Causes of Sudden Cardiac Death on Autopsy Findings; a Four-Year Report (original) (raw)
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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.
Sudden cardiac death in South India: Incidence, risk factors and pathology
Indian pacing and electrophysiology journal
Sudden cardiac death (SCD) is a major cause of mortality secondary to coronary artery disease (CAD) in the industrialized societies. Although South Asians have a high prevalence of CAD, the frequency and underlying pathology of SCD among this population are unknown. Medical records of consecutive patients presenting with unexplained sudden death (USD) in a tertiary care center were reviewed. Patients with trauma, violent deaths, positive toxicology and non-cardiac pathology were excluded to determine sudden cardiac death (SCD). Cardiac pathological findings were analyzed by autopsy. SCD rate was estimated based on census and government vital statistics for the years studied. During a two year period, 223 patients (mean age 55 + 10 yrs, 78.9% male, body mass index 26 + 4, 60% smokers, 39% known CAD, 46% hypertension, 43% diabetes) presented to hospital with USD. SCD was attributed to myocardial infarction (MI) in 87% of cases; 69% were acute (96% anterior MI); 76% were small/moderate...
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018
Sudden death is defined by World Health Organization (WHO) as death within 24 hours from the onset of symptoms. Young south Asians make up approximately 60% of the world's Coronary Artery Disease (CAD) load. India being a developing country is the CAD capital of the world according to WHO [1,2]. In contrast to the extensive study done on the pattern and prevalence of SD in western countries, this topic has been fairly untouched in the south Asian societies. It is partly due to a lack of systematic record acquisition, non uniform billing codes, varied payment strategies, absence of reporting and a social aversion to autopsy [3-6]. The present study was taken up as a means to shed light on the rate, pattern and underlying pathology of SD so as to promote strategies for prevention and therapy for the SD in this part of Indian population. MAterIAls And MethOds This was a retrospective cross-sectional study was conducted in Sri Devaraj Urs Medical College, Karnataka, India. The ethical clearance was obtained from Institutional Ethical Clearance Committee before starting the study. All autopsy cases of SD from 1 July 2012 to 30 June 2017 were collected from the archives of Pathology, Forensic Medicine and Toxicology Department. The sociodemographic data of the cases such as the age, gender, autopsy findings and cause of death were noted. Cases were considered to have SD, if they died at home or were found dead out of the hospital without a known cause and who were brought to the casualty for evaluation of cause of death. All study cases were known to have died within 24 hours of the onset of symptoms and presentation to the casualty. Patients with trauma, intoxication, poisoning and violent deaths were excluded from the study. Autopsy methodology was in accordance to the routine procedure followed in the pathology department. Grossing of the heart, lungs, liver, spleen, kidneys were done by conventional method. The histomorphological findings from tissue sections of tissue bits from the representative areas were noted and analysed. Atheromatous changes of the aorta and coronary arteries were graded based on the AHA 2011 criteria as; Grade 1: Initial lesion with isolated macrophages and foam cells, Grade 2: Fatty streak lesion with intracellular lipid accumulation, Grade 3: Grade 2 changes with small extracellular lipid pools, Grade 4: Atheroma lesion with Grade 2 changes and core of extracellular lipid, Grade 5: Fibroatheroma lesion with lipid core and fibrous cap, Grade 6: Complicated lesion with surface defect, haematoma, haemorrhage, and thrombus [7]. Cardiac abnormalities when found were considered to be Sudden Cardiac Death (SCD). Patients with non-cardiac pathology were considered to have non cardiac causes of SD. Absence of cardiac or non cardiac pathological findings indicated non structural causes of SD.
Autopsy review of sudden deaths in a tertiary hospital of northeastern India
Journal of Medical Society, 2014
Background: World Health Organization (WHO) defi nes sudden death as "deaths within 24 hours from the onset of the symptoms". It is also defi ned as death which is sudden, unexpected, clinically unexplained, or otherwise obscure even though there needs to be no unnatural element in their causation. This study was taken up to analyze histopathologically the possible cause of sudden deaths. Aims: To study the different histomorphological profi le of sudden deaths in the autopsy/postmortem specimens received in the Department of Pathology, Regional Institute of Medical Sciences (RIMS), Imphal. Materials and Methods: A review of all autopsies/postmortem of sudden deaths performed between 1 st January 2000 and 31 st December 2013 at Department of Pathology, RIMS, were done. Results: A total of 120 cases were autopsied for sudden deaths during the study period. The age ranged from 17 to 70 years with male predominance. Maximum deaths occurred in the age group between 31 and 35 years and males were affected more than females. The cause of deaths in 67 cases (55.83%) were attributed to cardiac causes, the most common cause being coronary artery disease and the remaining 53 cases (44.17%) were due to noncardiac causes. Conclusion: It is found that sudden deaths are most commonly found in young adults (31-35 years) and most of them are attributed to a cardiac cause. This study highlights the serious health concern in our society and a necessity to create awareness among the population at risk so that sudden deaths can be averted and life expectancy can be improved.
