Clinical characteristics and circumstances of death in the sudden arrhythmic death syndrome (original) (raw)
Related papers
Sudden arrhythmic death syndrome: a national survey of sudden unexplained cardiac death
Heart, 2007
Objective: To describe the characteristics of sudden arrhythmic death syndrome (SADS) and compare its incidence with official national mortality statistics for unascertained deaths. Design and setting: Sudden unexplained deaths were prospectively surveyed through 117 coroners' jurisdictions in England. Consecutive cases meeting the following criteria were included: white Caucasian, aged 4-64 years, no history of cardiac disease, last seen alive within 12 h of death, normal coroner's autopsy, cardiac pathologist's confirmation of a normal heart and negative toxicology. Main outcome measures: The estimated mortality from SADS was calculated and the official mortality statistics for unascertained causes of deaths in 4-64-year-olds was identified for the same time period. Results: 115 coroner's cases were reported and 56 (49%) SADS victims were identified: mean age 32 years, range 7-64 years and 35 (63%) male. 7 of 39 cases (18%) had a family history of other premature sudden deaths (,45). The estimated mortality from SADS was 0.16/100 000 per annum (95% CI 0.12 to 0.21), compared with an official mortality of 0.10/100 000 per annum for International Classification of Diseases 798.1 (sudden death, cause unknown-instantaneous death) or 1.34/100 000 per annum for unascertained causes of death. Conclusions: Deaths from SADS occur predominantly in young males. When compared with official mortality, the incidence of SADS may be up to eight times higher than estimated: more than 500 potential SADS cases per annum in England. Families with SADS carry genetic cardiac disease, placing them at risk of further sudden deaths. SADS should therefore be a certifiable cause of death prompting specialised cardiological evaluation of families.
Journal of Arrhythmia
Appendix 3 Evidence Table Study name or acronym; Author; Year published; PMID Aim of study; Endpoints; Study type (RCT, observationalmulticenter or single center; case series or other [if RCT include intervention and comparator]); Study size (N) Patient population with inclusion and exclusion criteria Results (absolute event rates, p values; OR or RR; 95% CI) Other relevant findings or adverse events Limitations; Other comments; Conclusions Epidemiology: Sudden Death 2 Study name or acronym; Author; Year published; PMID Aim of study; Endpoints; Study type (RCT, observationalmulticenter or single center; case series or other [if RCT include intervention and comparator]); Study size (N) Patient population with inclusion and exclusion criteria Results (absolute event rates, p values; OR or RR; 95% CI) Other relevant findings or adverse events Limitations; Other comments; Conclusions • Year published: 2007 • PMID: 17237131 coroner's autopsy, cardiac pathologist's confirmation of a normal heart and negative toxicology. for International Classification of Diseases 798.1 (sudden death, cause unknown-instantaneous death) or 1.34/100,000 per annum for unascertained causes of death. should therefore be a certifiable cause of death prompting specialized cardiological evaluation of families. Becker et al. Racial differences in the incidence of cardiac arrest and subsequent survival. The CPR Chicago Project.
Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death
Heart, 2006
Objective: To evaluate non-atherosclerotic cardiac deaths in the UK population aged over 15 years including elderly patients and to highlight the concept of the structurally normal heart in sudden death. Methods: Pathological data were collected prospectively for sudden adult deaths referred by UK coroners. Results: 453 cases of sudden death from 1994 to 2003 (278 men (61.4%) and 175 women (38.6%), age range 15-81 years) were reviewed. Males predominated in both age groups (( 35 years, . 35 years). More than half of the hearts (n = 269, 59.3%) were structurally normal. In the other 40.7%, cardiac abnormalities were noted, which included: (1) cardiomyopathies (23%) such as idiopathic fibrosis, left ventricular hypertrophy, hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic right ventricular dysplasia; (2) inflammatory disorders (8.6%) including lymphocytic myocarditis and cardiac sarcoidosis; (3) non-atheromatous abnormalities of coronary arteries (4.6%); (4) valve diseases; and (5) miscellaneous and rare causes. Conclusion: The concept of the structurally normal heart in sudden death and the need for histological examination to detect underlying disease is highlighted. Relatives need to be referred for cardiological and genetic screening in cases of normal hearts found at necropsy.
The very sudden cardiac death syndrome — a conceptual model for pathologists
Human Pathology, 1980
Sudden unexpected death usually involves one of two mechanisms, fast heart stoppage or slow heart stoppage with respiratory arrest. These physiological derangements arise from diverse causes that are sometimes purely functional without structural correlates. The autopsy is considered to be only an investigative tool to be employed and is interpreted in the light of the terminal event, social and medical history, and environmental circumstances.
EP Europace, 2021
The aims of this centre-based survey, promoted and disseminated by the European Heart Rhythm Association (EHRA) was to investigate the current practice for the investigation of Sudden Unexplained Death in the Young (SUDY) amongst European countries. An online questionnaire composed of 21 questions was submitted to the EHRA Research Network, European Cardiac Arrhythmia Genetics (ECGen) Focus Group members, and European Reference Network GUARD-Heart healthcare partners. There were 81 respondents from 24 European countries. The majority (78%) worked in a dedicated clinic focusing on families with inherited cardiac conditions and/or SUDY or had easy access to a nearby one. On average, an autopsy was performed in 43% of SUDY cases. Macroscopic examination of the body and all organs were completed in 71% of cases undergoing autopsy, and expert cardiac examination in 32%. Post-mortem genetic testing was requested on average in 37% of Sudden Arrhythmic Death Syndrome (SADS) cases, but not a...
Review on Sudden Deaths Due to Cardiac Abnormalities
Jurnal Teknologi, 2019
Sudden death is an unexpected natural death within the one-hour onset of a symptom or unwitnessed death that occurs within 24 hours. This definition is most often used to describe death caused by cardiac failure as it is one of the well-known causes of natural death. Various aetiologies are leading to sudden death, and myocardial infarction is reported to be one of the leading causes either due to coronary atherosclerosis and/ or thrombosis. An autopsy is a procedure routinely performed by the pathologist to determine the cause and manner of death which provides valuable information such as, demographic factors comprises gender, age, ethnic and lifestyle that were strongly linked to sudden deaths. This article review will discuss on autopsy in sudden death, as well as the aetiology of sudden death associated with cardiac abnormalities. Further, the contribution of demographic factors to sudden death will also be discussed and highlighted.
The spectrum of epidemiology underlying sudden cardiac death
Circulation research, 2015
Sudden cardiac death (SCD) from cardiac arrest is a major international public health problem accounting for an estimated 15%-20% of all deaths. Although resuscitation rates are generally improving throughout the world, the majority of individuals who experience a sudden cardiac arrest will not survive. SCD most often develops in older adults with acquired structural heart disease, but it also rarely occurs in the young, where it is more commonly because of inherited disorders. Coronary heart disease is known to be the most common pathology underlying SCD, followed by cardiomyopathies, inherited arrhythmia syndromes, and valvular heart disease. During the past 3 decades, declines in SCD rates have not been as steep as for other causes of coronary heart disease deaths, and there is a growing fraction of SCDs not due to coronary heart disease and ventricular arrhythmias, particularly among certain subsets of the population. The growing heterogeneity of the pathologies and mechanisms u...