Abstract

BackgroundSeveral inherited cardiac diseases may lead to sudden cardiac death (SCD) a devastating event in the families. It is crucial to establish a post mortem diagnosis to facilitate relevant work-up and treatment of family members. Sudden unexplained death (SUD) victims constitute roughly one third of all SCD cases in Denmark.MethodsThis was a single center, retrospective study investigating SUD cases. Victims who died unexplained due to suspected or confirmed cardiac disease were consecutively referred to a third line referral center established in 2005. All autopsy reports were investigated. Victims were divided into two groups: non-diagnostic cardiac findings and normal cardiac findings. None of the included victims had findings consistent with a diagnosis based on existing criteria.ResultsIn total, 99 SUD cases were referred. The mean age of the victims was 37 years (range 0–62 years, 75% males). A total of 14 (14%) victims had a cardiovascular diagnosis pre-mortem. Thirty-seven cases had normal cardiac findings and non-diagnostic cardiac findings were found in 62 cases (63%). The five most common findings included ventricular hypertrophy and/or enlarged heart (n = 35, 35%), coronary atheromatosis (n = 31, 31%), myocardial fibrosis (n = 19, 19%), dilated chambers (n = 7, 7%) and myocardial inflammation (n = 5, 5%).ConclusionOne third of SUD victims had normal cardiac findings and non-diagnostic cardiac findings were seen in almost two thirds of the SUD victims. These non-diagnostic findings may be precursors or early markers for underlying structural cardiac disorders or may be innocent bystanders in some cases. Further studies and improved post-mortem examination methods are needed for optimization of diagnostics in SUD.

Highlights

  • Several inherited cardiac diseases may lead to sudden cardiac death (SCD) a devastating event in the families

  • Twenty-nine (29%) of all Sudden unexplained death (SUD) victims could be classified as sudden arrhythmic death syndrome (SADS) as they had a negative toxicology screen performed

  • SADS victims were younger than SUD victims

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Summary

Introduction

Several inherited cardiac diseases may lead to sudden cardiac death (SCD) a devastating event in the families. It is crucial to establish a post mortem diagnosis to facilitate relevant work-up and treatment of family members. Sudden unexplained death (SUD) victims constitute roughly one third of all SCD cases in Denmark. Sudden cardiac death (SCD) leads to tragedies in families with huge social and psychological consequences and is an important contributor to years of life lost among the young. It is crucial to establish a post mortem diagnosis to facilitate relevant treatment of family members and avoid further deaths as inherited cardiac diseases play an important role in SCD of the young. The purpose of this study was to systematically present non-diagnostic autopsy findings in sudden unexplained death (SUD) victims Other reasons include cardiomyopathies (hypertrophic, Yazdanfard et al BMC Cardiovascular Disorders (2020) 20:58 presentations of these autopsy findings have been reported before [5].

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