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[成人心血管性猝死:361例尸检病例研究]

[Sudden cardiovascular death in adults: Study of 361 autopsy cases].

作者信息

Mesrati M A, Belhadj M, Aissaoui A, HajSalem N, Oualha D, Boughattas M, Messaoudi I, Hammedi F, Zakhama A, Chadly A

机构信息

Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie.

Service de médecine légale, CHU Fattouma Bourguiba, Monastir, Tunisie; Faculté de médecine, université de Monastir, Monastir, Tunisie.

出版信息

Ann Cardiol Angeiol (Paris). 2017 Feb;66(1):7-14. doi: 10.1016/j.ancard.2016.03.003. Epub 2016 Apr 21.

Abstract

AIMS OF THE STUDY

To describe epidemiological aspects of sudden cardiovascular death and to specify the etiopathogenic characteristics.

PATIENTS AND METHOD

Our study is retrospective and descriptive. It included 361 cases of sudden cardiovascular death, which underwent autopsy in forensic medicine department of Monastir during eight years, from 1st January 2004 to 31st December 2011.

RESULTS

The incidence of sudden cardiovascular death was 9 per 100,000 person. A marked male predominance was noted. The mean age was 55.75 years. In our series, myocardial infarction represents the leading cause of sudden cardiovascular death, 57.8% of cases. Other etiologies were hypertrophic cardiomyopathy (4.7%), heart failure (1.9%), arrhythmogenic right ventricular dysplasia (2.8%), valvular disease (2%), cardio-myo-pericarditis (1.9%), hydatid cyst of the heart (0.8%), ruptured aneurysm (2.5%), pulmonary embolism (1.9%) and aortic dissection (1.3%). A sudden cardiovascular death at work was found in 25 cases. These cases pose essentially a problem of imputability.

CONCLUSION

Sudden cardiac death is usually the complication of underlying heart disease, sometimes overlooked. Several risk factors are involved. Sudden cardiac death in healthy heart or death caused by arrhythmia is an important entity seeking the intervention of several actors (forensic doctor, cardiologist, geneticist, media…) for prevention.

摘要

研究目的

描述心血管性猝死的流行病学特征,并明确其病因学特点。

患者与方法

我们的研究为回顾性描述性研究。纳入了2004年1月1日至2011年12月31日期间在莫纳斯提尔法医学部进行尸检的361例心血管性猝死病例。

结果

心血管性猝死的发病率为每10万人中有9例。男性明显占主导。平均年龄为55.75岁。在我们的系列研究中,心肌梗死是心血管性猝死的主要原因,占病例的57.8%。其他病因包括肥厚型心肌病(4.7%)、心力衰竭(1.9%)、致心律失常性右室发育不良(2.8%)、瓣膜病(2%)、心肌心包炎(1.9%)、心脏包虫囊肿(0.8%)、动脉瘤破裂(2.5%)、肺栓塞(1.9%)和主动脉夹层(1.3%)。发现25例工作时发生的心血管性猝死。这些病例主要存在责任认定问题。

结论

心源性猝死通常是潜在心脏病的并发症,有时易被忽视。涉及多种危险因素。健康心脏的心源性猝死或心律失常导致的死亡是一个需要多个方面(法医、心脏病专家、遗传学家、媒体等)介入预防的重要问题。

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