Symptoms preceding sudden cardiac death in the young are common but often misinterpreted.
OBJECTIVE
To identify patients at risk of sudden cardiac death (SCD) by analysis of clinical history.


METHODS
A retrospective study of the Swedish cohort of 15-35 year olds having suffered an SCD during 1992-1999 and having undergone a forensic autopsy (162 individuals). We sought information in forensic, police and medical records and from interviews with family members.


RESULTS
Syncope/presyncope, chest pain, palpitations or dyspnoea were present in 92/162, unspecific symptoms such as fatigue, influenza, headache or nightmares in 35/162. Syncope/presyncope was most common (42/162). In 74 seeking medical attention, 32 had an ECG recorded (24 pathological). In 26 subjects there was a family history of SCD.


CONCLUSIONS
The patient seeking medical advice before suffering an SCD is characterized by one to three of the following: 1) cardiac-related symptoms or non-specific symptoms often after an infectious disease, 2) a pathological ECG, 3) a family history of SCD. In 6 out of 10 a cardiac diagnosis was not considered. We conclude that symptoms preceding SCD were common but often misinterpreted.
Wisten
Aase
A
Department of Internal Medicine, Sunderby Hospital, Luleå, Sweden. aase.wisten@nll.se
Messner
Torbjörn
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019992:Databases as Topic; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D013575:Syncope / Q000175:diagnosis / Q000235:genetics