1. Danuta Deboa Sudden natural death

2. Introduction The sudden death is due to a natural process, of rapid development and unexpected occurrence. It may be associated with many factors: cardiovascular, respiratory, central nervous system, metabolic and others. It results in biochemical and physiological dysfunction causing death.

3. Death in general can be divided in two groups: Caused by trauma -unnatural (accidental, suicide, homicide) Natural death - due to natural process. The death may be lingering, sudden or instantaneous Caused by trauma -unnatural (accidental, suicide, homicide) Natural death - due to natural process. The death may be lingering, sudden or instantaneous

4. Natural death-classification Cardiovascular Respiratory Central nervous system Gastrointestinal, genitourinary, haematologycal Metabolic factors Miscellaneous Unknown causes (SIDS, immunologyc defects Obstetrical and gynaecological Cardiovascular Respiratory Central nervous system Gastrointestinal, genitourinary, haematologycal Metabolic factors Miscellaneous Unknown causes (SIDS, immunologyc defects Obstetrical and gynaecological

5. Death caused by cardiovascular failure Cardiac tamponade Recent infarction Myocardial rupture Rupture of aneurysm Cardiac tamponade Recent infarction Myocardial rupture Rupture of aneurysm

6. Myocardial rupture and tamponade

7. Arrhythmias Tachycardias - (ventricular, supraventricular) Bradycardias - (AV nodal disease, sinus node failure) Tachycardias - (ventricular, supraventricular) Bradycardias - (AV nodal disease, sinus node failure)

8. Low-output staters Infarct - (cardiogenic shock, heart failure) Cardiomyopathy Acquired valvular stenosis - (aortal, mitral and tricuspid stenosis) Pericardial tamponade Hypovolemia (diuretic drugs and vasodilatators) Infarct - (cardiogenic shock, heart failure) Cardiomyopathy Acquired valvular stenosis - (aortal, mitral and tricuspid stenosis) Pericardial tamponade Hypovolemia (diuretic drugs and vasodilatators)

9. Others cardiovascular causes of death Cardiac rupture Aortic dissection Coronary embolism Cardiac tumours Primary pulmonary hypertension Cardiac rupture Aortic dissection Coronary embolism Cardiac tumours Primary pulmonary hypertension

10. Death caused by respiratory system failure Pneumothorax Embolia arteriae pulmonalis Embolia arteriae pulmonalis

11. Pulmonary embolism Air Fat Amniotic fluid Air Fat Amniotic fluid

12. Asphyxial causes Aspiration of blood or gastric contents Asthma Pneumonia ARDS Aspiration of blood or gastric contents Asthma Pneumonia ARDS

13. Death caused by central nervous system failure Vasodepressory syncope Carotid sinus oversensitivity Epilepsy Pulseless disease Infection (meningitis, abscesses) Cerebrovascular accident Psychological (hyperventilation, hysteria) Vasodepressory syncope Carotid sinus oversensitivity Epilepsy Pulseless disease Infection (meningitis, abscesses) Cerebrovascular accident Psychological (hyperventilation, hysteria)

14. Meningitis

15. Subdural haematoma Tumour site Intraventricular bleed Intracranial bleed Ruptured berry aneurysm Sudden death - neurological

16. Ruptured berry aneurysm

17. Gastrointestinal, genitourinary, haematological Haemorrhage (ulceration, varices) Intestinal obstruction (hernia, adhesions) peritonitis Insufficient liver (viral infections, alcohol) Renal insufficiency Spleen rupture Leukaemia & haemophilia Haemorrhage (ulceration, varices) Intestinal obstruction (hernia, adhesions) peritonitis Insufficient liver (viral infections, alcohol) Renal insufficiency Spleen rupture Leukaemia & haemophilia

18. Sudden death Alimentary truck Ulceration Oesophagus Stomach Duodenal Perforated urethra Alimentary truck Ulceration Oesophagus Stomach Duodenal Perforated urethra Ruptured aneurysm Ruptured spleen (leukaemia) Liver, Ruptured diverticule and intestine Ruptured aneurysm Ruptured spleen (leukaemia) Liver, Ruptured diverticule and intestine

19. Ruptured aneurysm

20. Ulceration oesophagus

21. Metabolic factors Hypoxemia Hypoglycaemia Hypocalcaemia Thyroid storm Pituitary apoplexy Adrenal cortices insufficiency Hypoxemia Hypoglycaemia Hypocalcaemia Thyroid storm Pituitary apoplexy Adrenal cortices insufficiency

22. Miscellaneous Sepsis Allergic reactions Massive haemorrhage Toxaemia S.I.D.S. Sepsis Allergic reactions Massive haemorrhage Toxaemia S.I.D.S.

23. Suprarenalis haemorhagia

24. Sudden Infant Death Syndrome (SIDS) SIDS is a medical disorder that claims the lives of thousands of young children one week to one year of age. Once known as crib death, these infant deaths remain unexplained after all known causes have been ruled out through autopsy, death scene investigation and review of the medical history. SIDS can affect families of all races, religions and income levels. It strikes without warning and usually occurs during sleep. Its victims appear healthy. Neither parents nor doctors can tell which babies will die. SIDS is not caused by vomiting and choking, or minor illnesses such as colds or infections. The DTP vaccine and other immunizations do not cause SIDS.