Sudden cardiac death in 15–35‐year olds in Sweden during 1992–99

Abstract

Objectives. To study the incidence, pathogenesis and symptoms preceding sudden cardiovascular death amongst 15-35-year olds without substance abuse in Sweden during 1992-99. Design. This was a register study of a national database of forensic medicine, Rattsbase. Clinical details were obtained from forensic, police and medical records and from interviews with family members. Setting. The whole nation of Sweden. Subjects. Individuals having suffered a sudden cardiac death. Results. We found 181 cases of sudden cardiovascular death in a nationwide database, Rattsbase, in 15-35-year olds, of which 132 (73%) were male and 49 (27%) were female, and a rather stable incidence of 0.93 per 100 000 per year. Preceding symptoms were seen in half of the cases. The most common forensic diagnoses were: no structural abnormality (21.0%), coronary atherosclerosis (17.7%), dilated cardiomyopathy (12.2%), hypertrophic cardiomyopathy (10.5%) and myocarditis (10.5%). Conclusion. Sudden cardiovascular death was uncommon in the young, but the incidence was not decreasing. Postmortem diagnoses were often difficult to establish. There was a high frequency of structurally normal hearts. Because premortal cardiac-related symptoms are relatively common and treatment methods are developing, we should learn to recognize early symptoms of heart disease. To identify individuals at risk, further studies of preceding symptoms, life-style factors and electrocardiogram (ECG) changes are needed.

Effectiveness of Screening for Life-Threatening Chest Pain in Children

“…The estimated incidence of pediatric sudden cardiac death ranges from 0.6 to 6.2 deaths per 100 000, with hypertrophic cardiomyopathy, coronary artery anomalies, and malignant arrhythmias being responsible for the majority of cases and deaths being more common during athletic activities. [16][17][18][19][20][21][22][23][24] Determining which children are at risk for sudden death is challenging, particularly because there often are no preceding symptoms.…”

Epidemiology of Sudden Cardiac Death: Clinical and Research Implications

“…In the Minnesota study, there was a family history of sudden cardiac death in only 3 of 18 cases (17%) -indicating that family history may be a reliable predictor of clinical risk for only a minority of SUD cases in the general population. Similar to overall sudden cardiac death, SUD seems to be more common in males (mean age range 24-32 years), with published autopsy series reporting 63-68% of affected subjects as males (23,24). However, given the lower overall sudden cardiac death rates in females, SUD cases are likely to comprise a higher proportion of sudden cardiac death cases in women compared to men, particularly among younger adults.…”

“…Subjects with sudden unexplained death have also been termed as having idiopathic ventricular fibrillation or sudden arrhythmic death syndromes (6,9,10,15). It is possible that some proportion of these patients had heritable monogenic disorders such as the long QT syndrome, Brugada syndrome and catecholaminergic polymorphic ventricular tachycardia (6,(20)(21)(22)(23)(24). Defects in the SCN5A gene, also causing long QT syndrome 3 and the Brugada syndrome, have been reported in some cases of the sudden infant death syndrome (25,26).…”

Autonomic Nervous Function and Arrhythmias in Patients with Acute Viral Myocarditis during a 6-Month Follow-Up Period

“…Although the initial stages of this disorder apparently result from direct cytopathic effects on the atrial and ventricular myocardium, later stages of progressive decompensation may result from immune-mediated myocyte destruction [13]. The increasing tendency of the incidence of viral myocarditis and the severity of arrhythmias of the disease should be readdressed clinically [14,15,16,17,18]. …”