A broken heart — or anguish in top-sport in antiquity

Cardiovascular disease is a major determinant of sudden death. Nevertheless the impact of autonomic dysregulation is grossly underestimated not to say ignored. The limited life expectancy of retired gladiators is a fine example of the interactive influence of an occupational- and socio-cultural hazard at the time. Possibly the fate of retired athletes in antiquity is sealed by autonomic dysregulation, cardiac adaptation and noxious exposure in fatal interaction. Observations like these could be helpful in the understanding of complex pathofysiological mechanisms, and may have implications in medical practice.