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Sudden Death Due to Thoracic Aortic Dissection in Young People: A Multicenter Forensic Study.
Benito Morentin Campillo1, Pilar Molina Aguilar2, Ana Monzó Blasco2
1Servicio de Patología Forense, Instituto Vasco de Medicina Legal y Ciencias Forenses, Bilbao, Vizcaya, Spain.
Revista Espanola De Cardiologia (English Ed.)
|September 5, 2018
Summary
Sudden death from thoracic aortic dissection (TAD) is rare in young individuals. Congenital heart disease, familial history, and cocaine use are key risk factors, necessitating TAD consideration for chest pain in young males.
Area of Science:
- Cardiology
- Forensic Pathology
- Public Health
Background:
- Thoracic aortic dissection (TAD) is uncommon in younger populations.
- TAD characteristics in young individuals differ significantly from adults.
- Sudden death in youth necessitates understanding underlying causes like TAD.
Purpose of the Study:
- To investigate the clinical and pathological features of sudden death attributed to TAD in individuals aged 1-35 years.
- To determine the incidence and risk factors associated with TAD-related sudden death in young people.
- To inform diagnostic considerations for chest pain in the young population.
Main Methods:
- A multicenter, population-based study utilizing forensic autopsy data.
- Data collected from Biscay (1991-2016), Valencia (2000-2016), and Seville (2004-2016).
- Analysis of demographic, clinical, and pathological findings in cases of sudden death due to TAD.
Main Results:
- Identified 35 cases of sudden death from TAD (80% males, mean age 29±5 years).
- Incidence of TAD-related sudden death was 0.09 per 100,000 inhabitants/year.
- Major risk factors included congenital heart disease (n=16), familial TAD suspicion (n=11), and cocaine use (n=6). Autopsy revealed cystic medial degeneration (n=27) and aortic dilatation (n=21).
Conclusions:
- Sudden death due to TAD is infrequent in the young population.
- Congenital heart disease, familial TAD, and cocaine use are primary risk factors.
- TAD should be considered in the differential diagnosis of chest pain among young males, particularly those with identified risk factors.
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