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

In cases of sudden death, the prevention of sudden cardiac death and the analysis of the cause of death after sudden cardiac death have always been a difficult problem. Therefore, clinical research and forensic pathological identification of sudden cardiac death are of great significance. In recent years, metabolomics has gradually developed into a popular field of life science research. The detection of "metabolic fingerprints" of biological fluids can provide an important basis for early diagnosis of diseases and the discovery of potential biomarkers. This article reviews the current research status of sudden cardiac death and the research on metabolomics of cardiovascular diseases that is closely related to sudden cardiac death and analyzes the application prospects of metabolomics in the identification of the cause of sudden cardiac death.
Biomarkers ; Death, Sudden, Cardiac/prevention & control* ; Forensic Pathology ; Humans ; Metabolomics

Sudden cardiac death (SCD) refers to sudden stop of breath and heartbeat and death within one hour caused by underlying cardiac diseases. Clinical manifestation of inherited arrhythmia is lethal arrhythmia without gross cardiac lesions, which can lead to SCD. The autopsy and pathological examination are difficult to identify the cause of death. Fatal mechanism of inherited arrhythmia is the change in the genes encoding for cardiac ion channel protein, which causes the dysfunctions of cardiac electrical activity. It is very important to detect genetic mutation by the technique of molecular biology in negative autopsy. This review presents the latest research on the relation between SCD and inherited arrhythmia, and the application of molecular autopsy used in identifying SCD due to inherited arrhythmia and its candidate gene.
Arrhythmias, Cardiac/pathology* ; Autopsy/methods* ; Cardiovascular Diseases/genetics* ; Death, Sudden, Cardiac/pathology* ; Humans ; Mutation ; Pathology, Molecular

OBJECTIVES: To study the epidemiological and pathological features of sudden death （SD） in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death. METHODS: Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed. RESULTS: The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death （SUD）, cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death. CONCLUSIONS The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.
Adult ; Aortic Rupture ; Autopsy ; Cause of Death ; China/epidemiology* ; Death, Sudden/pathology* ; Death, Sudden, Cardiac/pathology* ; Female ; Forensic Pathology ; Humans ; Incidence ; Male ; Middle Aged ; Pulmonary Embolism ; Retrospective Studies ; Seasons

The advancement of studies about the molecular biology and electronic physiology on sudden cardiac death was summarized in this article, including particularly cardiac concussion(commotio cordis), congenital long QT syndrome, and Brugada syndrome which probably resulting in fatal arrhythmia and sudden cardiac death. These corpses of fatal functional disorders often show the results of negative autopsy without obvious organic pathological changes. So when come across negative autopsy the medical examiner and the pathologist should be careful to investigate the inductive cause of sudden death, the history of disease, and the family history, then to rule out the possibility of the above disorders.
Arrhythmias, Cardiac/pathology* ; Death, Sudden, Cardiac/pathology* ; Forensic Medicine ; Heart Injuries/pathology* ; Humans ; Long QT Syndrome/pathology*

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*

Noncompaction of ventricular myocardium (NVM) is a rare cardiomyopathy. For the past few years, there have been more clinical reports and related scientific researches on NVM. It is one of the hottest topics in the field of clinical cardiovascular science. NVM is rare, but usually leads to fatal results, such as sudden unexpected death. Most forensic medical examiners in China have not recognized the importance of this disease. There are no good forensic pathological methods yet to identify this disease. Furthermore, NVM is easily to be confused with other types of heart diseases. As a result, we should be very careful about NVM, and understand the importance of making right diagnosis of NVM. This review focuses on NVM's pathological features, clinical diagnostic methods, and differential diagnosis from other cardiac disease. The key points on how to make right forensic pathological diagnosis of NVM have also been summarized.
Cardiomyopathies/pathology* ; Death, Sudden, Cardiac ; Diagnosis, Differential ; Forensic Pathology ; Heart Ventricles ; Humans

OBJECTIVE: To investigate the expression of monocyte chemotactic protein-1 (MCP-1) and its receptor CC chemokine receptor-2 (CCR-2) in coronary atherosclerosis plaques between sidden coronary death (SCD) and non-SCD. Methods The expression levels of MCP-1 and CCR-2 in SCD group, coronary atherosclerosis group (non-SCD), control group (normal coronary artery) were detected by immunohistochemistry. RESULTS: Positive rates of MCP-1 among the three groups were 78%, 47%, and 0%, respectively, with significant expressing differences between each two groups (P<0.05). Positive rates of CCR-2 among three groups were 72%, 47%, and 0%, respectively, with significant expressing differences between the SCD group and coronary atherosclerosis group as well as between the SCD group and control group (P<0.05), but with no significant expressing difference between coronary atherosclerosis group and control group (P>0.05). CONCLUSION Overexpression of MCP-1 and CCR-2 in coronary atherosclerotic plaques is closely correlated with SCD.
Chemokine CCL2/metabolism* ; Coronary Artery Disease/pathology* ; Death, Sudden, Cardiac/pathology* ; Humans ; Immunohistochemistry ; Receptors, CCR2/metabolism*

Routine pathological examination of unexplained sudden cardiac death (USCD) lacks significant morphological characteristics. In the field of forensic medicine, molecular biology methods have been used to find the cause of death by detecting genes and research related to the mechanism of sudden cardiac death has been carried out. From the molecular pathology point of view, the application of multiple levels of biomarkers to resolve the causes of USCD has already shown potential and provides an important path for forensic identification of USCD. This article reviews the latest research progress on USCD-related genes, RNA, proteins and USCD, and summarizes forensic application.
Biomarkers ; Death, Sudden, Cardiac/pathology* ; Forensic Medicine ; Forensic Pathology ; Heart ; Humans