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Non-diagnostic autopsy findings in sudden unexplained death victims

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BACKGROUND: 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.

METHODS: This 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.

RESULTS: In 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%).

CONCLUSION: One 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.

Original languageEnglish
JournalBMC Cardiovascular Disorders
Volume20
Issue number1
Pages (from-to)58
ISSN1471-2261
DOIs
Publication statusPublished - 4 Feb 2020

    Research areas

  • Adolescent, Adult, Arrhythmias, Cardiac/etiology, Autopsy, Cause of Death, Child, Child, Preschool, Death, Sudden, Cardiac/etiology, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Myocardium/pathology, Predictive Value of Tests, Retrospective Studies, Risk Factors, Sudden Infant Death/etiology, Young Adult

ID: 62033471