Sudden unexplained death in Asian immigrants: recognition of a syndrome in metropolitan Toronto.

OBJECTIVE

To determine the number of Southeast Asians in Ontario who died of the sudden unexplained death syndrome in Asian immigrants.

DESIGN

Retrospective review.

SETTING

Ontario.

CASES

All deaths reported to the Office of the Chief Coroner for Ontario from 1992 to 1995.

OUTCOME MEASURES

Age, residence and country of origin of people who died of sudden unexplained death syndrome in Asian immigrants, as defined by standard criteria, autopsy findings and social history of cases.

RESULTS

Eight cases of sudden unexplained death in Asian immigrants were reported during the study period. All involved men, and the mean age at death was 34 (standard error of the mean 7) years (range 23 to 44 years). All of the people were residents of metropolitan Toronto. Four were from Vietnam, three from China and one from the Philippines. Seven people lived with family members; the eighth was unemployed and lived alone. Death occurred during sleep or in the waking hours of the morning in six cases; in two of these cases the person's spouse was awakened by loud, laboured breathing. Two men experienced chest pain, and one of them also had sudden-onset dyspnea. There was no prodromal illness in any case. The only consistent autopsy finding was acute nonspecific pulmonary edema and congestion. Analysis of heart weights failed to reveal signs of significant cardiomegaly.

CONCLUSION

Men from Southeast Asia aged 20 to 45 years are at risk of sudden unexplained death, which usually occurs during sleep. No specific factors have been found that could be used to identify people at risk.