Sport-related (SR) acute coronary events are the main cause of sudden cardiac in the setting of sport activities; data are very scarce regarding the context of onset and the follow-up of SR acute myocardial infarction (AMI).

We prospectively invited subjects admitted in our University Hospital from April 2018 for a SR-AMI to participate in the IMACS observatory program which addresses to SR-AMI including a 12 months follow-up.

From April 2018 to April 2019, 21 subjects were included. The mean age of this male population was 57.5±11.0 (median 56). The context of event was available for 21 (provided by family for a subject with out of hospital (OH) SCA). Sport was mostly cycling (5), swimming (4) and fitness (3). The SR-AMI occurred during effort for 16 subjects and during recovery for 5. The SR-AMI occurred at home (5), in public area (8) and in a specific sport location (8), was witnessed in 17/19 and AED was available in the area in 7/19, absent in 12, unknown for 2. Cardiopulmonary resuscitation was initiated by witnesses in the subject with OH-SCA, they used a public AED which was ineffective. Among the 21 subjects, 3 were current tobacco smokers of whom one consumed cannabis 2h before the event, 7 were ex-smokers and 2 experienced cannabis and cocaine use. Strikingly, coronary history and/or recent symptoms were present in 14/21 (5/14 felt symptoms exclusively in the sport session) but signs induced a medical advice only for two. One patient with a previous SR-AMI neglected symptoms during this new event. Twelve months follow-up was achieved by phone in 17/19. No significant cardiovascular event occurred; rehabilitation program was performed in 16/17, each smoker quitted. 12/17 modified their sport activities: 1 stopped, 6 reduced the intensity and 5 enhanced it.

SR-AMI are usually witnessed with 2/3 of prior history or symptoms which are often neglected; at one-year follow-up, sport activity is usually continued.