Death from ischemic heart disease in young finns aged 15 to 24 years

Abstract

The epidemiology and autopsy findings of death from ischemic heart disease were studied among 7,998 Finns who died at age 15 to 24 years between 1961 and 1971 (9,150,000 person-years). In 34 of this group, ischemic heart disease was indicated as the cause of death in the death certificate. Eight cases were excluded, six because of questionable evidence of ischemic disease and two because of the presence of another severe underlying disease. With 26 accepted deaths, the incidence of death from ischemic heart disease was 0.51/100,000 man-years and 0.04/100,000 woman-years, respectively. The World Health Organization criteria for acute ischemic heart disease were met in 21 cases (81 percent); in the remaining 5 cases, death had occurred suddenly with no other known cause. In 24 of 25 cases with a known time of onset of the fatal attack, death occurred within 24 hours of onset. The acute symptoms appeared during or immediately after physical exertion hi 13 subjects (65 percent); in 5 of these the exercise was approximately maximal. Eight of 20 subjects with available data had a history of previous chest pain or arrhythmia. Autopsy was performed in 19 cases (73 percent). A stenosing process in the coronary arteries was found in 17 patients (89 percent). Among 15 to 19 year olds the stenosis was generally ostial and non-sclerotic; ostial stenosis was found in half of this group. After age 20, atherosclerosis was the major cause of coronary stenosis. The role and etiology of sclerotic and nonsclerotic coronary processes as a cause of acute ischemic heart disease in young persons are discussed.