1. An Approach to Sudden Cardiac Deaths in Medicolegal Autopsies First Author : Demeny Andrea Coauthor : Munteanu Lucian Coordinator : Lecturer Hadareanu Viorel

2. BackgroundBackground Sudden cardiac death(SCD) is defined as being a natural death, of a cardiac nature, with an unexpected loss of consciousness, related, or not, to the existing heart condition. It’s a major health issue, in the developed countries being the main cause of death. That’s why the causes of SCD must be intensively studied, to prevent unexpected deaths.

3. ObjectiveObjective We focused our study on discovering the main causes of premature death and predisposed population.

4. Material and Method In our retrospective study, we focused on the year 2012, and we have documented the nature and the main causes of death, as well as the associated cardio-coronary pathology, based on macroscopic descriptions and histopathology reports.

5. Out of the total of 739 necropsies carried out at the “Forensic Medicine Institute in Tirgu Mures”, in 2012, it was determined that 234 were sudden deaths which were included in our study.

6. ResultsResults Based on gender, 171(73%) were males and 63(27%) were females.

7. The majority of the deaths, 72(31%) occurred during the 6 th decade of life. Out of these, 16 were females and 56 were males. There was a noticeable difference for the deaths over 70 as well: 18% were men, and twice as many were women, 36%.

9. Marital status also seems to have made a difference: only 79(34%) were married. Out of the 234 necropsies, 35(15%) were of a violent cause.

10. The most frequent causes of death were: acute cardio-respiratory failure (ACRF) 89(38%), acute cardio-circulatory failure 43(18%), cardiac arrest 39(16%), other 63(28%).

11. In the “ Other” causes of death we included : Intoxications Deaths due asphyxia Cerebral palsy Trauma Shock (hemorrhagic and septic) Hypothermia Internal bleeding

12. The cardiac modifications observed macroscopically were: atherosclerosis 196(84%), miocardiosclerosis 154(66%), anemia 87(37%) and other.

17. Histopathologically, in 45 cases, there was evidence of an older myocardial infarction, and in 17(7%), of an acute myocardial infarction.

18. ConclusionsConclusions A much higher rate of sudden death was noticed in single/divorced men in their 50s, with the main cause of death being ACRF, due to major cardiac arrhythmias. Atherosclerosis was found in 196 necropsies, out of the total of 234, meaning 84%. 85% were of a non-violent cause.