CAUSES OF SUDDEN CARDIAC DEATH- AN AUTOPSY STUDY

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CAUSES OF SUDDEN CARDIAC DEATH- AN AUTOPSY STUDY

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 95

Abstract

BACKGROUND Sudden death is defined in many different ways by different authorities. Some believe that the term should be restricted to those cases wherein the time of onset of symptoms to ‘collapse and death’, is instantaneous or within minutes. In forensic parlours,“sudden death” is defined in a little different way as an ‘apparently normal person, who is not known to be suffering from any illness, suddenly falls ill and dies within 24 hours of onset of the disease symptoms. In short ‘sudden death’ is restricted to natural causes only. Sudden unexpected natural death cases in adults are steadily increasing world over and is an issue of great concern for medical professionals. Sudden death especially of a young and apparently healthy adult is not only shocking but also has profound impact on the psyche of the society. Most of the sudden deaths occur outside the hospitals and in the emergency rooms, reflecting their unexpected character. As per the Indian law, all cases of sudden unexpected deaths or deaths in which the cause of death was not diagnosed or ascertained by the doctor, should be subjected to medico-legal autopsy. Objectives1. To find out the age and sex distribution of victims who died of ‘sudden cardiac death’. 2. To find out the aetiological factors associated ‘with sudden cardiac death’. MATERIALS AND METHODS Study design- Retrospective case series study. Sample size- 230 cases of sudden natural death brought for autopsy. Source population- All cases of sudden natural death brought for autopsy to the Department of Forensic Medicine Government Medical College, Kottayam during the year 2016. Inclusion Criteria- All autopsies in which death was due to sudden natural death were included in the study. Exclusion criteria1. All unidentified bodies. 2. All decomposed bodies. Data collection- Baseline data like age, sex, history of any previous illness, and a brief history of the case were collected from the requisition provided by the investigating officer. Details of the post-mortem findings were collected from the post-mortem certificate. Analysis- Data collected was entered in MS-Excel and analysed using SPSS version 15. RESULTS Among the 230 cases of sudden natural death, 155 (67.4%) were due to occlusive coronary artery disease, a natural disease of the heart. The next most common cause was Pneumonia, 19 (8.3%) cases; followed by Cerebrovascular disease, 17 (7.4%) cases; Pulmonary tuberculosis, 9 cases (3.9%); Chronic obstructive pulmonary disease, 6 (2.6%) cases; Ruptured oesophageal varices, 5 (2.2%) cases; and septicaemia 4 (1.7%) cases. CONCLUSION Occlusive coronary artery disease is the most common cause of sudden natural death (67.4%). The age group most commonly involved in sudden cardiac death was 51-60 years (27.7%)followed by 61-70 years (21.3%) and 41-50 years (19.4%). 41 to 70 years age group is the most vulnerable group (68.4%) to be affected by sudden cardiac death. Among those involved in sudden cardiac death, 83.8% were males. Atherosclerosis is the dominant cause of cardiovascular disease including myocardial infarction. The most common coronary artery affected by atherosclerosis was the anterior descending branch of the left coronary artery (93.5%). The right coronary artery was affected in 65.8%. Coronary thrombosis is the reason for most cases of sudden cardiac death.

Authors and Affiliations

Rajeev V. M, Santhosh Joy, Ravi Kumar K

Keywords

EP ID EP280625
DOI 10.14260/jemds/2017/1518
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