title: Sudden death due to nonarrhythmic cause in a patient with L-TGA.
abstract: We report a case of sudden death in a clinically stable adult with l-transposition of the great arteries (l-TGA). Sudden death has been reported to be the leading cause of death in l-TGA and is often attributed to arrhythmias in the absence of another identifiable cause. However, the contribution of nonarrhythmic causes to the burden of sudden death in this population is unknown. Comprehensive postmortem investigation, including autopsy and pacemaker interrogation, demonstrated that the cause of death was massive pulmonary hemorrhage due to stenosis of the patient's mechanical tricuspid (systemic AV) valve. This report highlights the important contribution of nonarrhythmic causes of sudden death in this population and the value of autopsy and device interrogation in determining true cause of death.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California, San Francisco, CA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hayward
authors.forename: Philip C
authors.initials: PC
authors.lastname: Ursell
authors.forename: Elyse
authors.initials: E
authors.lastname: Foster
authors.forename: Zian H
authors.initials: ZH
authors.lastname: Tseng
mesh_terms: D000328:Adult; D001344:Autopsy; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D008297:Male; D011475:Prosthesis Failure / Q000009:adverse effects*; D014188:Transposition of Great Vessels / Q000150:complications* / Q000601:surgery; D014264:Tricuspid Valve Stenosis / Q000150:complications*
keywords: autopsy; cardiac arrest/sudden death; congenial heart disease