PATTERNS AND PATHOLOGICAL CAUSES OF SUDDEN DEATH IDENTIFIED THROUGH AUTOPSY
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Keywords
Sudden death, Autopsy, Coronary artery disease, Cardiovascular pathology, Histopathology
Abstract
Objective: To determine the histopathological patterns and underlying causes of sudden death (SD) through autopsy.
Study Design: A retrospective case series.
Place and Duration: This study was conducted at, Jinnah Sindh Medical University (JSMU) Karachi January 2022 to January 2025.
Methods: This study analyzed 45 cases of SD selected from a total of 100 medico-legal autopsies. Cases involving trauma, suicide, or homicide were excluded. Standard gross and microscopic examinations were performed, and histopathological findings were reviewed. Statistical analysis was carried out using SPSS v21.0, with results expressed as frequencies, percentages, and means with standard deviations.
Results: The age of the deceased ranged from 24 to 47 years (mean ± SD: 35.7 ± 3.3 years). The highest frequency was observed in the 36–40-year group (n = 15, 33.3%), followed by 31–35 years (n = 12, 26.7%). Cardiovascular causes were identified in 25 cases (55.6%), with coronary artery disease (CAD) being the leading pathology (n = 15, 60.0%). Other cardiac causes included myocarditis (n = 2, 8.0%), cardiomyopathies (n = 2, 8.0%), and coarctation of the aorta (n = 1, 4.0%). Non-cardiac causes accounted for 20 cases (44.4%), with pulmonary causes (n = 5, 25.0%), septicemia (n = 3, 15.0%), and cerebrovascular events (n = 3, 15.0%) being most common.
Conclusion: Cardiovascular pathology, particularly CAD, is the predominant cause of sudden death in this cohort. Integration of molecular autopsy in unexplained cases and improved public health strategies targeting early risk detection are recommended.
References
2. Lynge TH, Albert CM, Basso C, Garcia R, Krahn AD, Semsarian C, et al. Autopsy of all young sudden death cases is important to increase survival in family members left behind. Europace. 2024;26(6):euae128.
3. Yow AG, Rajasurya V, Ahmed I, Sharma S. Sudden cardiac death. StatPearls [Internet]: StatPearls Publishing; 2024.
4. Radu I, Farcas AO, Nyulas V, Radu CC, Brinzaniuc K. Sudden Cardiac Death-Etiology, Risk Factors and Demographic Characteristics: An Extensive Study of 1618 Forensic Autopsies. Diseases [Internet]. 2024; 12(8).
5. Fu M, Kontogeorgos S, Thunström E, Zverkova Sandström T, Kroon C, Bollano E, et al. Trends in myocarditis incidence, complications and mortality in Sweden from 2000 to 2014. Scientific Reports. 2022;12(1):1810.
6. Lema AS, Tekle ST. Epidemiological profiles and causes of sudden deaths of various ages in Ethiopia: an autopsy-based study. F1000Research. 2025;12:1441.
7. Estes NAM. Predicting and Preventing Sudden Cardiac Death. Circulation. 2011;124(5):651-6.
8. Solomon N, Gascho D, Adolphi NL, Filograna L, Sanchez H, Gill JR, et al. The evolution of postmortem investigation: a historical perspective on autopsy's decline and imaging's role in its revival. Frontiers in Radiology. 2025;5:1565012.
9. Singh D, Tiwari RC, Kumar A, Bhute AR, Meshram RP, Dikshit M, et al. A comprehensive review of pathological examination in forensic medicine: past, present, and future. Cureus. 2022;14(3).
10. Fadoni J, Santos A, Amorim A, Cainé L. Sudden Cardiac Death: The Role of Molecular Autopsy with Next-Generation Sequencing. Diagnostics [Internet]. 2025; 15(4).
11. Hamza A. Declining rate of autopsies: implications for anatomic pathology residents. Autopsy & case reports. 2017;7(4):1.
12. Aborode AT, Karra-Aly A, Ogunleye SC, Olorunshola MM, Folorunso TN, Aloba CO, et al. Overcoming hurdles: Enhancing post-mortem capabilities for neurological investigations in Africa. Aging Brain. 2023;4:100099.
13. Naeem U, Khan Q, Satti I, Bibi A. An examination of autopsies in a 400 bedded government hospital in Jhelum. An insight into the sudden cause of death and costs associated with autopsy in young government personnel. Journal of the Pakistan Medical Association. 2024;75:74-7.
14. Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL, et al. Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark. Circulation: Arrhythmia and Electrophysiology. 2014;7(2):205-11.
15. Bagnall Richard D, Weintraub Robert G, Ingles J, Duflou J, Yeates L, Lam L, et al. A Prospective Study of Sudden Cardiac Death among Children and Young Adults. New England Journal of Medicine.374(25):2441-52.
16. Singh A, Mishra R, Billey A. CARDIAC LESIONS IN SUDDEN DEATH: INSIGHTS FROM AUTOPSY AND HISTOPATHOLOGICAL ANALYSIS. Int J Acad Med Pharm. 2023;5(5):1567-73.
17. Lynge TH, Nielsen TS, Winkel BG, Tfelt-Hansen J, Banner J. Sudden cardiac death caused by myocarditis in persons aged 1–49 years: a nationwide study of 14 294 deaths in Denmark. Forensic sciences research. 2019;4(3):247-56.
18. Martínez-Barrios E, Grassi S, Brión M, Toro R, Cesar S, Cruzalegui J, et al. Molecular autopsy: Twenty years of post-mortem diagnosis in sudden cardiac death. Frontiers in Medicine. 2023;10:1118585.
19. Tomassini L, Ricchezze G, Fedeli P, Lancia M, Gambelunghe C, De Micco F, et al. New Insights on Molecular Autopsy in Sudden Death: A Systematic Review. Diagnostics [Internet]. 2024; 14(11).
20. Cordeiro FP, Cainé L. Viral infection and sudden non-cardiac death: A systematic review. Journal of Forensic and Legal Medicine. 2024;106:102727.
21. Chaturvedi M, Satoskar M, Khare MS, Kalgutkar AD. Sudden, unexpected and natural death in young adults of age between 18 and 35 years: A clinicopathological study. Indian Journal of Pathology and Microbiology. 2011;54(1).
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Raffat Rasool
Raffat Rasool, Assistant Professor Forensic Medicine & Toxicology, Karachi Medical & Dental College (KM&DC) Karachi Pakistan.
Lubna Riaz
Lubna Riaz, Associate Professor Forensic Medicine, Jinnah Sindh Medical University (JSMU) Karachi Pakistan.
Jamshad ul Qadir Memon
Jamshad ul Qadir Memon, Assistant Professor Forensic Medicine, Bilawal Medical College LUMHS Jamshoro Pakistan.
Wasiq Ahmed
Wasiq Ahmed, Assistant Professor Forensic Medicine & Toxicology, Karachi Medical & Dental College (KM&DC) Karachi Pakistan.
Haya Afzal
Haya Afzal, Assistant Professor Forensic Medicine, Indus Medical College Tando Mohammed Khan Pakistan.
Shahla Imran
Shahla Imran, Assistant Professor Forensic Medicine, Bilawal Medical College LUMHS Jamshoro Pakistan.