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[Sudden death caused by atheromatous coronary disease in the young]
B Morentin1, M F Paz Suárez-Mier, B Aguilera
1Instituto Anatómico Forense de Bilbao, Madrid, Spain. morentin.b@aju.ej-gv.es
Insights
Atheromatous coronary disease (ACD) caused 18% of sudden deaths (SD) in young males aged 27-35. This study highlights the critical need for primary prevention and rapid emergency response for ACD-related sudden cardiac death.
Area of Science:
- Cardiovascular pathology
- Forensic medicine
- Public health
Context:
- Sudden death (SD) due to Atheromatous coronary disease (ACD) is a significant concern in adults.
- Limited research exists on ACD-related SD in individuals under 35 years old.
- This study addresses the incidence and characteristics of ACD as a cause of death in young populations.
Purpose:
- To analyze the incidence of Atheromatous coronary disease (ACD) as a cause of sudden death (SD) in young individuals (1-35 years).
- To investigate the clinical and pathological features of ACD-related SD in this demographic.
- To identify risk factors and circumstances surrounding ACD-related SD in young males.
Summary:
- Atheromatous coronary disease (ACD) accounted for 19 out of 107 sudden deaths (SD) (18%) in individuals aged 1-35 years.
- All ACD-related SD cases occurred in males aged 27-35, with an incidence of 3.7/100,000/year in males aged 30-35.
- Pathological findings included coronary thrombosis, myocardial necrosis, old ischemic damage, and cardiac hypertrophy; ACD was often the first manifestation of the disease.
Impact:
- ACD is a critical cause of sudden death in young males, often presenting as the initial sign of the disease.
- The difficulty in identifying at-risk individuals and the rapid onset of death underscore the importance of primary prevention.
- Enhanced emergency response and public CPR education are crucial for reducing mortality from Atheromatous coronary disease.
Introduction And Objectives:
Atheromatous coronary disease (ACD) is the most frequent cause of sudden death (SD) in adults. Few studies have focused in SD due to ACD in those patients under 35 years old. The aim of this study is to analyze the incidence, and clinical and pathological characteristics of ACD as a cause of death in young people.
Material And Methods:
We reviewed all SD cases in people from 1-35 years old which occurred in Bizkaia and in which there was a legal-medical autopsy from 1991 to 1998. A complete autopsy was performed in each case. SD due to ACD were analyzed, including pathological antecedents.
Results:
19 out of 107 SD (18%) occurred by ACD. All of them were males from 27 to 35 years of age. According to the male population from 30 to 35 years, the incidence was 3.7/100,000/year. In two patients ACD was diagnosed before death. Coronary risk factors were obtained in 10 cases and prodromal symptoms were described in 5 (chest pain in 4). In 79% death occurred during routine activity. None of the 19 patients arrived alive to hospital. In 6 cases multiple coronary disease was observed; coronary thrombosis in 8; recent acute ischemic myocardial necrosis in 4 and old ischemic damage in 7. 18 cases showed cardiac hypertrophy.
Conclusions:
ACD is an important cause of SD in young males, frequently being the first manifestation of the disease. As identification of groups at risk is so difficult and death occurs so quickly, primary prevention of ACD, rapid intervention of emergency services and educational programs in cardiopulmonar resuscitation for normal population are fundamental in reducing the mortality.