Significant coincidental findings at autopsy in accidental childhood death

Three cases of unexpected childhood death are presented in which significant potentially life-threatening lesions were identified that were considered coincidental to the cause of death. Two children died of accidental asphyxia and one died of potassium fluoride poisoning. Abnormalities identified at autopsy included established myocarditis (two cases) and cardiac rhabdomyomas (one case). In one case a previously unsuspected abnormal familial karyotype was found. These cases emphasize the value of complete autopsy investigations in all types of sudden childhood death, even when the cause of death appears obvious; they also demonstrate that potentially lethal organic disease may be asymptomatic in childhood and unrelated to death.