title: Clinical characteristics of unexplained sudden cardiac death in Korea.
abstract: In Western countries, sudden cardiac death (SCD) is closely related to coronary artery disease, but in Korea the clinical characteristics of SCD are not well determined. Over a 4-year period (June 1995 to May 1999), 186 cases of SCD, ranging in age from 16 to 75 years, were admitted to the Chonnam National University Hospital. In 82 (44.1%) of these, neither symptoms nor evidence of structural heart disease was found and so their clinical characteristics were investigated. There were 66 (80.5%) men and 16 (19.5%) women (male/female ratio = 4.1:1). The mean age was 50 +/- 14 years: 19 (23.2%) were in their 40s, 21 (25.6%) in their 50s, and 17 (20.7%) in their 60s. The time of circulatory collapse witnessed in 68 cases of SCD showed 2 peaks: between midnight and 03.00h (n=16, 23.5%) and between 09.00h and midday (n=15, 22.1%). Unexplained SCD occurred at home in 48 (64.9%) cases and on the street in 12 (16.2%); it occurred during normal daily routine activity in 23 (39.6%) and during sleep in 15 (25.9%). Thirty-three patients (40.2%) experienced various prodromal symptoms, including chest discomfort (n=13, 15.9%) and dyspnea (n=8, 9.8%). The electrocardiogram taken on arrival recorded asystole in 65 (79.3%) and ventricular fibrillation in 17 (20.7%). Idiopathic ventricular fibrillation was diagnosed in 14 (10 men, 4 women; 45 +/- 11 years) of 21 patients who recovered spontaneous circulation. Five (6.1%) patients were discharged alive, and an implantable cardioverter-defibrillator was implanted in 2. Unexplained SCD is common in Korea and develops predominantly in middle-aged males around midnight or in the late morning usually with no prodromal symptoms (59.8%). Idiopathic ventricular fibrillation is thought to be one of the important causes.
authors.affiliation: Division of Cardiology, Chonnam National University Hospital, Kwangju, Korea. chojg@unitel.co.kr
authors.forename: J G
authors.initials: JG
authors.lastname: Cho
authors.forename: H W
authors.initials: HW
authors.lastname: Park
authors.forename: J Y
authors.initials: JY
authors.lastname: Rhew
authors.forename: S R
authors.initials: SR
authors.lastname: Lee
authors.forename: W K
authors.initials: WK
authors.lastname: Chung
authors.forename: O Y
authors.initials: OY
authors.lastname: Park
authors.forename: W
authors.initials: W
authors.lastname: Kim
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.forename: K T
authors.initials: KT
authors.lastname: Kang
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: N H
authors.initials: NH
authors.lastname: Kim
authors.forename: J C
authors.initials: JC
authors.lastname: Park
authors.forename: Y K
authors.initials: YK
authors.lastname: Ahn
authors.forename: M H
authors.initials: MH
authors.lastname: Jeong
authors.forename: J C
authors.initials: JC
authors.lastname: Park
authors.forename: J C
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D002940:Circadian Rhythm / Q000502:physiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006802:Human Activities; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014693:Ventricular Fibrillation / Q000150:complications