Althea Medical Journal, 2021
Background: Sudden death (SD) is a sudden and unexpected death with an unknown cause. However, it has been assummed that the most common causes of sudden deaths are cardiovascular or non-cardiovascular causes such as gastrointestinal disease, respiratory disease, genitourinary disease, epilepsy, and trauma. This study aimed to portray histopathological findings and causes of sudden cardiac death (SCD) cases based on 5 year autopsy experience in a tertiary hospital in Bandung, Indonesia. Methods: This study was a descriptive cross-sectional study exploring causes of SCD from 2015 to 2019 at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. All medical records with SCD and histopathology findings were retrieved from September to December 2020. Only cases with histopathological examination results were included.Results: SCD was found in 7 of 16 patients with sudden death. Coronary atherosclerosis was the most common (n=4), followed by myocardial infarction (n=2) and ruptured aort...
The Epidemiology of Sudden Cardiac Death : A Forensic Autopsy Study in Iran 2013 - 2016
World family medicine journal, 2017
Background: Sudden cardiac death is the most common and deadliest manifestation of coronary artery disease that causes more deaths than any other cause each year. This study has been conducted with regard to the highly fatal and the high prevalence and the lack of adequate information in this area in our country. Objective: To determine the epidemiological findings of sudden cardiac death in Tehran, Iran from April 2013 to April 2016. Materials and Methods: In this descriptive-analytic cross-sectional study, referring to the forensic archives of Tehran Legal Medicine Organization, information was collected based on a researcher-made questionnaire from patients who died of natural symptoms within 24 hours of onset of symptoms. Using statistical software SPSS V16 data was subjected to descriptive and analytical reviews. Results: Findings show that about 77% of male subjects with an average age of 58.05 years (SD=13.56), 41.5% of cases in the age range of 50 to 65 years, were generally free or retired from their job (47.8% and 25.3%). The most common cause of death was "heart attack" (more than 99%) and mainly the location of death was prehospital (50%), which occurred in 82% of cases during rest or during normal activity, and mainly during the initial hour (60%) and the most common time of death was 6 to 12 in the morning (39.6%). The mean heart weight was 380 g ±67.42, pulmonary fibrosis was 65%, and hyperemia was seen in 47%. The most common site of coronary involvement was LAD + RCA (77%). Conclusion: Considering the rapid growth of sudden cardiac deaths over a three-year period, and considering the difference in the results of this research with similar research abroad, the need for the attention of clinicians to these differences could be helpful in the management of such valuable patients.
SUDDEN CARDIAC DEATH – A CASE REPORT
The Forensic autopsy or post-mortem examination is ordered by the competent legal authority to investigate sudden, unexpected, suspicious, unnatural, or criminal deaths. A medico-legal expert conducts an accurate autopsy examination is to ascertain the underlying and possible contributing cause and manner of death. Herein, we report a case of accidental death turn into sudden natural death following careful autopsy
Contribution of sudden cardiac death to total mortality in India — A population based study
International Journal of Cardiology, 2012
Introduction: Epidemiology of sudden cardiac death (SCD) in India is understudied. Methods: We assessed proportion of SCD among total mortality in a population in Southern India using a staged, questionnaire-based kindred-wide approach. Detailed questionnaires (DQs) were completed by medical trainees from 8 medical colleges. Preliminary questionnaires evaluated total deaths in the kindred of a respondent. Deaths due to obvious non-cardiac causes were excluded. DQs were completed for the remaining deaths and categorized using a three-member adjudication system. Results: A total population of 22,724 was evaluated by 478 respondents, (278 M and 200 F). Out of a total of 2185 deaths, 1691 (77.4%) were recallable. A total of 173 (10.3%; 128 M and 45 F; mean age-60.8± 14 years) deaths were adjudicated as SCD. Of these, 82 (47.3%) were ≤60 years of age. Prior MI, LV dysfunction and prior aborted SCD were found in 33.5%, 22.5% and 5.7% respectively. Coronary artery disease (CAD) was observed in 66 (38%) and acute myocardial infarction documented in 30 (17%). At least 1 of 3 CAD risk factorshypertension, diabetes, or smoking was observed in 80.6%. Proportion of subjects with at least one risk factor for CAD were similar in the age groups above and below 50 years (67.6% vs. 81.7%, p = 0.065). Conclusions: SCD contributed to 10.3% of overall mortality in this population from Southern India. On an average, SCD cases were 5-8 years younger compared to populations reported in the western hemisphere, with a high prevalence of major risk factors for CAD.
Spectrum of sudden cardiac death in Nepalese population - an institutional based study
Sri Lanka Journal of Forensic Medicine, Science & Law, 2020
Introduction: Sudden cardiac death (SCD) is non traumatic deaths occurring within 24 hours from the onset of symptom due to a cardiac cause. This study was designed with an objective to evaluate spectrum of SCD in the Nepalese community. Materials and Methods: This was a prospective analytical study, done at an autopsy center in Nepal, over one year. All SCD's were verified using histopathological examination. Analysis was done using SPSS, Version-20. Mean and standard deviation was calculated for age. The frequency and percentage were calculated for gender, and cause of death. Stratification was done for age and post-stratification Chi square test or Fisher exact test was used. Results: There was a total of 51 cases, with 44(86.3%) males and 7(13.7%) females. Peak death was between 40-60 years. The most common cause of death was coronary artery diseases (CAD) (62.7%). There was significant association of gender with the different spectrum of SCD, with male gender having tendencies towards CAD and cardiomyopathy (CM). Conclusion: Coronary artery disease is the commonest cause of sudden cardiac deaths, followed by cardiomyopathy. Both these diseases had significantly increased tendencies towards male gender.