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Sudden death after a cold drink: case report.

A P Burke1, M N Afzal, D S Barnett

  • 1Department of Cardiovascular Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

The American Journal of Forensic Medicine and Pathology
|April 20, 1999
PubMed
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Sudden cardiac death in a 12-year-old boy was linked to a frozen drink and an undiagnosed heart tumor. Cold liquid ingestion may trigger fatal arrhythmias in those with underlying cardiac conditions.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Forensic Pathology

Background:

  • Sudden cardiac death (SCD) in children is a critical concern.
  • Cardiac rhabdomyomas are rare pediatric tumors, often associated with genetic syndromes.
  • Cold liquid ingestion can trigger vasovagal responses, potentially leading to syncope.

Observation:

  • A 12-year-old boy experienced sudden cardiac death shortly after rapidly consuming a frozen slurry drink.
  • Autopsy revealed an undiagnosed cardiac rhabdomyoma with significant myocardial scarring as the primary cause of death.
  • The terminal cardiac arrhythmia was likely precipitated by bradycardia from a cold-induced vasovagal reflex.

Findings:

  • This case highlights a potential link between rapid cold liquid ingestion and fatal cardiac arrhythmias.

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  • Undiagnosed cardiac rhabdomyoma, even without significant structural compromise, can be a substrate for lethal arrhythmias.
  • Cold-induced vasovagal response may act as a trigger in susceptible individuals with underlying cardiac pathology.

    • Implications:

    • Clinicians should consider the potential arrhythmogenic effects of rapid cold liquid ingestion in pediatric patients, especially those with known or suspected heart disease.
    • Screening for underlying cardiac conditions may be warranted in cases of unexplained syncope or sudden death potentially related to cold stimuli.
    • This case underscores the importance of a comprehensive autopsy in determining the cause of sudden cardiac death in young individuals.