Pattern of sudden cardiac deaths

BACKGROUND AND OBJECTIVE

Sudden cardiac death can be defined as a sudden, unexpected death caused by loss of heart function. Notwithstanding major developments in the diagnosis and treatment of heart disease, it remains the major contributing factor for deaths. This considers the pattern of sudden cardiac deaths.Methodology: This prospective study was conducted on all cases subjected to medico-legal autopsy in the forensic medicine department at a tertiary care hospital for a period of 18 months. All sudden cardiac deaths satisfying the WHO criteria were included. Unknown cases and bodies in advanced stage of decomposition were excluded.

RESULTS

Sudden cardiac deaths accounted for 55% (82 cases) of 149 cases of sudden natural deaths and 6.5% of total autopsies conducted. The age group most commonly affected by sudden cardiac death ranged from 31 to 50 years. The majority of the cadavers had 90-95% degree of stenosis of left anterior descending artery, 70-80% of right coronary artery and 60-70% left circumflex artery. Coronary insufficiency was the major cause for sudden cardiac deaths with a total of 53 (64.63%) cases.

CONCLUSION

Sudden cardiac deaths accounted for 6.5% of all the autopsies conducted and males outnumbered females with M:F ratio of 10.7:1, with mean age of 44.5 ± 12.63 years. The largest number - 60.97% - were aged between 31 and 50 years. Coronary insufficiency accounted for 64.63% of sudden cardiac deaths.

Dying from haemorrhagic cardiac tamponade - a case series

Cardiac tamponade is a condition produced by the rapid accumulation of pericardial fluid, which restricts the filling of the heart. Often the forensic pathologist comes across different naturally occurring sudden deaths. Cardiovascular causes are the most common. Death due to cardiac tamponade can cause sudden cardiac death. Acute cardiac tamponade is almost invariably fatal, unless the pressure is relieved by removing the pericardial fluid, either by needle pericardiocentesis or surgical procedures. Cardiac tamponade is more commonly associated with cases of trauma, operative procedures, secondary to myocardial infarction or intra pericardial rupture of great vessels. Previous literature showed an association of cardiac tamponade with many other pathological conditions such as malignancy, central venous catheterisation, open heart surgery, dissecting aneurysm of the aorta, myocardial abscess, infective endocarditis, etc. We report a series of three cases where cardiac tamponade was given as the cause of death on autopsy secondary to post-myocardial infarction wall rupture.

Sudden cardiac death and kidney health related problems among Nepali migrant workers in Malaysia

This paper reports on a consultation meeting that discussed two emerging health issues of Nepali migrant workers in Malaysia and the ways they can be addressed. Primarily, it focused on the issue of sudden cardiac deaths of Nepali migrant workers in Malaysia. This issue has been raised internationally by both scientific and media in the recent years. Secondly, it discussed kidney health related problem among Nepali migrant workers which has caught the attention of Nepali media recently. The meeting was organized in Kuala Lumpur, Malaysia on 19th April, 2019 where twenty people including health researchers, representatives of migrant related national and international organizations, and Nepali migrant workers participated. The meeting concluded that three types of data collection are needed: (1) good record of deaths, if at possible proper post-mortems; (2) a verbal autopsy tool to help identify underlying causes ; and qualitative research into kidney related problems.