Forensic pathological study of 334 cases of sudden cardiac death in Genoa ( Italy) district. A seven-year report

Background. Sudden cardiac death (SCD) is one of the main causes of death worldwide. The analysis of such cases is a complex and delicate task, which is invariably carried out by the forensic pathologist.Methods. We conducted a retrospective analysis of cases of SCD identified among cases of sudden death on the basis of complete autopsy study at the Institute of Legal Medicine from 2011 to 2017.Objectives. Our aim was to analyze the epidemiological data and etiological distribution. This review is the first study to analyze the etiological distribution and epidemiological data of SCD in an arca of north-western Italy from the perspective of forensic identification.Results. In the period considered, 334 cases of SCD were identified; the mean age of the subjects was 65.4 years, and males were clearly predominant (78.14%). In 91.62% of our overall series, the cause of SCD was coronary atherosclerotic disease (CAD), the highest occurrence of which was found in subjects aged over 60 years (98.02%). In over 85% cases of CAD, the left anterior descending artery (LAD) presented sclerotic degeneration and stenosis. A markedly lower percentage of CAD (28.58%; 4 cases) was found in subjects aged less than 40 years, in whom the leading cause of SCD was hypertrophic cardiomyopathy (35.72%; 5 cases).Conclusions. That the leading cause of SCD was CAD. In subjects aged less than 40 years, hypertrophic cardiomyopathy was the most frequent pathology. LAD was the coronary branch most often involved in CAD-related SCD.