Cases reported "Death, Sudden"

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11/69. Sudden death in angiodysplasia of the gastroesophageal junction.

    A 22-year-old Korean soldier, who had received blows to the neck and epigastrium from an officer 10 h earlier, suddenly died after massive hematemesis. He had been in relatively good health except for episodes of blood-tinged vomiting approximately 5 and 7 months prior to this event. Postmortem examination revealed angiodysplasia involving the gastroesophageal junction, and the stomach was distended with blood. No abnormal findings were present around the whole viscera, and the duodenum was free of blood. The pathologic significance of upper gastrointestinal angiodysplasia as a potential source of bleeding and a chronologic correlation between the trauma and bleeding are discussed.
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ranking = 1
keywords = dysplasia
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12/69. arrhythmogenic right ventricular dysplasia: a possible cause of sudden incapacitation.

    arrhythmogenic right ventricular dysplasia (ARVD) is an important cause of sudden death in the young. The classic presentation is with sustained ventricular tachycardia, with an electrocardiographic pattern of a left bundle branch block, but a proportion of the patients may present as sudden cardiac death. Establishing the diagnosis in aviators may be particularly important since it may prevent sudden incapacitation. We present a case of an aviator with ARVD, in whom the diagnosis was delayed despite an abnormal ECG pattern witnessed over 20 yr. The aviator presented with symptomatic sustained ventricular tachycardia at the age of 46 after nearly 3 decades of active flight duty as a rotary wing pilot in the Israeli air force. This case illustrates the potential of ARVD to result in in-flight incapacitation and emphasizes the need to establish the diagnosis early, particularly in aviators.
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ranking = 1827.8921204836
keywords = ventricular dysplasia, right ventricular dysplasia, dysplasia
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13/69. Hypertrophic cardiomyopathy associated with sudden death during marathon racing.

    An experienced marathon runner died suddenly during a competitive race. At necropsy, ventricular hypertrophy but no asymmetrical septal hypertrophy was found. Histological studies showed features of hypertrophic cardiomyopathy. The coronary arteries were normal. We propose that the runner died from myocardial ischaemia, precipitated by marathon running on a background of hypertrophic cardiomyopathy. Excess cardiac work, induced by marathon running in the presence of mild congenital cardiac defects, could have contributed to the development of the cardiomyopathy.
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ranking = 2.7550866953807
keywords = cardiomyopathy
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14/69. Sudden, unexpected death due to splenic artery aneurysm rupture.

    splenic artery aneurysms are an uncommon form of vascular disease that have a significant potential for rupture, resulting in life-threatening intraperitoneal hemorrhage. We describe the case of a 33-year-old man who died suddenly and unexpectedly due to the rupture of a splenic artery aneurysm. At medicolegal autopsy, 3000 mL of fluid blood were recovered from the peritoneal cavity. The source of bleeding was a sack-like aneurysm of the splenic artery, measuring 2 cm in diameter. Histologic examination of the splenic artery aneurysm revealed fibromuscular dysplasia. No atherosclerotic lesions or any inflammatory changes were apparent within the wall of the splenic artery. Portal hypertension and pancreatitis, previously described as important factors promoting splenic artery aneurysm formation, were excluded by autopsy and histology. From the forensic pathologist's viewpoint, this rare case underlines the importance of splenic artery aneurysm rupture as a relevant differential diagnosis of intraperitoneal hemorrhage and sudden death, respectively, since such cases may be misinterpreted as a result of blunt-force trauma.
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ranking = 0.16666666666667
keywords = dysplasia
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15/69. Sudden death during pregnancy in hypertrophic cardiomyopathy.

    A 27-year-old asymptomatic woman became pregnant 6 months after a diagnosis of hypertrophic cardiomyopathy and was well until 28 weeks' gestation when she died suddenly while running up stairs. The potential pathophysiological mechanisms of sudden death during pregnancy in hypertrophic cardiomyopathy, as well as the diagnostic and therapeutic implications, are discussed.
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ranking = 2.3615028817549
keywords = cardiomyopathy
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16/69. Internal cardioverter defibrillator: component failure.

    Sudden death occurred in a patient with congestive cardiomyopathy, sustained ventricular tachycardia refractory to amiodarone, and an automatic internal cardioverter defibrillator. Interrogation of the AICD at the time of death was indicative of malfunction. Postmortem analysis documented component failure involving a voltage regulating transistor resulting in prolonged charge times.
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ranking = 0.39358381362582
keywords = cardiomyopathy
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17/69. Incessant ectopic atrial tachycardia and sudden death.

