Ding Zijiao, Yang Mingzhen, Wang Yunyun, Wu Shifan, Qiu Xingang, Liu Qian
Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.
Forensic Sci Med Pathol. 2017 Sep;13(3):336-341. doi: 10.1007/s12024-017-9888-z. Epub 2017 Jul 27.
Sudden cardiac death (SCD) is a major health challenge. The records of 769 autopsy cases of SCD examined at Tongji Medicolegal Expertise Center from January 2006 to December 2015 were retrospectively reviewed. The mean age of the cases was 46 years, excluding 27 victims in whom the exact age could not be confirmed. The highest incidence of SCD occurred among the 40- to 60-year-old group (45.0%). Male preponderance was observed in SCD cases (male: female ratio: 5.0:1), and this preponderance was even higher (8.0:1) in the 10- to 20-year-old and 60- to 70-year-old groups. Death predominantly occurred in hospitals (37.4%) and outdoors (32.5%). The incidence of SCD did not differ significantly between the seasons. Coronary atherosclerotic disease (CAD) was the main cause of SCD (67.9%), followed by unexplained SCD (6.1%), myocarditis (5.7%), cardiomyopathy (4.7%), rupture of aortic dissection (3.9%), and cardiac conduction system disease (3.9%). In terms of the CAD cases, the mean age was 52.0 years and coronary artery stenosis exceeding 75% accounted for 73.6% of cases. The left anterior descending branch was involved with atherosclerosis in 92.0% of cases. In conclusion, detailed autopsy and forensic pathology examination is key to diagnosing SCD. Making an early diagnosis and performing early intervention of CAD may reduce the mortality of SCD. Additionally, the use of molecular genetic tests plus forensic pathology diagnosis will help further determine the underlying cause of death in individuals with SCD.
心脏性猝死（SCD）是一项重大的健康挑战。回顾性分析了2006年1月至2015年12月在同济法医学鉴定中心检查的769例SCD尸检病例记录。病例的平均年龄为46岁，其中27例受害者的准确年龄无法确认。SCD的最高发病率出现在40至60岁年龄组（45.0%）。SCD病例中男性占优势（男性与女性比例为5.0:1），在10至20岁和60至70岁年龄组中这种优势更为明显（8.0:1）。死亡主要发生在医院（37.4%）和户外（32.5%）。SCD的发病率在不同季节之间没有显著差异。冠状动脉粥样硬化性心脏病（CAD）是SCD的主要原因（67.9%），其次是不明原因的SCD（6.1%）、心肌炎（5.7%）、心肌病（4.7%）、主动脉夹层破裂（3.9%）和心脏传导系统疾病（3.9%）。就CAD病例而言，平均年龄为52.0岁，冠状动脉狭窄超过75%的病例占73.6%。92.0%的病例左前降支出现动脉粥样硬化。总之，详细的尸检和法医病理学检查是诊断SCD的关键。对CAD进行早期诊断和早期干预可能会降低SCD的死亡率。此外，使用分子基因检测加上法医病理学诊断将有助于进一步确定SCD患者的潜在死因。
