title: Symptoms Before Sudden Arrhythmic Death Syndrome: A Nationwide Study Among the Young in Denmark.
abstract: BACKGROUND
  No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation of SADS.
  
  
  RESULTS
  We have previously identified all of the autopsied sudden cardiac deaths (SCD; n = 314) in Danes aged 1-35 years between 2000 and 2006. After comprehensive pathological and toxicological investigation did not reveal a cause of SCD, 136 of the patients were identified as SADS. The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13%), palpitations (n = 2, 1%), presyncope/syncope (n = 23, 17%), and aborted SCD (n = 2, 1%). In addition, seizures (n = 25, 18%) were prevalent. In 61 (45%) SADS cases, no previous medical history were recorded.
  
  
  CONCLUSIONS
  In this unselected, nationwide study of 136 young SADS patients, 35% had experienced cardiac symptoms before death, most commonly presyncope/syncope, but only one out of five had contacted a healthcare provider with cardiac symptoms.
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Charlotte
authors: C
authors: Glinge
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Reza
authors: R
authors: Jabbari
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Bjarke
authors: B
authors: Risgaard
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Thomas Hadberg
authors: TH
authors: Lynge
authors: Department of Medicine and Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Thomas
authors: T
authors: Engstrøm
authors: Center for Arrhythmia Prevention, Division of Preventive Medicine, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Christine M
authors: CM
authors: Albert
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.|Department of Medicine and Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Stig
authors: S
authors: Haunsø
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.|Department of Medicine and Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Bo Gregers
authors: BG
authors: Winkel
authors: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Denmark.|Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.|Department of Medicine and Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Jacob
authors: J
authors: Tfelt-Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D003718:Denmark; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D013575:Syncope / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D055815:Young Adult
keywords: antecedent cardiac symptoms; prodromal cardiac symptoms; sudden arrhythmic death syndrome; sudden cardiac death; sudden unexplained death