scholarly journals Pathology of heart, coronaries and aorta in autopsy cases with history of sudden death: an original article

2017 ◽  
Vol 5 (8) ◽  
pp. 3287 ◽  
Author(s):  
Sushil Y. Sonawane ◽  
Pushkar P. Matkari ◽  
Gopal A. Pandit
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Tertiary Care ◽  
Hypertensive Heart Disease ◽  
Autopsy Study ◽  
Formidable Challenge ◽  
History Of

Background: Natural deaths represent a large proportion of sudden (unexpected and unattended) deaths. The term “sudden cardiac death” (SCD) refers to death from the abrupt cessation of cardiac function due to cardiac arrest. The objective of this study was to identify various causes, risk factors, age and sex distribution associated with sudden cardiac death in an Indian setting.Methods: Detail review of medical records and an autopsy study of all cases of sudden cardiac death that occurred instantaneously or within 24 hours of onset of symptoms in a tertiary care institution, between December 2010 and December 2015 was carried out.Results: In total, 124 cases of sudden death were studied during this period. Out of 124 cases, 109 cases (87.90%) showed pathology in heart and aorta. Atherosclerotic coronary heart disease was the most common cause of death (72.58%) followed by Hypertensive heart disease (4.83%), Hypertrophic cardiomyopathy (3.22%), Myocarditis (3.22%), Infective endocarditis (1.61%), Rheumatic heart disease (0.8%), Aortic dissection (0.8%), and syphilitic aortitis (0.8%).Conclusions: Sudden death is a source of concern and a detailed postmortem examination is mandatory to ascertain its cause. Presence of co-existing conditions like diabetes and hypertension contribute immensely to the risk of sudden death. Occurrence of sudden death at a younger age presents a formidable challenge. Prevention of development of risk factors of atherosclerosis at an early age can be an effective strategy to counter this ailment at all levels.

Ventricular tachyarrhythmias, myocardial ischemia, and sudden cardiac death in patients with hypertensive heart disease

1995 ◽  
Vol 18 (7) ◽  
pp. 377-383 ◽  
Author(s):  
Manfred Zehender ◽  
Thomas Faber ◽  
Ursula Koscheck ◽  
Hanjörg Just ◽  
Thomas Meinertz
Keyword(s):  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Myocardial Ischemia ◽  
Cardiac Death ◽  
Hypertensive Heart Disease ◽  
Ventricular Tachyarrhythmias

Abstract 3667: Comparison of Risk Profiles between Survivors and Victims of Sudden Cardiac Death of an Acute Coronary Event

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kari S Kaikkonen ◽  
Marja-Leena Kortelainen ◽  
Heikki V Huikuri
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Sudden Cardiac Death ◽  
Cardiac Hypertrophy ◽  
Odds Ratio ◽  
Cardiac Death ◽  
Coronary Event ◽  
Acute Coronary Event ◽  
Risk Profiles ◽  
History Of

Introduction. There is little information on the specific risk factors leading to sudden cardiac death (SCD) during an acute coronary event, because the risk variables may overlap with those of non-fatal coronary event. This study was designed to compare the risk profiles of SCD victims and survivors of an acute coronary event. Methods and Results. A case-control study included consecutive victims of SCD (n=425, mean age 64±11 years) verified to be due to an acute coronary event at medicolegal autopsy and consecutive patients surviving an acute myocardial infarction (AMI, n=644, mean age 62±10 years). Common cardiovascular risk factors, cardiac hypertrophy, and severity of coronary artery disease (CAD) were assessed in both groups. Family history of SCD (odds ratio 1.5, 95% CI 1.0 to 2.2, p=0.03), male gender (odds ratio 1.8, 95% CI 1.3 to 2.4, p<0.001), current smoking (odds ratio 2.0, 95% CI 1.5 to 2.6, p<0.001), cardiac hypertrophy (odds ratio 3.0, 95% CI 2.3 to 3.9, p<0.001) and 3-vessel CAD (odds ratio 5.4, 95% CI 3.6 to 8.2, p<0.001) were more common among the victims of SCD as compared to survivors of AMI. On the contrary, history of hypercholesterolemia (p<0.001) was less common among the SCD victims. There was a cumulative increase of risk of being a SCD victim vs. AMI survivor when more than one risk factor was present, the odds ratio being 44.3 (95% CI 8.0 to 246.7) in a current male smoker with a family history of SCD and cardiac hypertrophy. When 3-vessel CAD was added to the combined risk score, all subjects (7% of the SCD victims) were in the group of SCD giving a 100% sensitivity and specificity, respectively, in differentiating between the SCD victims and AMI survivors. Conclusions. There are specific features that differentiate the victims of SCD from survivors of an acute coronary event. Clustering of several variables, such as family history of SCD, smoking, cardiac hypertrophy, and 3-vessel CAD indicate a very high risk of SCD.

