Symptoms preceding sudden cardiac death in young individuals are common, particularly syncope and chest pain, but are frequently misinterpreted by medical professionals.
Frequent misinterpretation of cardiac symptoms in young patients warrants clinical caution; this cohort study leaves open whether recognition improves SCD prevention.
OBJECTIVES: To identify patients at risk of sudden cardiac death (SCD) by analysis of clinical history. DESIGN: A retrospective study of the Swedish cohort of 15-35 year olds having suffered an SCD during 1992-1999 and having undergone a forensic autopsy (162 individuals). We sought information in forensic, police and medical records and from interviews with family members. RESULTS: Syncope/presyncope, chest pain, palpitations or dyspnoea were present in 92/162, unspecific symptoms such as fatigue, influenza, headache or nightmares in 35/162. Syncope/presyncope was most common (42/162). In 74 seeking medical attention, 32 had an ECG recorded (24 pathological). In 26 subjects there was a family history of SCD. CONCLUSIONS: The patient seeking medical advice before suffering an SCD is characterized by one to three of the following: 1) cardiac-related symptoms or non-specific symptoms often after an infectious disease, 2) a pathological ECG, 3) a family history of SCD. In 6 out of 10 a cardiac diagnosis was not considered. We conclude that symptoms preceding SCD were common but often misinterpreted.
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Wisten et al. (2005) studied this question.
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