Clinical InvestigationAcute Ischemic Heart DiseaseEtiology of sudden death in the community: Results of anatomical, metabolic, and genetic evaluation
Section snippets
Setting
Hennepin is the largest county (population > 1.2 million) in the 7-county metropolitan area of Minneapolis-St Paul, MN, and includes the city of Minneapolis, as well as suburban and rural areas. By statute, all sudden or unexpected deaths in Hennepin County must be reported to the office of the county Medical Examiner (ME). Deaths due to other causes (eg, violence, burns, foul play, and others) and deceased persons with special circumstances (eg, inmates, organ donors, and others) also need to
Clinical characteristics and circumstances of SCD
The study participants were 49.5 ± 7 years old (range 27-60 years), and 86% were male (Table I). History of hypertension, diabetes mellitus, and/or hyperlipidemia were common. Smoking and obesity were highly prevalent. Overall, 61% of the participants were current (48%) or past (13%) smokers, and 80% had a body mass index in the overweight or obese range (Table I). Only 2 participants had a history of CHD, and 1 had a documented previous MI. Family history of MI and sudden death were present in
Discussion
The objective of the present investigation was to perform a detailed examination of adult patients who had SCD without an initially apparent cause of death, to uncover potential clinical, anatomical, metabolic, and genetic risk factors for SCD. We found that >80% of the subjects had previously undiagnosed but anatomically severe CHD on autopsy, including 27% with acute ischemic lesions and 34% with previous silent MI. Many also had signs of chronic cardiac disease characterized by LV
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