oranlar\u0131n\u0131 %70’lerin \u00fczerine \u00e7\u0131karabilmektedir6<\/sup>.<\/p>\n\n\n\n

Spor tesislerinde acil eylem planlar\u0131n\u0131n (EAP) \u00f6nceden haz\u0131rlanm\u0131\u015f olmas\u0131 gerekir. Antren\u00f6rlerin, hakemlerin ve sporcular\u0131n temel ya\u015fam deste\u011fi (CPR) e\u011fitimi almas\u0131 hayati \u00f6nem ta\u015f\u0131r. Kalp durmas\u0131 ger\u00e7ekle\u015fti\u011finde “agonal solunum” denilen i\u00e7 \u00e7ekmeler, genellikle yanl\u0131\u015fl\u0131kla nefes al\u0131yor gibi alg\u0131lanabilir. Bu durum m\u00fcdahalede gecikmeye yol a\u00e7mamal\u0131; bilinci kapal\u0131 ve normal nefes almayan her sporcuya CPR ba\u015flanmal\u0131d\u0131r.<\/p>\n\n\n\n

Etik Tart\u0131\u015fmalar ve Spor Yasaklar\u0131<\/h2>\n\n\n\n

Riskli bir durum saptanan sporcuya sporu yasaklamak, t\u0131p d\u00fcnyas\u0131nda ciddi bir etik tart\u0131\u015fma konusudur. Bir yandan sporcunun hayat\u0131n\u0131 korumak, di\u011fer yandan kariyerini ve hayallerini sonland\u0131rmak aras\u0131nda ince bir \u00e7izgi vard\u0131r. Modern yakla\u015f\u0131m, art\u0131k her kalp hastal\u0131\u011f\u0131nda sporu tamamen yasaklamak yerine “ortak karar verme” modelini benimsemektedir. Bu modelde riskler sporcuya net \u015fekilde anlat\u0131l\u0131r ve belirli g\u00fcvenlik s\u0131n\u0131rlar\u0131 i\u00e7inde spora devam edip edemeyece\u011fi tart\u0131\u015f\u0131l\u0131r.<\/p>\n\n\n\n

\u00d6zellikle ICD (\u0130mplante Edilebilir Kardiyoverter Defibrilat\u00f6r) ta\u015f\u0131yan sporcular i\u00e7in eski kat\u0131 kurallar esnemeye ba\u015flam\u0131\u015ft\u0131r. Baz\u0131 \u00e7al\u0131\u015fmalar, d\u00fc\u015f\u00fck riskli hastalarda ICD ile profesyonel spora devam etmenin san\u0131ld\u0131\u011f\u0131 kadar tehlikeli olmayabilece\u011fini g\u00f6stermektedir. Ancak bu kararlar her vaka i\u00e7in bireysel olarak, uzman ekip taraf\u0131ndan verilmelidir. Genetik testlerin geli\u015fmesi, bu s\u00fcre\u00e7te daha isabetli risk analizi yap\u0131lmas\u0131n\u0131 sa\u011flamaktad\u0131r.<\/p>\n\n\n\n

Sonu\u00e7<\/strong><\/h2>\n\n\n\n

Sporcularda ani kardiyak \u00f6l\u00fcm, d\u00fc\u015f\u00fck olas\u0131l\u0131kl\u0131 ancak y\u00fcksek etkili bir olayd\u0131r. Bilimsel veriler, d\u00fczenli taramalar\u0131n ve sahalarda AED bulundurulmas\u0131n\u0131n hayat kurtard\u0131\u011f\u0131n\u0131 a\u00e7\u0131k\u00e7a ortaya koymaktad\u0131r. Spor camias\u0131, antren\u00f6rler ve aileler, egzersiz s\u0131ras\u0131nda olu\u015fan bay\u0131lmalar\u0131 asla “yorgunluk” olarak ge\u00e7i\u015ftirmemelidir. Unutulmamal\u0131d\u0131r ki; do\u011fru te\u015fhis ve h\u0131zl\u0131 m\u00fcdahale, sahadaki trajedileri birer ba\u015far\u0131 hikayesine d\u00f6n\u00fc\u015ft\u00fcrebilir.<\/p>\n\n\n\n

Acil T\u0131p Hekimleri i\u00e7in Mesaj<\/h2>\n\n\n\n

Egzersiz s\u0131ras\u0131nda geli\u015fen senkop, a\u00e7\u0131klanamayan g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, eforla ortaya \u00e7\u0131kan nefes darl\u0131\u011f\u0131 veya \u00e7arp\u0131nt\u0131 yak\u0131nmalar\u0131 olan sporcular ayr\u0131nt\u0131l\u0131 kardiyovask\u00fcler de\u011ferlendirmeye y\u00f6nlendirilmelidir. \u00d6zellikle egzersiz s\u0131ras\u0131nda geli\u015fen senkop, aksi ispat edilene kadar kardiyak k\u00f6kenli kabul edilmelidir.<\/p>\n\n\n\n

\n\n\n\n

Kaynak\u00e7a<\/h2>\n\n\n\n
\n

1.Maron, B. J., et al. (2015).<\/strong>\u00a0“Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities.”\u00a0Journal of the American College of Cardiology<\/em>, 66(21), 2343-2349.<\/p>\n\n\n\n

2.Harmon, K. G., et al. (2011).<\/strong>\u00a0“Incidence of sudden cardiac death in National Collegiate Athletic Association athletes.”\u00a0Circulation<\/em>, 123(15), 1594-1600.<\/p>\n\n\n\n

3.Marijon, E., et al. (2011).<\/strong> Sports-related sudden death in the general population.\u00a0Circulation<\/em>,\u00a0124<\/em>(6), 672\u2013681.<\/p>\n\n\n\n

4.Corrado, D., et al. (2006).<\/strong> “Trends in sudden cardiovascular death in young competitive athletes after implementation of a national screening program.” JAMA<\/em>, 296(13), 1593-1601<\/p>\n\n\n\n

5.Maron, B. J., & Estes, N. M. (2010).<\/strong> “Commotio cordis.” The New England Journal of Medicine<\/em>, 362(10), 917-927.<\/p>\n\n\n\n

6.Drezner, J. A., et al. (2013).<\/strong>\u00a0Outcomes from sudden cardiac arrest in US high schools: a 2-year prospective study from the National Registry for AED Use in Sports.\u00a0British journal of sports medicine<\/em>,\u00a047<\/em>(18), 1179\u20131183<\/p>\n<\/div><\/div>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Yazar: Uzm. Dr. Hasan Pak\u0131r Edit\u00f6r: Dr. \u00d6\u011fr. \u00dcyesi \u00d6mer Yusuf Erdurmu\u015f Spor, sa\u011fl\u0131kl\u0131 ya\u015fam\u0131n temel ta\u015f\u0131 olarak kabul edilse de, nadir durumlarda trajik olaylara sahne olabilmektedir. Gen\u00e7 ve sa\u011fl\u0131kl\u0131…<\/p>\n","protected":false},"author":177,"featured_media":424,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[1,10014,10015],"tags":[10018,10027,10017,10021],"class_list":["post-420","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","category-akademik-blog-yazisi","category-sosyal-blog-yazisi","tag-acil-tip","tag-kardiyak-arrest","tag-spor","tag-spor-acilleri"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/420","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/users\/177"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/comments?post=420"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/posts\/420\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media\/424"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/media?parent=420"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/categories?post=420"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/sportibbi\/wp-json\/wp\/v2\/tags?post=420"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}