    A patient with refractory and incessant ectopic atrial tachycardia (IEAT) is reported in whom it was possible to document, during ECG (Holter) the occurrence of aborted sudden death by spontaneous ventricular fibrillation (VF). Following the second of two attempts at surgical ablation of the origin of the IEAT, the patient has been asymptomatic without antiarrhythmic drugs and in sustained sinus rhythm for 24 months. Although we cannot exclude the residual action of amiodarone and flecainide (proarrhythmia) or the residual peripartum cardiomyopathy it is probable that the observed VF was a true complication of a cardiomyopathy induced by a chronically increased heart rate (HR). Although unclear, this VF might be considered as a form of adrenergic-dependent long qt syndrome due to early afterdepolarization in the presence of predisposing myocardial conditions.
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ranking = 0.78716762725164
keywords = cardiomyopathy
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18/69. Right ventricular dysplasia associated with sudden death in young adults.

    The frequency of right ventricular dysplasia (RVD) in an autopsy series of young persons with sudden cardiac death in the united states has not been previously reported. We reviewed the autopsies from cases of sudden cardiac deaths in young adults in the state of maryland and noted three cases of RVD among 547 cardiac deaths (0.55%). These three cases of RVD in young adults and three additional cases from our file are presented. Their ages ranged from 19 to 28 yr, and there were five males and one female. Five deaths occurred during strenuous exercise while the sixth was unwitnessed. Three of these cases had a documented history of arrhythmias and 1 had palpitations. In each case, autopsy revealed right ventricular dilatation with partial absence of the myocardium and extensive fatty infiltrates with and without fibrosis. In four cases, collections of chronic lymphocytic infiltrates were seen, of which two had associated myocyte necrosis. In one patient, the disease was familial, while in the remaining five it was sporadic, suggesting a nongenetic cause.
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ranking = 1214.6499258261
keywords = ventricular dysplasia, right ventricular dysplasia, dysplasia
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19/69. 3-Hydroxydicarboxylic aciduria due to long-chain 3-hydroxyacyl-coenzyme a dehydrogenase deficiency associated with sudden neonatal death: protective effect of medium-chain triglyceride treatment.

    Two siblings were found to be affected by long-chain 3-hydroxyacyl-coa dehydrogenase deficiency, one of which died suddenly and unexpectedly on the 3rd day of life suffering from extreme hypoketotic hypoglycaemia. The younger sibling started to have feeding problems, lowered consciousness, and liver dysfunction at the age of 5 months. Her urine contained large amounts of C6-C14 3-hydroxydicarboxylic acids and conjugated 3-hydroxyoctanoic acid, as verified by gas chromatography/mass spectrometry. plasma long-chain acylcarnitine was increased. A clue to the diagnosis was given by the results of a phenylpropionic acid loading test. This revealed small, but significant amounts of conjugated 3-hydroxyphenylpropionic acid (phenylhydracrylic acid) in the patient's urine. Subsequently, the activity of long-chain 3-hydroxyacyl-coa dehydrogenase was found to be deficient in cultured skin fibroblasts. Based on the findings obtained by a medium-chain triglyceride load, a diet enriched in this type of fat was prescribed. On this regimen the patient started to thrive, signs of cardiomyopathy disappeared, and her liver function normalized.
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ranking = 0.39358381362582
keywords = cardiomyopathy
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20/69. Sudden death due to right ventricular cardiomyopathy.

    A 21-year-old man died suddenly at a small party. He had had no clinical signs of cardiac disease except for a slightly abnormal electrocardiogram (occasional premature ventricular contractions) since he was 15 years of age. autopsy examination revealed cardiomegaly (469 g), with right atrial and ventricular dilatation. The right ventricular myocardium was massively replaced with adipose tissue, and there was one isolated fatty lesion in the right side of the ventricular septum. There were no congenital malformations such as a septal defect or valvular deformity. Histologically, muscular fibers remaining in the right ventricular wall showed neither degenerative nor inflammatory changes. An isolated lesion of the ventricular septum consisted of almost complete replacement of the muscle bundles with adipose tissue. Such a pathologic condition has recently been termed right ventricular cardiomyopathy. Postmortem examination is necessary to make a definite diagnosis of the disease, because in most adult cases of the disease, sudden death occurs before there have been any critical signs.
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ranking = 165.12053113985
keywords = right ventricular cardiomyopathy, ventricular cardiomyopathy, cardiomyopathy
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