Abstract 4069: Refusal to Seek Medical Care for Symptoms Prior to Sudden Cardiac Death

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Anne G Rosenfeld ◽  
Mohamud Daya ◽  
Vivian Christensen ◽  
Rebecca Rawson
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Sudden Cardiac Death ◽  
Medical Care ◽  
Cardiac Death ◽  
Significant Proportion ◽  
Heart Association ◽  
Qualitative Description ◽  
Cardiac Symptoms ◽  
History Of

Sudden cardiac death (SCD) is accompanied by preceding symptoms in a significant proportion of victims, with a median duration of up to 2 hours in some cases. The purpose of this study was to describe the characteristics of SCD victims with heralding symptoms who refused medical care. We conducted a secondary data analysis of interview data from witnesses of 99 cases of out-of-hospital presumed myocardial infarction death with known symptoms. Qualitative description methods were used to analyze qualitative data. Logistic regression was used to test the influence of type of symptoms (chest pain vs. non-chest pain), history of heart disease, and age on refusal of medical care. Categorization as refusal of medical care required conversation with someone where refusal was expressed verbally by the victim. There were 19 cases (19%) that refused medical care; their mean age was 72. The majority were male (16/19, 84%). Fifteen cases involved persistent refusal, defined as refusing care until collapse (range of <15 minutes to 60 hours). Four victims initially refused care and then permitted access to medical care. The suggestion for seeking medical care came from someone else in all but one case, and usually included multiple attempts. The care options offered but refused included calling 911 or a doctor, as well as going to the hospital, emergency department or a doctor’s office. Reasons for refusal of medical care (more than one reason in some cases) included stating the symptoms were due to something not urgent (n=10), other obligations (n=3), expressed dislike of hospitals or doctors (n=4), or recent medical reassurance of health status (n=7). Controlling for age, victims with chest pain vs. non-chest pain symptoms were more likely (OR = 3.56, p = .036, 95% CI = 1.09 –11.66) to refuse medical care and those with a history of heart disease were less likely (OR = .16, p = .004, 95% CI = .05–.55) to refuse medical care. Patients with chest pain and no history of heart disease are more likely to refuse advice to seek medical care. Public health messages about how to respond to cardiac symptoms should include strategies to overcome the reasons people refuse medical care. This research has received full or partial funding support from the American Heart Association, AHA Pacific/Mountain Affiliate (Alaska, Arizona, Colorado, Hawaii, Idaho, Montana, Oregon, Washington & Wyoming).

scholarly journals A comprehensive work up of various ventricular tachy-arrhythmias in relation to the underling cardiac disorder / status

2017 ◽  
Vol 5 (10) ◽  
pp. 4292
Author(s):  
Tusharkanti Patra ◽  
Prashant Kumar ◽  
Somnath Mukherjee ◽  
Anurag Passi ◽  
S. K. Saidul Islam
Keyword(s):  
Heart Disease ◽  
Family History ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Heart Diseases ◽  
Ventricular Tachyarrhythmia ◽  
Triple Vessel Disease ◽  
History Of ◽  
Ventricular Tachy ◽  
Work Up

Background: Main objective of the study is details work up of the patients of ventricular tachy-arrhythmias and to find out its association with any structural heart disease.Methods: This institution based observational study was conducted in patients of documented sustained VT (ventricular tachycardia) with consecutive 102 patients.Results: The mean age of the VT patients was 56.7 years and the number of male patients were 70 (69%). In our study, among 102 patients 45 patients were diabetic, 64 patients were hypertensive, 30 patients were current smoker, family history of heart disease was present in 25 patients and family history of SCD (sudden cardiac death) was present in 5 patients. Among the patients who presented with symptoms of ventricular tachy arrhythmia, 25 patients had EF (ejection fraction) above 40%, 36 had EF between 31 to 40% and only 2 had EF below 30%. CAG (coronary angiography) done in 98 patients and 16 had normal coronaries. 20, 16 and 46 patients had single, double and triple vessel disease respectively. 80 patients had coronary heart disease (78%), 20 patients among them had acute ischemic events and 60 had chronic ischemic disease. 12 patients didn’t have any structural heart disease.Conclusions: Ischemic heart disease, acute or chronic, is the most common causes of ventricular tachyarrhythmia. male sex, diabetes mellitus, hypertension, smoking, family history of heart diseases or sudden cardiac death being the risk factors of coronary artery disease are also predisposing factors of ventricular tachyarrhythmia.

