Sudden cardiac death (SCD) is a term used for an unexpected, non-traumatic fatal event in an otherwise healthy subject.
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Epidemiology
Sudden cardiac death is estimated to account for about 50% of all cardiac deaths with first-time events making up more than 25% 1. The incidence ranges between 0.5 to 6.7 per 100 000 person-years depending on the population looked at including age and gender differences. Men are more commonly affected than women 2.
Diagnosis
The exact definition and diagnosis of sudden cardiac death vary across publications 1-4. A definition given used by the European Society of Cardiology 2:
- death occurs within one hour of symptom onset (if witnessed) or the person was in good health 24 hours earlier (if not witnessed)
and at least one of the following 1:
- a potentially fatal congenital or acquired cardiac disease was known
- a cardiac or vascular condition was identified as the probable cause of death by autopsy
- no extra-cardiac causes could be determined on autopsy and as a consequence, the likely cause of death is an arrhythmic event
Pathology
Etiology
Common causes of sudden cardiac death include the following 4-6:
- causes related to the coronary arteries
- structural heart disease
- conduction disorders
- Wolff Parkinson White syndrome
- ventricular arrhythmias
- congenital long QT syndrome
- Brugada syndrome
- acquired cardiac conditions
- myocarditis
- cardiac contusion
- cardiac toxicity
- hypothermia/hyperthermia
- cardiac amyloidosis