The negative autopsy: sudden cardiac death or other?
One of the most frustrating challenges faced by the forensic pathologist is the inability to determine the cause of death in a young person previously thought healthy. The four steps in the investigation of a sudden death include obtaining the history and scene information, performing a gross and microscopic autopsy, performing appropriate laboratory tests, and making the diagnosis. When examining the heart grossly it is important to preserve the anatomic landmarks, section the coronary arteries closely, and recognize lethal abnormalities such as anomalous origin of the coronary arteries. Specimens useful for toxicologic analysis include whole blood, serum, vitreous humor, gastric contents, bile, urine a purple top tube of blood, and frozen myocardium and spleen. Lethal cardiac diseases with minimal or no anatomic findings include Brugada and Garg's syndromes, the long QT syndrome, and Wolff-Parkinson-White (WPW) syndrome. Consultation with other experts, including cardiac pathologists, cardiologists, electrophysiologists, and molecular biologists, may be helpful in determining a cause of death.
Further characterization of the syndrome of right bundle branch block, ST segment elevation, and sudden cardiac death
Right bundle-branch block and ST-segment elevation in leads V1 through V3: a marker for sudden death in patients without demonstrable structural heart disease
Familial sudden cardiac death associated with a terminal QRS abnormality on surface 12-lead electrocardiogram in the index case
Heart-type fatty acid binding protein and cardiac troponin I may have a diagnostic value in electrocution: A rat model
The electrical heart: 25 years of discovery in cardiac electrophysiology, arrhythmias and sudden death
Recommendations for the use of genetic testing in the clinical evaluation of inherited cardiac arrhythmias associated with sudden cardiac death: Canadian Cardiovascular Society/Canadian Heart Rhythm Society joint position paper
Targeted mutational analysis of the RyR2-encoded cardiac ryanodine receptor in sudden unexplained death: a molecular autopsy of 49 medical examiner/coroner's cases
Sudden death: ethical and legal problems of post-mortem forensic genetic testing for hereditary cardiac diseases
Clinicians didn't reliably distinguish between different causes of cardiac death using case histories
Significant QT interval prolongation and long QT in young adult ex-preterm newborns with extremely low birth weight
Anatomopathological changes of the cardiac conduction system in sudden cardiac death, particularly in infants: advances over the last 25 years
Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.