scholarly journals Description of Ventricular Arrhythmia after Taking Herbal Medicines in Middle-Aged Couples

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Mohammad Ali Zakeri ◽  
Vahid Mohammadi ◽  
Gholamreza Bazmandegan ◽  
Maryam Zakeri
Keyword(s):  
Cardiac Arrest ◽  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Sudden Cardiac Death ◽  
Ventricular Arrhythmia ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Herbal Medicines ◽  
Medicinal Herbs ◽  
History Of

Medicinal herbs and some derivatives have been used in the treatment of heart disease which is rarely responsible for ventricular arrhythmias and cardiac arrest. Ventricular tachycardia (VT) increases the risk of sudden cardiac death (SCD). However, only a few reports are available about the cardiac ventricular arrhythmia followed by taking herbal medicines. We present two patients (a couple) without a history of heart disease who referred to the hospital with ventricular arrhythmia.

Morbidity and Associated Sudden Death in Sickle Cell Disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2348-2348 ◽  
Author(s):  
Courtney Fitzhugh ◽  
Naudia Lauder ◽  
Jude Jonassaint ◽  
F. Roosevelt Gilliam ◽  
Marilyn J. Telen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
Sudden Cardiac Death ◽  
Sickle Cell Disease ◽  
Sudden Death ◽  
Cardiac Death ◽  
Causes Of Death ◽  
Left Ventricular ◽  
Acute Chest Syndrome ◽  
Cell Disease

Abstract Sickle cell disease (SCD) is associated with extensive morbidity and early mortality. Although the most common known causes of death for adults with SCD are acute chest syndrome, stroke, pulmonary hypertension, and infection, the direct cause of death is frequently undefined, and patients often die suddenly. In one series of 306 autopsies of patients with SCD, death was sudden and unexpected in 41% of cases (Manci et al 2003). The incidence of sudden cardiac death and associated risk factors in patients with SCD are currently unknown. We sought to identify risk factors for mortality in adult subjects with SCD and to evaluate the frequency, risk factors and co-morbidities of sudden death in this population. We identified 43 adult patients (21 males and 22 females) who had been followed in the SCD clinic at Duke University Medical Center (DUMC) and who had died between January 2000 and April 2005. Clinical characteristics and laboratory data were evaluated by retrospective chart review. Findings were compared with data from patients who were actively followed during the same time period and were still living (n=197). The average age at death was 44.3 years (range 21–83). The most frequently listed causes of death were liver failure, multiorgan failure, stroke, and pulseless electrical activity (PEA) arrest. The etiology of death in 29 of the 43 patients was unknown. Recognized risk factors for sudden cardiac death, including ejection fraction (52% vs. 54%), left ventricular size (LVIDd 5.0cm vs. 5.2cm), and fractional shortening (0.30 ±0.01 vs. 0.33± 0.01) as measured by echocardiogram, were not significantly different between deceased and living patients, respectively. Left ventricular hypertrophy (LVH), defined as a left ventricular mass index ≥134 and ≥110 g/m2 for men and women, was reported in 41% of the deceased patients but in only 31% of living subjects. Of the 12 deceased patients with LVH, 7 had mild LVH and 5 had moderate-severe LVH. The average tricuspid regurgitant jet velocity measured by Doppler echocardiogram was higher in patients who died compared to those who were still living (3.72 vs. 2.17 m/s). The most frequently documented cardiopulmonary complications among deceased patients were acute chest syndrome/pneumonia, pulmonary hypertension, systemic hypertension, and stroke. Identified risk factors associated with premature death were pulmonary hypertension (p&lt;0.0001) and severe anemia (p=0.002). Baseline WBC count and oxygen saturation were not significantly different between deceased and living patients. We conclude that despite improved medical care and therapeutic advances, adult patients with SCD continue to experience a high rate of premature mortality, and a significant number of patients die suddenly. The etiology of death is frequently multifactorial and poorly defined. Identifying the variables contributing to sudden death in SCD patients may enable clinicians to successfully intervene and prevent early demise.

