© 2001 by European Society of Cardiology
Copyright © 2001, European Society of Cardiology
Postmortem diagnosis in sudden cardiac death victims: macroscopic, microscopic and molecular findings
Institute of Pathology, University of Padua, Via A. Gabelli, 61 35121 Padua, Italy
* Corresponding author. Tel.: +39-49-827-2283; fax: +39-49-827-2284 cardpath@ux1.unipd.it
Received 9 October 2000; accepted 29 January 2001
KEYWORDS Epidemiology; Histo(patho)logy; Sudden death
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1 Introduction |
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When sudden death (SD) occurs in adults and elderly persons, coronary atherosclerosis is the usual cause [1,2]. On the contrary, a large spectrum of cardiovascular diseases, both congenital and acquired, may account for SD in the young [3–10]. These diseases are frequently concealed and discovered with surprise only at postmortem by means of a thorough macroscopic and microscopic investigation. This review will address the spectrum of structural substrates of cardiac SD with particular emphasis given to the possible role of molecular biology techniques in identifying subtle or even merely functional disorders accounting for electrical instability.
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2 Epidemiology, pathophysiology and substrates of cardiac SD |
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SD is defined as a natural, unexpected fatal event occurring within 1 h of the beginning of symptoms, in an apparently healthy subject or one whose disease was not so severe enough as to predict such an abrupt outcome [11]. In the USA, the annual incidence of SD in people aged 35–74
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3 New molecular assays: perspectives of application in the study of SD |
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4 Cardiovascular diseases at risk of SD: potential targets of molecular pathology investigation |
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4.1 Infective cardiac disease
4.1.1 Myocarditis
4.1.2 Unstable coronary plaque
4.2 Genetically determined cardiac disease
4.2.1 Cardiomyopathy
4.2.2 Marfan syndrome
4.2.3 Supravalvular aortic stenosis
4.2.4 Ion channel disease
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5 Final consideration on the pathologist's role in the diagnosis of causes and prevention of SD |
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