Sudden adult death syndrome and other non ischaemic causes of sudden cardiac death: a UK experience

Aurélie Fabre ¹ and Mary N Sheppard ^2*

¹ Royal Brompton and Harefield NHS Trust, London, United Kingdom
² Royal Brompton Hospital and Harefield NHS Trust, United Kingdom

^* To whom correspondence should be addressed. E-mail: m.sheppard{at}rbh.nthames.nhs.uk.

Accepted 13 May 2005

Abstract

Background: While the majority of sudden adult deaths are due to ischaemic heart diseases, other causes are often overlooked and the concept of the structurally normal heart in sudden death has only recently been recognised.

Methods: We acted as a referral centre for sudden adult deaths referred to us by UK coroners and prospectively collected pathological data.

Results: We reviewed 453 cases from 1994-2003 (278 men (61.4%) and 175 women (38.6%, age range 1581). Males predominated in both age groups (n35 y.o, >35 y.o). More than half of the hearts (n=269, 59.3%) were structurally normal. In the other 41.1 %, cardiac abnormalities were noted which included (i) cardiomyopathies (23.6%) such as idiopathic fibrosis, left ventricular hypertrophy, hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrythmogenic right ventricular dysplasia, (ii) inflammatory disorders (8.6%) including lymphocytic myocarditis and cardiac sarcoidosis, (iii) non atheromatous pathologies of coronary arteries (4.6%), (iv) valve diseases, and (v) miscellaneous and rare causes.

Discussion: The concept of the structurally normal heart in sudden death and the need for histological examination in order to detect underlying disease is highlighted. There is a need for the referral of relatives for cardiological /genetic screening in cases of normal hearts found at autopsy.

Keywords: autopsy, cardiomypathy, coroner, normal heart, sudden death

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