Abstract

Introduction: Sudden death is one of the common mode of the death now a days. According to ICD 10 of the World Health Organization sudden death is defined as “Death occurring in less than 24 hours from onset of symptoms not otherwise explained”. It also emphasizes that sudden death is better known as non­violent or instantaneous for which no cause can be discovered. Despite modernization in medicine, the diagnosing tools lack in accuracy to find clinical cause of death in comparison with autopsy cause of death. Across all age groups, cardiac related diseases play a significant role in both sudden and unexpected death. In this study, cases of sudden deaths are examined histopathologically to establish possible causes of the sudden deaths. Aim: To study histopathology of the organs of sudden death cases in autopsy and identify common but clinically important causes of sudden death. This study would show the impact of lifestyle of our society and thus help to increase awareness in population at risk as well as lifestyle modification which might reduce the incidence of sudden death. Material and Method: A study of autopsies of sudden deaths between August 2014 to July 2017(3 Years) at department of Pathology, BRIMS, Bidar. Result: Total autopsies received during August 2014 to July 2017 were 198, among which those with sudden death were 54 cases (27.27%). The age ranged from 11 years to 90 years, among which sudden death was maximum in 41 to 60 years of age and males were affected more than the females. Out of 54 sudden deaths, 37 cases (68.52%) died of cardiovascular causes, mainly myocardial infarction; while 17cases (31.48%) were of non cardiac causes, in which pulmonary aetiologies predominate. Among 37 cases of cardiovascular causes, 9 had other co­morbid conditions. Conclusion: It is concluded that sudden deaths were more common in 4th and 5th decade of life with male preponderance and most common causes are cardiovascular, while sudden deaths between 11 to 30 years of age were mainly due to non cardiac causes.

• 1.   Pathology of Sudden Natural Death: Candace H Schoppe, MD; Chief Editor: J Scott Denton, MD; Patrick E Lantz, MD.
• 2.   WHO International Classification of Diseases and related health problems 10th revision (ICD 10) version for 2016.
• 3.   Goldman L, Sayson R, Robbins S, Cohn LH, Bettman M, Weisberg M. The value of the autopsy in three medical eras. N Engl J Med 1983;308:1000­5.
• 4.   Kwok KM, Lee KL, Lau CP, Tse HF. Sudden cardiac death: Prevention and treatment. Hong Kong Med J 2003;9:357­62.
• 5.   Bancroft J, Suvarna K. Theory and Practice of Histological Techniques.7th ed. Philadelphia: Churchill Livingstone; 2013.p.69­179.
• 6.   Thomas AC, Knapman PA, Krikler DM, Davies MJ. Community study of the causes of “natural” sudden death. BMJ 1988;297:1453­6.
• 7.   Farb A, Tang AL, Burke AP, Sessums L, Liang Y, Virmani R. Sudden coronary death. Frequency of active coronary lesions, inactive coronary lesions, and myocardial infarction. Circulation 1995;92: 1701­9.
• 8.   Park K. WHO report. Parks textbook of Social and Preventive Medicine. 17th ed. Banarsi Bhanat; 1999. p. 273­6.
• 9.   Doolan A, Langlois N, Semsarian C. Causes of sudden cardiac death in young Australians. Med J Aust 2004; 180:110­2.
• 10.   Chugh SS, Kelly KL, Titus JL. Sudden cardiac death with apparently normal heart. Circulation 2000;102:649­54.
• 11.   Bowker TJ, Wood DA, Davies MJ, Sheppard MN, Cary NR, Burton JD, et al. Sudden unexpected cardiac or unexplained death in England: A national survey. QJM 2003;96:269­79.
• 12.   Sheppard M, Davies MJ. Investigation of sudden cardiac death: Practical cardiovascular Pathology. London: Arnold; 1998. p. 191­204.
• 13.   WHO/ Cardiovascular Diseases; Fact sheet, reviewed in June 2016. Assessed on www.who.int/ cardiovascular diseases/en/.
• 14.   David D McManus, Hoa L Nguyen, Jane S Saczynski, Mayra Tisminetzky, Peter Bourell, Robert J Goldberg. Multiple cardiovascular comorbidities and acute myocardial infarction: temporal trends (1990–2007) and impact on death rates at 30 days and 1 year: Clinical Epidemiology 2012;4:115–123.
• 15.   Lekston A, Kurek A, Tynior B. Cardiol J. Impaired renal function in acute myocardial infarction. 2009;16(5):400­6.
• 16.   Bobrowitz ID.Active tuberculosis undiagnosed until autopsy. Am J Med 1982;72:650­8.
• 17.   Rastogi P, Kanchan T, Menezes RG. Sudden unexpected deaths due to tuberculosis: An autopsy based study. J Foren Med Toxicol 2011;28:81­3.
• 18.   Renal failure secondary to acute tubular necrosis: epidemiology, diagnosis, and management.Gill N1, Nally JV Jr, Fatica RA. Chest 2005 Oct;128(4):2847­63.
• 19.   Sudden unexplained death in adults caused by intracranial pathology: M Black, D I Graham. J Clin Pathol 2002;55:44–50.
• 20.   Incidentally Discovered Liver Diseases­ An Autopsy Study of Fifty Cases Jamila Alagarsamy1, Yogambal Muthureddy2, N. Subhash Rao Yadav3. International Journal of Science and Research (IJSR) ISSN (Online): 2319­7064 Impact Factor 2012;3:358.