Coronary arterial vessels in relation to sudden cardiac death: a review

Area of Science:

• Cardiovascular Medicine
• Pathology
• Medical Research

Background:

• Sudden cardiac death (SCD) is a critical clinical concern with diverse underlying causes.
• Understanding the specific coronary vascular factors contributing to SCD is essential for prevention and diagnosis.

Purpose of the Study:

• To conduct a comprehensive literature review on coronary vascular factors associated with sudden cardiac death.
• To synthesize current knowledge on the etiology of SCD from published articles and case reports.

Main Methods:

• Systematic electronic search of major databases (Medline, Internet) for relevant articles and case reports.
• Hand scanning of literature for comprehensive coverage of sudden cardiac death.
• Comparative analysis of studies to identify common themes and consensus opinions.

Main Results:

• The etiology of SCD is multifactorial, involving coronary atherosclerosis, hypoplastic coronary vessels, and coronary artery dissections.
• Congenital coronary anomalies and muscle bridges, previously considered benign, are increasingly recognized as causes of SCD.
• The role of coronary arterial thrombi remains controversial, and the protective effect of exercise is questioned due to SCD reports in athletes.

Conclusions:

• Sudden cardiac death cases are rising, necessitating broader diagnostic considerations.
• Autopsy protocols for sudden death investigations should routinely include examination for atherosclerosis, congenital coronary anomalies, coronary vessel tunneling, and hypoplastic vessels.
• These findings should be evaluated alongside valvular and myocardial disorders for a complete understanding of SCD.