Document Detail

Cardiac pathologic findings reveal a high rate of sudden cardiac death of undetermined etiology in younger women.
MedLine Citation:
PMID:  14564316     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women aged 35 to 44 years. In contrast, the sudden cardiac death rate in age-matched men showed a decreasing trend (-2.8%). Due to under-representation of younger adults in published autopsy series, etiologies of sudden cardiac death merit further investigation. METHODS: We reviewed autopsy and detailed cardiac pathologic findings in younger women (age 35-44 years) from a 270-patient, 13-year (1984-1996) autopsy series of sudden cardiac death, and performed comparisons with findings in age-matched men. RESULTS: Women aged 35 to 44 years constituted 32% of all women in the series compared to men, who constituted 24% of total men (P =.004 vs women). A presumptive cause of sudden cardiac death could not be determined in 13 women (50%). Among women, 6 cases (22%) had significant coronary artery disease. Findings in others included coronary artery anomalies (n = 3), myocarditis (n = 2), hypertrophic cardiomyopathy (n = 1), coronary artery dissection (n = 1) and accessory pathway (n = 1). In younger men, a presumptive cause of sudden cardiac death remained undetermined in only 24% (P =.025 vs younger women), and coronary artery disease accounted for 40% of cases. CONCLUSIONS: In younger women, despite autopsy and detailed cardiac pathologic examination, an attributable cause of sudden cardiac death was not determined in 50% of cases; a 2-fold increase compared to men of the same age. Given the dynamic and multifactorial nature of sudden cardiac death, comprehensive population-based investigations are likely to be necessary to further investigate this unexpected sex-based disparity.
Sumeet S Chugh; Kiyon Chung; Zhi-Jie Zheng; Benjamin John; Jack L Titus
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-17     Completed Date:  2003-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-9     Citation Subset:  AIM; IM    
Division of Cardiology, Oregon Health and Science University, Portland, Ore 97239, USA.
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MeSH Terms
Coronary Disease / pathology*
Death, Sudden, Cardiac / etiology,  pathology*
Hypertrophy, Left Ventricular / pathology*
Mitral Valve Prolapse / pathology*
Myocardium / pathology

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