Unexplained sudden cardiac death: an opportunity to identify hereditary cardiac arrhythmias

Abstract

This editorial refers to ‘Nationwide study of sudden cardiac death in persons aged 1–35 years’, by B.G. Winkel et al. doi:10.1093/eurheartj/ehq428 Death is inevitable, and what better way to die than suddenly. This statement is applicable to the elderly, but sudden death in a young person not only is a tragedy for the victim but also has a devastating effect on parents, spouses, and the victim's children. But why study the causes of sudden death, particularly sudden death, in the young since there is little that can be done to bring them back to life? The answer is that these untimely deaths can reveal clinical and genetic defects that trigger arrhythmias and this information may prevent inherited sudden cardiac death in family members. However, first, we need to examine the magnitude of the problem. In the meticulously performed study by Winkel et al. ,1 all deaths in persons age 1–35 years in Denmark, from 2000 to 2006, were carefully evaluated. In retrospective studies of the causes of sudden cardiac death, a major concern is the lack of a medical history of the patients and absence of uniformity in the quality of the autopsy findings due to lack of cardiac expertise of the pathologist. However, in this study, the investigators had access to the National Patient Registry containing information on all in- and outpatient activity in Danish Hospitals and emergency rooms. Death certificates were evaluated independently by two physicians to identify the causes of sudden unexpected deaths. The cause of death …