A review of sudden unexpected death in the young in British Columbia

Lim, Zaneta; Gibbs, Karen; Potts, James E.; Sanatani, Shubhayan

doi:10.1016/s0828-282x(10)70329-9

Cited by 32 publications

(13 citation statements)

References 15 publications

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“…In addition to genomic effects, sex steroids also have acute, nongenomic effects, especially in the vasculature where both estrogen and androgens cause acute vasodilation (17). …”

Section: Sex Steroids and Receptorsmentioning

confidence: 99%

Sex and gender differences in control of blood pressure

2013

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In recent years the interest in studying the impact of sex steroids and gender on the regulation of blood pressure and cardiovascular disease has been growing. Women are protected from most cardiovascular events compared to men, until after menopause, and postmenopausal women are at increased risk of cardiovascular complications compared to premenopausal women. The pathophysiological mechanisms have not been elucidated but are not likely as simple as the presence or absence of estrogens, since hormone replacement therapy in elderly women in the Women’s Health Initiative or the HERS Trials did not provide primary or secondary prevention against cardiovascular events. Men are also thought to be at risk for cardiovascular disease at earlier ages than women, and these mechanisms too are not likely to be as simple as the presence of testosterone since androgen levels drop in men with cardiovascular and other chronic diseases. In fact, many investigators now believe that it is the reduction in androgen levels that frequently accompanies chronic disease and may exacerbate cardiovascular disease in men. In this review the roles of sex steroids and gender in mediating or protecting against hypertension and cardiovascular disease will be discussed.

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“…In addition to genomic effects, sex steroids also have acute, nongenomic effects, especially in the vasculature where both estrogen and androgens cause acute vasodilation (17). …”

Section: Sex Steroids and Receptorsmentioning

confidence: 99%

Sex and gender differences in control of blood pressure

2013

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“…However, most textbooks suggest CiRCA by tradition without revising views on cases initially founded on this diagnosis. Our systematic review has shown that CiRCA is a diagnosis by exclusion that requires a thorough investigation including histopathological, metabolic, genetic [39], and toxicological analysis to rule out other mechanism of sudden unexplained death or identify carotid bifurcation stimulation as a contributory factor (Table 3) [40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

“…Circumstances of death and the known duration and time sequence of events are therefore essential to help experts distinguish CiRCA from other mechanism such as commotio cordis [44,45], contention gagging, vagal mediated cardiac arrest [46], phrenic paralysis [47], or other causes of sudden death such as arrhythmias resulting from channelopathies or excited delirium alone (Table 3) [40][41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Death caused by cardioinhibitory reflex cardiac arrest—A systematic review of cases

Schrag

Vaucher

Bollmann

et al. 2011

Forensic Science International

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“…30 Despite this, a general lack of referrals has been well documented. 31 A possible cause for this disparity is a knowledge gap among medical professionals concerning inherited arrhythmia substrates, presumably stemming from a deficit in the education that medical students receive throughout their training.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Assessing the knowledge of sudden unexpected death in the young among Canadian medical students and recent graduates: a cross-sectional study

et al. 2012

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ObjectiveTo determine the level of knowledge concerning Sudden Unexpected Death in the Young (SUDY) among Canadian medical students and recent graduates (≤5 years after graduating).DesignA cross-sectional study was conducted by distributing a standardised, multiple choice, online questionnaire which assessed basic knowledge of SUDY.SettingCanadian medical schools and residency training programmes.Participants614 Canadian medical students (in either their penultimate or final year) and recent graduates (≤5 years after graduating) completed an anonymous online questionnaire.Primary and secondary outcome measuresThe level of knowledge regarding molecular aetiology, clinical presentation, pharmacological management and modes of inheritance of six of the commonest conditions causing SUDY, including hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), long QT syndrome (LQT) and Wolff-Parkinson White syndrome (WPW), were compared between medical students and recent graduates. Questions were broken down into basic knowledge and advanced categories and analysed as a secondary outcome measure.ResultsOf 614 responses, approximately two-thirds were answered by recent graduates, who generally scored 10% higher on all subject categories than medical students. Overall, questions regarding HCM were best answered (40%), followed by WPW syndrome (32%), CPVT (30%), ARVC (23%), Brugada syndrome (21%) and LQT syndrome (17%). Questions categorised as basic knowledge were answered 30% and 39% correctly in medical student and recent graduate groups, respectively, and those in the advanced category were answered 20% and 25% correctly.ConclusionsSurvey respondents fared poorly when answering questions regarding SUDY, which may be a reflection of inadequate medical education regarding these disorders. Standardised teaching regarding SUDY needs to occupy a stronger focus in Canadian medical curricula in order to prevent more unnecessary deaths by these syndromes in the future.

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A review of sudden unexpected death in the young in British Columbia

Cited by 32 publications

References 15 publications

Sex and gender differences in control of blood pressure

Sex and gender differences in control of blood pressure

Death caused by cardioinhibitory reflex cardiac arrest—A systematic review of cases

Assessing the knowledge of sudden unexpected death in the young among Canadian medical students and recent graduates: a cross-sectional study

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