Catastrophic Sudden Cardiac Death. Are there Lessons to be Learnt

Dhiraj Kumar, G. Sabnis, D. More, H. Shah, C. Lanjewar, P. Kerkar, R. Shriwastav, P. Vaideeshwar
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Abstract

Background: Sudden cardiac death is a catastrophic event which leads to loss of young and middle-aged population with dire consequences. Sometimes, a careful history, physical examination and most importantly electrocardiogram (ECG) can help in suspecting the common causes in young population like underlying channelopathies and cardiomyopathies which can further be diagnosed using echocardiography, cardiac MRI and in some cases genetic tests. Case summary: A 33-year-old male presented with sycope and ventricular tachycardia leading to death. This patient was diagnosed to have Arrythmogenic right ventricular dysplasia (ARVD) on post mortem pathological examination with features of fatty infiltration and thinning of right ventricular myocardium. Furthermore, on histologically fatty infiltration with inflammatory infiltrates were visualized. Discussion: Clinical awareness amongst physicians about cardiomyopathies especially ARVD with its subtle yet suggestive ECG changes is the need of the hour. ARVD is a rare disease and can be diagnosed with certainty by analyzing ECG and adding imaging to it. When diagnosed cases are treated appropriately, at least a few cases of sudden cardiac death can be averted.
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灾难性心源性猝死。有什么值得借鉴的教训吗
背景:心源性猝死是一种导致中青年人口死亡的灾难性事件,其后果十分严重。有时,仔细的病史、体格检查和最重要的心电图(ECG)可以帮助怀疑年轻人的常见病因,如潜在的通道病和心肌病,这些疾病可以通过超声心动图、心脏MRI和某些情况下的基因测试进一步诊断。病例总结:一名33岁男性,因晕厥和室性心动过速死亡。该患者死后病理诊断为心律失常性右心室发育不良(ARVD),以脂肪浸润及右心室心肌变薄为特征。组织学上可见脂肪浸润伴炎性浸润。讨论:医生对心肌病尤其是ARVD的临床意识及其微妙但暗含的心电图变化是迫切需要的。ARVD是一种罕见的疾病,通过心电图分析和影像学检查可以确定诊断。当确诊病例得到适当治疗时,至少可以避免少数心源性猝死病例。
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