[Autopsies are essential for a better knowledge and prevention of sudden cardiac death]

Area of Science:

• Forensic Pathology
• Cardiology
• Genetics

Background:

• Sudden cardiac death (SCD) affects 30,000-50,000 individuals annually in France.
• While atherosclerotic coronary disease causes most SCD in the general population, younger individuals (<35 years) experience diverse causes, including genetic factors.
• A comprehensive, multidisciplinary strategy is essential for understanding and preventing SCD.

Purpose of the Study:

• To examine various autopsy and complementary investigation aspects for SCD.
• To highlight the importance of a multidisciplinary approach through case examples.
• To emphasize the role of molecular autopsy in identifying genetic causes of SCD in young individuals.

Main Methods:

• Review of autopsy procedures, distinguishing between medicolegal and medical autopsies.
• Discussion of complementary investigations: histopathology, toxicology, biochemistry, genetics, and virology.
• Analysis of six illustrative cases demonstrating the value of a multidisciplinary approach.

Main Results:

• Medicolegal autopsies, performed by non-pathologists, may have limited analyses requested by judicial authorities, potentially leaving causes of death uncertain.
• Medical autopsies, conducted by pathologists with family consent, allow for comprehensive analyses essential for precise cause-of-death determination.
• Molecular autopsy, alongside traditional methods, is vital for uncovering genetic etiologies of SCD in younger populations.

Conclusions:

• A multidisciplinary approach integrating various investigative techniques is critical for accurate SCD diagnosis.
• Medical autopsies with comprehensive testing, including molecular autopsy, are superior for determining the cause of death, especially in young individuals.
• Identifying specific causes, particularly genetic ones, through thorough autopsy is key to preventing future sudden cardiac deaths.