I'm Dr. Joshua Schwimmer, a nephrologist and internal medicine physician in New York City. • Kidney Notes was the first active nephrology blog. (Trivia: Kidney Notes is so old that the National Library of Medicine still uses it as an example of how to formally cite blogs.) • Professionally, you can find me at Kidney.nyc. • Kidney Notes is for educational purposes only, not medical advice. Consult qualified health care professionals. See disclaimer.

Saturday, March 11, 2006

Sudden Cardiac Death: More Than Half Of Hearts Are Structurally Normal

Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death -- Fabre and Sheppard 92 (3): 316 -- in Heart:
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.
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