scholarly journals Comparison of Family History of Sudden Cardiac Death in Nonischemic and Ischemic Heart Disease

2012 ◽  
Vol 5 (4) ◽  
pp. 757-761 ◽  
Author(s):  
Eeva Hookana ◽  
M. Juhani Junttila ◽  
Kari S. Kaikkonen ◽  
Olavi Ukkola ◽  
Y. Antero Kesäniemi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Family History ◽  
Sudden Cardiac Death ◽  
Ischemic Heart Disease ◽  
Cardiac Death ◽  
Ischemic Heart ◽  
History Of

scholarly journals Pattern of mortality in sudden death: an autopsy study

2017 ◽  
Vol 4 (3) ◽  
pp. 792
Author(s):  
Pinkal A. Shah ◽  
Bhavna Gamit ◽  
Chintan Dalal ◽  
Pinal Shah
Keyword(s):  
Risk Factors ◽  
Sudden Death ◽  
Wide Spectrum ◽  
Tertiary Care ◽  
Care Hospital ◽  
Autopsy Study ◽  
Multiple Risk Factors ◽  
Multiplicative Effect ◽  
Male Preponderance ◽  
Symptom Complex

Background: Sudden death has plagued mankind from time Immemorial. Clinical presentations include wide spectrum from symptom complex to completely asymptomatic. Sudden cardiac death in many cases, ‘first and only symptom. The high incidence, sudden, unexpected nature, combining with the low successful rate of resuscitation, make sudden cardiac deaths a major unsolved problem. Therefore, this study was conducted to illustrate etiolopathology, risk factors and triggers of sudden death with the expectation to provide new insight in epidemiological aspects of sudden death, which will help in care of patients, and prevention of premature cardiac deaths.Methods: A study of 50 cases of sudden death was conducted at tertiary care hospital. After evaluating detailed history from the family members, autopsy has been performed to find out cause of sudden death.Results: Principal culprit of sudden death is cardiovascular disease. Highest numbers of sudden death are in middle age group and having male preponderance might be due to presence of multiple risk factors, which have added or multiplicative effect. There are few autopsy negative cases, which are unexplained sudden death.Conclusions: Sudden and unexpected deaths in young population frequently become the subject of pathologic investigation to determine the cause of death. 

Abstract P113: Underestimation Of Sudden Death Due To Restrictive Sudden Cardiac Death Criteria

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Caroline Tybout ◽  
Susan K Keen ◽  
Sanjana Thota ◽  
Albert Chang ◽  
Feng-Chang Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Sudden Death ◽  
Cardiac Death ◽  
Missing Values ◽  
Failure Time ◽  
World Health ◽  
Categorical Variables ◽  
Case Definitions ◽  
Effective Prevention

Background: Efforts to prevent sudden death may be hampered by restrictive case definitions impairing accurate estimates of incidence and risk factors of sudden death. Sudden cardiac death (SCD) definitions include requirements for presence of comorbid coronary artery disease (CAD) and various time criteria since onset of symptoms or when victims were last seen well. We compared prevalence of three SCD definitions within a registry of all-cause natural, sudden deaths. Hypothesis: We assessed the hypothesis that the restrictive criteria of three SCD definitions underestimate sudden death and exclude populations with increased medical comorbidities. Methods: Using a registry of 399 adjudicated sudden death cases among adults aged 18-64 in Wake County, North Carolina in 2013-2015, we included 271 cases after excluding for missing values, chronic kidney disease, or heart failure. Time since last seen alive was classified as less than one hour or 24 hours from scene reports. Presence of CAD and co-morbidities were defined from clinical or autopsy records. Prevalence of SCD using criteria defined by Atherosclerosis Risk in Communities (ARIC), the World Health Organization (WHO), and the Oregon Sudden Unexpected Death (SUD) registry were calculated. Prevalence of SCD risk factors were calculated for the 3 SCD subgroups and compared to the original 271 victims using two-sample t-test and Fisher’s exact test for continuous and categorical variables. Results: Among the 271 cases, criteria were met for the three SCD definitions for n (%): ARIC 28 (10%), WHO 54 (20%), and SUD 90 (33%) (Table 1). ARIC and WHO-defined SCD cases were younger than the original 271 cases. There were no significant differences in sociodemographic and clinical factors by any SCD group compared to the original 271 cases. Conclusion: Restrictive SCD definitions that require the presence of CAD or a specific time frame of identification of death underestimate the incidence of sudden death and hinder effective prevention efforts for sudden death.

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