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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

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Published on: December 28, 2012

Sudden cardiac death with apparently normal heart.

S S Chugh1, K L Kelly, J L Titus

  • 1Jesse E. Edwards Registry of Cardiovascular Disease, United Hospital, St Paul, MN, USA. chughs@ohsu.edu

Circulation
|August 10, 2000
PubMed
Summary

Sudden cardiac death (SCD) in individuals with seemingly normal hearts is often the first sign of underlying disease. Autopsy and clinical history reviews helped identify potential causes in over half of these cases.

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Area of Science:

  • Cardiology
  • Forensic Pathology
  • Medical Autopsy

Background:

  • Sudden cardiac death (SCD) in individuals with structurally normal hearts remains poorly understood.
  • Clinical investigations in survivors may not definitively confirm cardiac normalcy.
  • Autopsy series offer a unique method to verify heart structure before clinical history review.

Purpose of the Study:

  • To investigate the mechanisms of SCD in individuals with structurally normal hearts.
  • To correlate autopsy findings with clinical histories in SCD cases.

Main Methods:

  • Reexamination of archived hearts from a 13-year SCD series.
  • Detailed review of clinical history and circumstances of death for cases with structurally normal hearts.
  • Analysis of serum for substances and ECGs for abnormalities.

Main Results:

  • Out of 270 SCD cases, only 14 (5%) had structurally normal hearts.
  • In 50% of structurally normal hearts, SCD was the initial manifestation of disease.
  • Substances associated with SCD were found in 6 cases; 2 ECGs showed preexcitation.

Conclusions:

  • SCD can be the first presentation of disease in individuals with structurally normal hearts.
  • Combining autopsy examination with clinical history review is effective in identifying potential SCD mechanisms.