Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death

• Published in: Heart (British Cardiac Society) Vol. 92; no. 3; pp. 316 - 320
• Main Authors: Fabre, A, Sheppard, M N
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.03.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; arrhythmogenic right ventricular dysplasia; ARVD; Biological and medical sciences; Cardiac arrhythmia; Cardiology. Vascular system; Cardiomyopathies - complications; Cardiomyopathies - epidemiology; cardiomyopathy; Cardiovascular disease; Cardiovascular Medicine; Coronary Vessel Anomalies - complications; Coronary Vessel Anomalies - epidemiology; coroner; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Defibrillators; Female; HCM; Heart attacks; Heart Conduction System; Heart Defects, Congenital - complications; Heart Defects, Congenital - epidemiology; Heart Valve Diseases - complications; Heart Valve Diseases - epidemiology; Humans; hypertrophic cardiomyopathy; left ventricular hypertrophy; London - epidemiology; LVH; Male; Medical sciences; Middle Aged; necropsy; normal heart; SADS; Sex Distribution; sudden adult death syndrome; sudden death; Womens health; London; United Kingdom > UK; Human; Ischemia; Sudden death; Cardiovascular disease; Adult; Circulatory system; Cardiology; Phlebology
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2004.045518

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.