Sudden cardiac death (SCD) is the most common death mode. No test has been able to accurately predict SCD. This article reviews the risk factors and warning signs of SCD with an attempt to effectively prevent SCD events.
Death, Sudden, Cardiac ; etiology ; pathology ; prevention & control ; Humans ; Risk Factors

Adult ; Aortic Rupture ; pathology ; Death, Sudden, Cardiac ; etiology ; Heart Ventricles ; pathology ; Humans ; Male

Sudden unexplained nocturnal death syndrome （SUNDS） is always a difficulty in forensic medicine researches. Although the development of molecular genetics promotes the etiologic study of SUNDS, the pathogenesis of most such cases is still unclear. Sleep apnea syndrome （SAS） is one of the common forms of sleep disorders, and obstructive sleep apnea hypopnea syndrome （OSAHS） is the most common. In recent years, some domestic and international researches show that OSAHS is related to the development of cardiovascular disease, which may cause cardiac arrhythmia, even sudden death. This article reviews the relationship between SUNDS and OSAHS and aims to provide new ideas for the pathogenesis of SUNDS.
Arrhythmias, Cardiac ; Brugada Syndrome/pathology* ; Death, Sudden/etiology* ; Humans ; Male ; Sleep Apnea, Obstructive/pathology*

Torsades de Pointes is a life-threatening arrhythmia associated with a number of causes, but is very rare among endocrinologic disorders. We report a case of male pseudohermaphroditism with hyperaldosteronism due to a 17alpha-hydroxylase deficiency presented with sudden cardiac arrest.
46, XY Disorders of Sex Development/*diagnosis/drug therapy ; Adult ; Death, Sudden, Cardiac/*etiology/*pathology ; Female ; Humans

Karoshi remains one of the most troublesome issues in forensic identification. It is rather a social medicine than a clinical disease. Japanese scholars pioneered examining the relation between sud- den cardiac death (SCD) and chronic fatigue from long time and/or high-tension work. In the current case, a 55-year-old man, whose job was loading and carrying heavy cement bags, was found dead after 11 days of continuous hard work. His family members sued the cement factory for his death and claimed for compensation. The problem was the difficulty of identifying the causative relation without the precedent or the relevant regulations. However, the forensic problems were finally acknowledged after autopsy and calculation of labor intensity. The lawsuit was won as the first case pertaining to Karoshi in the Chinese court.
Autopsy ; Death, Sudden, Cardiac/etiology* ; Fatigue/mortality* ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Workload/legislation & jurisprudence*

Arrhythmogenic Right Ventricular Dysplasia ; complications ; Autopsy ; Cardiomyopathy, Hypertrophic ; complications ; Cause of Death ; Coronary Disease ; complications ; Coronary Vessel Anomalies ; complications ; Death, Sudden, Cardiac ; etiology ; pathology ; Humans

OBJECTIVE: To investigate the pathological features and significance of myocardial contraction band necrosis in sudden cardiac death. METHODS: Using HE and PTAH staining, the distribution sites and pathological features of myocardial contraction band necrosis were observed. The data were analyzed according to the extent of necrosis. RESULTS: The locations, pathological features and the extent of necrosis were similar in different sudden death cases. The locations were related with sites of myocardial damage. The papillary muscles of left ventricular were most occurred, followed by the anterior wall of left ventricular. In the sudden death cases caused by stress cardiomyopathy, the extent of myocardial contraction band necrosis was lighter than the others. Most cases were predominantly level 1, the others were level 2. CONCLUSION Used as the diagnosis basis of acute myocardial ischemia, the myocardial contraction band necrosis has important significance to determination of death.
Adult ; Aged ; Aged, 80 and over ; Coronary Disease/complications* ; Death, Sudden/etiology* ; Death, Sudden, Cardiac/pathology* ; Female ; Heart Diseases/pathology* ; Humans ; Male ; Middle Aged ; Myocardial Contraction/physiology* ; Myocardium/pathology* ; Necrosis

Coronary artery anomalies are associated often with myocardial ischemia or sudden cardiac death. A 19-year-old woman who participated in an exertive game lost consciousness upon one such exertion. She was taken to a hospital where she died on the same day. An autopsy revealed that she had bifurcated coronary arteries, which arose from one coronary ostium in the left sinus of Valsalva. The right coronary artery arose from the left sinus and traveled between the aorta and the pulmonary trunk. The heart as well as the cardiac conduction system depended exclusively on the single coronary artery ostium for oxygenated blood supply, and the unbalanced blood distribution on her exertion probably led to sudden cardiac death. The case highlights the medicolegal importance of unexpected sudden cardiac death related to an anomalous origin of the coronary arteries.
Autopsy ; Coronary Vessel Anomalies/*complications/pathology ; Coronary Vessels/pathology ; Death, Sudden, Cardiac/*etiology/pathology ; Female ; Humans ; Physical Exertion ; Sinus of Valsalva/abnormalities ; Young Adult

OBJECTIVETo investigate the Toll like receptor 4 (TLR4) expression in the coronary atherosclerotic plaques in patients died from sudden cardiac death (SCD) or non SCD.

METHODSAutopsied coronary artery samples from 75 patients died from SCD (n = 28), non-SCD (n = 28) or non-CHD (n = 19) were examined and the R value (positive cells' areas/scanning areas) and A value (average optical density) of TLR4 expression in the coronary arteries were detected qualitatively by the immunohistochemistry (SABC method) and image analysis technologies.

RESULTSSCD group: 13 (46.4%) cases showed strong positive expression of TLR4; 11 (39.3%), positive expression; 4 (14.3%), weak positive expression. CHD group: 8 (28.6%) cases showed weak positive expression; 17 (60.7%), very weak positive expression; 3 (10.7%), no positive expression. There was no positive expression of TLR4 in non-CHD samples. A (1.140 +/- 0.101) and R value (0.0269 +/- 0.0027) in SCD group were significantly higher than in non-SCD and control groups (all P < 0.01). A value was siginificantly higher in CHD group (0.719 +/- 0.205) than that in control group (0.481 +/- 0.033, P < 0.05) while R value (0.0085 +/- 0.0007, 0.0046 +/- 0.0004) was similar between the groups (P > 0.05).

CONCLUSIONThe increased positive expressive of TLR4 in the atherosclerotic plaque can be regarded as an important pathological marker of SCD.

Adult ; Aged ; Coronary Artery Disease ; metabolism ; pathology ; Death, Sudden, Cardiac ; etiology ; Female ; Humans ; Male ; Middle Aged ; Toll-Like Receptor 4 ; metabolism

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease of unknown etiology characterized by fatty or fibrofatty infiltration of the right ventricular myocardium. It is well known that ARVC is one of the important causes of sudden death in young individuals. The significant pathological change of ARVC is atrophy and fibrofatty myocardial replacement of the right ventricular free wall. According to the histopathological substrate ARVC could be divided into 2 types: fatty and fibrofatty myocardial replacement. Possible etiology including: (1) apoptosis or programmed cell death; (2) inflammatory; (3) myocardium dysplasia and (4) myocyte transdifferentiation theory.
Adipose Tissue/pathology* ; Adolescent ; Adult ; Apoptosis ; Arrhythmias, Cardiac/etiology* ; Arrhythmogenic Right Ventricular Dysplasia/pathology* ; Child ; Child, Preschool ; Death, Sudden, Cardiac/etiology* ; Female ; Forensic Medicine ; Humans ; Infant ; Male ; Middle Aged