CORONARY ARTERIAL VESSELS IN RELATION TO SUDDEN CARDIAC DEATH: A REVIEW

Abstract

Objective: To review literature on the coronary vascular factors related to the syndrome of
sudden cardiac death.
Data source/synthesis: Major published articles and case reports on the nature of sudden
cardiac death were searched electronically (Medline, Internet) and through hand scanning.
Comparison of the different studies with regard to common themes was undertaken and
consensus opinions highlighted.
Results: The aetiology of sudden cardiac death is diverse. Many conditions, hitherto
considered benign, including coronary arterial anomalies and muscle bridges have been
shown to cause sudden cardiac death. Coronary atherosclerosis, hypoplastic coronary
vessels, coronary artery dissections are the commoner causes. The role of coronary arterial
thrombi is controversial. The protective role of exercise is seriously questioned by the many
reports of sudden cardiac death in long distance runners.
Conclusion: Cases of sudden cardiac death are increasingly being reported. As a minimum,
autopsy worksheets for cases of sudden death should include atherosclerosis, congenital
coronary anomalies, tunneling of coronary vessels and hyposplastic vessels in addition to
valvular and myocardial disorders.