Sudden death due to aortic dissection: autopsy study (2011-2023)

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine
• Epidemiology

Background:

• Aortic dissection is a critical cardiovascular emergency with a high risk of sudden death.
• Understanding the epidemiological and death-related characteristics of aortic dissection is crucial for public health.

Purpose of the Study:

• To investigate the epidemiological and thanatological features of sudden deaths attributed to aortic dissection.
• To identify risk factors and common presentations associated with fatal aortic dissections.

Main Methods:

• Retrospective descriptive study analyzing autopsy-confirmed cases from 2011 to 2023.
• Data collection included demographics, medical history (hypertension, Marfan syndrome), symptoms, affected aortic segments, cause of death, and circumstances of death.

Main Results:

• Aortic dissection represented 3.28% of all sudden deaths, with a mean age of 54.7 years and a significant male predominance (M/F ratio of 9).
• Hypertension (37.5%) and Marfan syndrome (10%, <40 years) were key comorbidities. Chest pain (25%) and discomfort (30%) were reported symptoms. The ascending aorta was involved in 60% of cases.
• Cardiac tamponade (62.5%) was the primary cause of death, predominantly in type A dissections (92%). Deaths often occurred in the morning, with 48% of individuals found at home.

Conclusions:

• Sudden death from aortic dissection frequently occurs without a prior diagnosis.
• The condition disproportionately affects a relatively young, predominantly male demographic.
• Autopsy findings are essential for enhancing early detection strategies and emergency management protocols for aortic dissection.