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Causes of sudden death in a young (<40 years old) South European population: a postmortem study
Session:
Comunicações Orais - Sessão 13 - Taquicardia Ventricular e Morte Súbita Cardíaca
Speaker:
Mafalda Carrington
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.7 Ventricular Arrhythmias and SCD - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Mafalda Carrington; Rosa Henriques de Gouveia; Rogério Teixeira; Francisco Corte Real; Lino Gonçalves; Rui Providência
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aims</strong>: To describe the annual incidence and the leading causes of sudden non-cardiac and cardiac death (SCD) in children and young adult Portuguese population.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong>: We retrospectively reviewed autopsy of sudden unexpected deaths reports from the Portuguese National Institute of Legal Medicine and Forensic Sciences’ database, between 2012 and 2016, for the central region of Portugal, Azores and Madeira (ages 1-40: 26% of the total population). Young adults with sudden unexpected death were included. Violent deaths were excluded.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong>: During a 5-year period, 159 SD were identified, corresponding to an annual incidence of 2,4 (95%confidence interval, 1,5-3,6) per 100.000 people-years. Victims had a mean age of 32±7 years-old, and 72,3% were male. There were 70,4% cardiac, 16,4% respiratory, 7,5% neurologic and 3,1% digestive causes of SD. The most frequent cardiac histopathological diagnosis was atherosclerotic coronary artery disease (CAD) (33,0%), with acute myocardial infarction identified as a final cause of SCD in 18,9% of the cases.. There were 15,2% victims with left ventricular hypertrophy, with a diagnosis of hypertrophic cardiomyopathy only possible in 2,7%. 12,5% of deaths were due to acute pulmonary embolism. Acute myocarditis (4,5%) had the highest prevalence in children and teenagers. The prevalence of cardiac pathological findings of uncertain significance was 30,4%. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions:</strong> The annual incidence of SD was low. Atherosclerotic CAD was diagnosed in 33,0% victims, suggesting the need to intensify primary prevention measures in the young. The high prevalence of pathological findings of uncertain significance emphasizes the importance of molecular autopsy and screening of first-degree relatives.</span></span></p>
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