Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death.
OBJECTIVE
To evaluate non-atherosclerotic cardiac deaths in the UK population aged over 15 years including elderly patients and to highlight the concept of the structurally normal heart in sudden death.


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 (< or = 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.


CONCLUSIONS
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.
Fabre
A
A
Department of Pathology, Royal Brompton and Harefield NHS Trust, London, UK.
Sheppard
M N
MN
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000150:complications / Q000453:epidemiology; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006329:Heart Conduction System; D006330:Heart Defects, Congenital / Q000150:complications / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution