Author(s): Drory Y, Turetz Y, Hiss Y, Lev B, Fisman EZ,
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Abstract This study retrospectively assesses the underlying causes of sudden unexpected death and the occurrence of prodromal symptoms in 162 subjects (aged 9 to 39 years) over a 10-year period (1976 to 1985). Underlying cardiac diseases accounted for sudden death in 73\% and noncardiac causes in 15\% of subjects. In 12\% of subjects, the causes were unidentifiable. Myocarditis (22\%), hypertrophic cardiomyopathy (22\%) and conduction system abnormalities (13\%) were the major causes in 32 subjects aged less than 20 years. Major causes of 46 deaths in subjects 20 to 29 years were atherosclerotic coronary artery disease (24\%), myocarditis (22\%) and hypertrophic cardiomyopathy (13\%). The largest number of deaths in 84 subjects aged greater than or equal to 30 years was attributed to coronary artery disease (58\%), followed by myocarditis (11\%). Among noncardiac causes of sudden death, intracranial hemorrhage was the most frequent (5\%), followed by infectious disease (4\%). Prodromal symptoms were reported by 54\% of subjects; most frequent were chest pain (25\%) in subjects aged greater than or equal to 20 years, and dizziness (16\%) in those aged less than 20. Sudden death, which occurred during routine daily activity in 49\% and during sleep in 23\% of subjects, was related to physical exercise in 23\% and emotional upset in 6\%. Sudden unexpected death in the young is still an unresolved medical problem. The early recognition of prodromal symptoms could be crucial in the prevention of sudden death, specifically when exercise-related.
This article was published in Am J Cardiol
and referenced in Emergency Medicine: Open Access