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Sudden Cardiac Death in Forensic Pathology

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Clinical Approach to Sudden Cardiac Death Syndromes

Abstract

Sudden cardiac death (SCD) is the leading mode of death in all communities of the United States and the European Union, but its precise incidence is unknown. Internationally accepted methods of death certification do not include a specific category of SCD. Estimates for the United States range from 250,000 to 400,000 adult people dying suddenly each year owing to cardiovascular causes, with an overall incidence of 1-2/1,000 population per year.1-3 A task force of the European Society of Cardiology has adopted the incidence ranges from 36 to 128 deaths per 100,000 population per year.4,5 More than 60% of these are because of coronary heart disease. Among the general population of adolescents and adults younger than the age of 30 years, the overall risk of SCD is 1/100,000 and a wider spectrum of diseases can account for the final event.6 The major difficulties in interpreting the epidemiological data on sudden death are the lack of standardization in death certificate coding and the variability in the definition of sudden death. Sudden death has been defined as “a natural, unexpected fatal event occurring within one hour from the onset of symptoms in an apparently healthy subject or whose disease was not so severe as to predict an abrupt outcome. 7” This well describes many witnessed deaths in the community or in emergency departments. It is less satisfactory in forensic practice, where autopsies may be requested on patients whose deaths were not witnessed, occurred during sleep, or at an unknown time before their bodies were discovered. Under the latter circumstances, it is probably more satisfactory to assume that the death was sudden if the deceased was known to be in good health 24 h before the occurrence of death.

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Acknowledgments

This work has been supported by Fondi di Ateneo Linea D1-2008, Università Cattolica del Sacro Cuore, Rome, Italy.

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  1. Institute of Forensic Medicine, Catholic University, School of Medicine, Rome, Italy

    Antonio Oliva

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  1. Antonio Oliva
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  2. Vincenzo L. Pascali
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Correspondence to Antonio Oliva .

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  1. Masonic Medical Research Laboratory, Bleecker St. 2150, Utica, 13501, U.S.A.

    Ramon Brugada

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Oliva, A., Pascali, V.L. (2010). Sudden Cardiac Death in Forensic Pathology. In: Brugada, R. (eds) Clinical Approach to Sudden Cardiac Death Syndromes. Springer, London. https://doi.org/10.1007/978-1-84882-927-5_7

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