Sudden Death in The Young Adult: An Autopsy-Based Series

Background: We aim to study the epidemiological and pathological characteristics of sudden death in young, to determine the etiology of death and to purpose recommendations for prevention. Methods: we performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir. A review of all autopsies performed during 28 years was done. In each case, clinical information and circumstances of death were obtained and a complete forensic autopsy and histological and toxicological investigations were performed. We have included all sudden death in persons aged between 18 years and 35 years.Results: we collected 137 cases of sudden death during studied period. The mean age of the studied population was 26.47 years. In 72.6% death was classified as cardiac death and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6% and from a neurological origin in 4.5%. The cause of sudden death in this group was not established in 9.5%.Conclusion: there are several potential causes of sudden unexplained death such as structural abnormalities, ion channels abnormalities. Unexplained deaths, presumed to result from sudden primary arrhythmogenic causes, occur in young adult with structurally normal hearts. That underlying disease-causing genetic defects may be involved has clinical implications for family members. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.