Abstract
In the past 20 years, cardiovascular mortality has decreased in high-income countries in response to the adoption of preventive measures to reduce the burden of coronary artery disease and heart failure. Despite these encouraging results, cardiovascular diseases are responsible for approximately 17 million deaths every year in the world, approximately 25% of which are sudden cardiac death. The risk of sudden cardiac death is higher in men than in women, and it increases with age due to the higher prevalence of coronary artery disease in older age. Accordingly, the sudden cardiac death rate is estimated to range from 1.40 per 100 000 person-years in women to 6.68 per 100 000 person-years in men. Sudden cardiac death in younger individuals has an estimated incidence of 0.46–3.7 events per 100 000 person-years, corresponding to a rough estimate of 1100–9000 deaths in Europe and 800–6200 deaths in the USA every year. Cardiac diseases associated with sudden cardiac death differ in young vs. older individuals. In the young there is a predominance of channelopathies and cardiomyopathies, myocarditis and substance abuse, while in older populations, chronic degenerative diseases predominate. In younger persons, the cause of sudden cardiac death may be elusive even after autopsy, because conditions such as inherited channelopathies or drug-induced arrhythmias that are devoid of structural abnormalities are epidemiologically relevant in this age group. Identification of the cause of an unexpected death provides the family with partial understanding and rationalization of the unexpected tragedy, which facilitates the coping process and allows an understanding of whether the risk of sudden death may extend to family members. Accordingly, author present their experience with autopsies of unexplained sudden death young victims in which a cardiac origin was suspected and the relevance of a standardized protocol for heart examination and histological sampling, as well as for toxicology and molecular investigation.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Priori SG (2015) The Task force for the Management of patients with ventricular arrhythmias and the prevention of Sudden cardiac death of the European Society of Cardiology: 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 36:2793–2867
Ackerman M, Atkins DL, Triedman JK (2016) Sudden cardiac death in the young. Circulation 133:1006–1026
Stecker EC, Reinier K, Marijon E et al (2014) Public health burden of sudden cardiac death in the United States. Circ Arrhythm Electrophysiol 7:212–217
Semsarian C, Sweeting J, Ackerman MJ (2004) Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 141:829–834
Zipes DP, Wellens HJ (1998) Sudden cardiac death. Circulation 98:2334–2351
Eckart RE, Shry EA, Burke AP et al (2011) Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. J Am Coll Cardiol 58:1254–1261
Bagnall RD, Weintraub RG, Ingles J et al (2016) A prospective study of sudden cardiac death among children and young adults. N Engl J Med 374(25):2441–2452
Winkel BG, Holst AG, Theilade J et al (2011) Nation wide study of sudden cardiac death in persons aged 1–35 years. Eur Heart J 32(8):983–990
Doolan A, Langlois N, Semsarian C (2004) Causes of sudden cardiac death in young Australians. Med J Aust 180(3):110–112
Puranik R, Chow CK, Duflou JA, Kilborn MJ et al (2005) Sudden death in the young. Heart Rythm 2(12):1277–1281
Bagnall RD, Weintraub RG, Ingles J et al (2011) A prospective study of sudden cardiac death among children and young adults. N Engl J Med 374(25):2441–2452
de Nronha SV, Behr ER, Papadakis M et al (2014) The importance of specialist cardiac histopathological examination in the investigation of young sudden cardiac death. Europace 16(6):899–907
Papadakis M, Raju H, Behr ER et al (2013) Sudden cardiac death with autopsy findings of uncertain significance: potential for erroneous interpretation. Circ Arrhytm Electrophysiol 6(3):588–596
McKenna WJ, Stewart JT, Nihoyannopoulos P et al (1990) Hypertrophic cardiomyopathy without hypertrophy: two families with myocardial disarray in the absence of increased myocardial mass. Br Heart H 63(5):287–290
Varnava AM, Elliott PM, Baboonian C et al (2001) Hypertrophic cardiomyopathy: hitopathological features of sudden death in cardiac troponin T disease. Circulation 104(12):1380–1384
Semsarian C, Hamilton RM (2012) The key role of the molecular autopsy in sudden unexpected death. Heart Rhythm 9:145–150
Semsarian C, Ingles J, Wilde AA (2015) Sudden cardiac death in the young: the molecular autopsy and a practical approach to surviving relatives. Eur J Heart 36:1290–1296
Ingles J, Semsarian C (2014) Conveying a probabilistic genetic test result to families with an inherited heart disease. Heart Rhythm 11:1073–1078
Ingles J, Semsarian C (2014) The value of cardiac genetic testing. Trends Cardiovasc 24:217–224
Papadakis M, Sharma S, Cox S, Sheppard MN, Panoulas VF, Behr ER (2009) The magnitude of sudden cardiac death in the young: a death certificate-based review in England and Wales. Europace 11(10):1353–1358
Bagnall RD, Semsarian C (2015) Role of the molecular autopsy in the investigation of sudden cardiac death. Progr Ped Cardiol 45:17–23
Behr ER, Dalageorgou C, Christiansen M et al (2008) Sudden arrhythmic death syndrome: familial evaluation identifies inheritable heart disease in the majority of families. Eur Heart J 28:1670–1680
Behr E, Wood DA, Wright M et al (2003) Cardiological assessment of first degree relatives in sudden arrhythmic death syndrome. Lancet 362:1457–1459
Amin AS, Wilde AM (2017) The future of sudden cardiac death research. Prog Ped Cardiol 45:49–54
Lahrouchi N et al (2017) Utility of post mortem genetic testing in cases of sudden arrhythmic death syndrome. J Am Coll Cardiol 69(17):2134–2145
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this paper
Cite this paper
D’Errico, S., Martelloni, M., Niballi, S., Bonuccelli, D. (2019). Hospital Autopsy for Prevention of Sudden Cardiac Death. In: Bagnara, S., Tartaglia, R., Albolino, S., Alexander, T., Fujita, Y. (eds) Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018). IEA 2018. Advances in Intelligent Systems and Computing, vol 819. Springer, Cham. https://doi.org/10.1007/978-3-319-96089-0_48
Download citation
DOI: https://doi.org/10.1007/978-3-319-96089-0_48
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-96088-3
Online ISBN: 978-3-319-96089-0
eBook Packages: Intelligent Technologies and RoboticsIntelligent Technologies and Robotics (R0)