Chest
Volume 96, Issue 4, October 1989, Pages 790-793
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Clinical Investigations
Unexpected, Unexplained Sudden Death in Young Asthmatic Subjects

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The clinical course of asthma in four patients younger than 25 years was considered. Three died unexpectedly of their disease, and the fourth was successfully resuscitated after cardiopulmonary arrest. None of these patients met the criteria for status asthmaticus in the period preceding their death. The time course of the illness from apparent wellness to death was documented as seconds to minutes. No obvious cause of the severe disease was found at postmortem in two patients or by clinical analysis in all four. Patients with bronchial asthma may die with this disease unexpectedly, rapidly and with no obvious cause for the severity of this process.

Section snippets

CASE 1

A 15-year-old girl with mild bronchial asthma died suddenly and unexpectedly at home while talking on the telephone with a friend. The girls were having an apparently normal conversation when the patient abruptly stopped talking. She was found dead in bed with the telephone still by her hand. The time from the cessation of the telephone call to cardiopulmonary arrest could be estimated as seconds to minutes.

She had been diagnosed as having exercise-induced asthma several years prior to her

DISCUSSION

We describe four young patients with bronchial asthma who had unexpected, unexplained sudden cardiopulmonary arrest. The clinical data on these patients is summarized in Table 1. “Unexpected” refers to the relatively mild or asymptomatic state of bronchial asthma in the immediate period preceding death or cardiac arrest. “Unexplained” refers to the fact that the postmortem examination of patient 1 or the clinical course of all four patients did not provide an obvious explanation for cardiac or

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    Supported by a grant from the Samuel and Leah Osher Medical Education Fund.

    Manuscript received December 15; revision accepted March 7.

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