1971 Non-Atherosclerotic Sudden Cardiac Deaths Referred for Specialist Opinion to a Tertiary Centre in the UK during 1994-2010
Sofia V de Noronha, Keiko Ohta-Ogo, Katsuya Norita, Winston Banya, Mary N Sheppard. NHLI Imperial College London, London, United Kingdom; Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom
Background: Sudden cardiac death (SCD) from non-atherosclerotic causes is rare but is becoming increasingly recognised when it prematurely takes the life of an individual who is otherwise healthy and is of major importance because it often includes genetic diseases. There have been recent reports on sudden death based on extrapolations from death certificates and public media reports, the accuracy of which have been questioned due to a lack of an autopsy review. We report the results of the largest series to date of SCD with examination of cardiac tissue following a systematic protocol in a tertiary referral centre.
Design: Sudden cardiac death was defined as an unexpected sudden death within 1-24h of symptom onset. Case selection was performed to exclude cases of significant atherosclerotic disease, congestive heart failure, infant (≤1 year) and postoperative death or when toxicology was considered to have contributed to the death. Cases were retrieved in the period 1994-2010 and organised into 2 age groups: 1-35 years and ≥36 years.
Results: 1971 cases were retrieved with a male predominance (n=1263, 64%), median age 33 (range 1-98) years and predominately young (1-35 years); n=1107, 56%. A morphologically normal heart indicating Sudden Arrhythmic Death Syndrome (SADS) and channelopathy was the single leading cause of death (n=998, 51%). Cardiomyopathy accounted for almost a third of the deaths (n=578, 29%), with LVH (n=210, 11%), HCM (n=132, 7%) and ARVC (n=84, 4%) as the most significant contributors.
Conclusions: This large case series highlights the importance of SADS as the major cause of SCD particularly in the young, followed by cardiomyopathy. SCD organ retention and referral to specialist cardiac pathologists must be regarded as the 'gold standard'. When the autopsy identifies SADS or cardiomyopathy, the families of victims should be referred for cardiological screening since a significant proportion of these conditions are inherited.
Wednesday, March 21, 2012 9:30 AM
Poster Session V # 3, Wednesday Morning