title: Sudden unexpected death in persons less than 40 years of age.
abstract: This study retrospectively assesses the underlying causes of sudden unexpected death and the occurrence of prodromal symptoms in 162 subjects (aged 9 to 39 years) over a 10-year period (1976 to 1985). Underlying cardiac diseases accounted for sudden death in 73% and noncardiac causes in 15% of subjects. In 12% of subjects, the causes were unidentifiable. Myocarditis (22%), hypertrophic cardiomyopathy (22%) and conduction system abnormalities (13%) were the major causes in 32 subjects aged less than 20 years. Major causes of 46 deaths in subjects 20 to 29 years were atherosclerotic coronary artery disease (24%), myocarditis (22%) and hypertrophic cardiomyopathy (13%). The largest number of deaths in 84 subjects aged greater than or equal to 30 years was attributed to coronary artery disease (58%), followed by myocarditis (11%). Among noncardiac causes of sudden death, intracranial hemorrhage was the most frequent (5%), followed by infectious disease (4%). Prodromal symptoms were reported by 54% of subjects; most frequent were chest pain (25%) in subjects aged greater than or equal to 20 years, and dizziness (16%) in those aged less than 20. Sudden death, which occurred during routine daily activity in 49% and during sleep in 23% of subjects, was related to physical exercise in 23% and emotional upset in 6%. Sudden unexpected death in the young is still an unresolved medical problem. The early recognition of prodromal symptoms could be crucial in the prevention of sudden death, specifically when exercise-related.
authors.affiliation: Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Drory
authors.forename: Y
authors.initials: Y
authors.lastname: Turetz
authors.forename: Y
authors.initials: Y
authors.lastname: Hiss
authors.forename: B
authors.initials: B
authors.lastname: Lev
authors.forename: E Z
authors.initials: EZ
authors.lastname: Fisman
authors.forename: A
authors.initials: A
authors.lastname: Pines
authors.forename: M R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000401:mortality; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000401:mortality; D003645:Death, Sudden / Q000453:epidemiology* / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies