Introduction and objectives
Atheromatous coronary disease (ACD) is the most frequent cause of sudden death (SD) in adults. Few studies have focused in SD due to ACD in those patients under 35 years old. The aim of this study is to analyze the incidence, and clinical and pathological characteristics of ACD as a cause of death in young people
Material and Methods
We reviewed all SD cases in people from 1-35 years old which occurred in Bizkaia and in which there was a legal-medical autopsy from 1991 to 1998. A complete autopsy was performed in each case. SD due to ACD were analyzed, including pathological antecedents
19 out of 107 SD (18%) ocurred by ACD. All of them were males from 27 to 35 years of age. According to the male population from 30 to 35 years, the incidence was 3.7/100,000/year. In two patients ACD was diagnosed before death. Coronary risk factors were obtained in 10 cases and prodromal symptoms were described in 5 (chest pain in 4). In 79% death ocurred during routine activity. None of the 19 patients arrived alive to hospital. In 6 cases multiple coronary disease was observed; coronary thrombosis in 8; recent acute ischemic myocardial necrosis in 4 and old ischemic damage in 7. 18 cases showed cardiac hypertrophy
ACD is an important cause of SD in young males, frequently being the first manifestation of the disease. As identification of groups at risk is so difficult and death occurs so quickly, primary prevention of ACD, rapid intervention of emergency services and educational programs in cardiopulmonar resuscitation for normal population are fundamental in reducing the mortality
[Show abstract][Hide abstract] ABSTRACT: The study of sudden death is one of the most important responsibilities of Forensic Pathology. A full investigation is necessary in order to find out the cause of death. However, currently there is no uniform method of study common to the different Institutes of forensic medicine. In this article we review the clinico-pathological characteristics of the diseases that have been associated with sudden cardiac death in children and young adults. We also present basic guidelines on clinical and pathological data for post-mortem
Revista Espanola de Medicina Legal 07/2009; 35(2). DOI:10.1016/S0377-4732(09)70013-6
[Show abstract][Hide abstract] ABSTRACT: INTRODUCCIÓN: La enfermedad aterosclerótica se sospecha desde la época de la sexta dinastía egipcia (2625-2475 a.n.e.) hace 4 500 años, cuando aparece esculpida en la tumba del faraón Sessi At Sakara la imagen de una muerte súbita, en esta misma escultura y para diferenciarla de la muerte real aparece otra imagen de un desmayo que pronto se recupera. Según los egiptólogos las posiciones de las manos en la cabeza de las personas indican la diferencia entre la muerte (la mano izquierda) y el desmayo (la mano derecha). En los primeros años del siglo xx (1910-1911), Ruffer y Shattockpublicaron los resultados de una serie de autopsias realizadas a momias egipcias, definiendo bien las lesiones ateroscleróticas encontradas en diferentes arterias, que se identifican exactamente con las distribuciones y peculiaridades de las lesiones hoy día encontradas. Esto demuestra que las lesiones ateroscleróticas no han sufrido evolución alguna en sus características patomorfológicas durante todos estos años 1.
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