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. 2023 Apr 21;25(Suppl B):B16-B20.
doi: 10.1093/eurheartjsupp/suad077. eCollection 2023 Apr.

Causes of sudden death

Monica De Gaspari  1 , Stefania Rizzo  1 , Gaetano Thiene  1 , Cristina Basso  1
Affiliations

Causes of sudden death

Monica De Gaspari et al. Eur Heart J Suppl. .

Abstract

Sudden cardiac death (SCD) pathophysiological point of view can be either mechanical or electrical. In case of mechanical SCD, the most frequent causes are pulmonary thromboembolism and cardiac tamponade due to intrapericardial rupture (aortic dissection, heart rupture). This distinction is important because cardiac arrest retains survival potential through cardiopulmonary resuscitation and defibrillators only if the rhythm is shockable. The heart diseases that can cause SCD vary according to the age of the individual. In young people, primary electrical diseases ('ion channel diseases') and cardiomyopathies (particularly hypertrophic and arrhythmogenic), both genetically determined and therefore potentially recurred in the proband's family, as well as myocarditis and coronary anomalies prevail; in adult-elderly populations, coronary atherosclerosis with its complications and degenerative valve diseases (aortic stenosis and mitral valve prolapse) predominate. In this short text, the main structural heart diseases characterized by electrical instability at risk of SCD will be recalled, with a focus on coronary, myocardial, and valvular diseases.

Keywords: Cardiac arrest; Ion channel diseases; Sudden cardiac death.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Association between SD incidence and age. The incidence of SD in adolescents and young adults (<35 years) ranges from 0.5 to 8/100 000/year in the reported epidemiological studies. SD is due to different heart diseases throughout life. Cardiomyopathies, myocarditis, premature coronary artery disease, congenital anomalies of the coronary arteries and channelopathies are prevalent in young people in contrast to the adult–old age in which ischaemic heart disease from coronary atherosclerosis dominates (from Myerburg and Vetter).
Figure 2
Figure 2
Cases of SD due to coronary atherosclerosis in adults and young people. (A) Occlusive coronary thrombosis due to rupture of fibrous cap of fibro-atheromasic atherosclerotic plaque; (B) critical stenosis due to uncomplicated fibroatheromasic plaque with exuberant proliferation of intimal smooth muscle cells and preserved media.
See this image and copyright information in PMC

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