Key result
Young SCD victims with HCM experience cardiac symptoms prior to death in ~55% of cases.
Why the study?
Are cardiac symptoms more frequent prior to death in young individuals suffering sudden cardiac death due to hypertrophic cardiomyopathy compared to controls?
Case-Control (n=112)
Yes
Are cardiac symptoms more frequent prior to death in young individuals suffering sudden cardiac death due to hypertrophic cardiomyopathy compared to controls?
Absolute Event Rate: 55% vs 1%
p-value: p=<0.001
A significant proportion (55%) of young individuals who suffer sudden cardiac death due to hypertrophic cardiomyopathy experience cardiac symptoms prior to death, highlighting a potential window for clinical intervention.
Symptoms may precede SCD in young HCM; hypothesis-generating and requires confirmation before clinical adoption.
AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431 autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought medical attention. One (1%) control had cardiac symptoms before death. Consequently, a significantly higher proportion of cases had cardiac symptoms before death and cases more often sought medical attention than controls (P < 0.001). CONCLUSION: In conclusion, this nationwide study demonstrates a high frequency of cardiac symptoms prior to death in SCDY cases who died of HCM, as 55% had cardiac symptoms and nearly half of the cases sought medical attention.
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Lynge et al. (2016) conducted a case-control in Sudden cardiac death due to hypertrophic cardiomyopathy (n=112). Sudden cardiac death due to HCM vs. Traffic accident victims was evaluated on Cardiac symptoms >1 h prior to death (p=<0.001). Cardiac symptoms prior to death were significantly more frequent in young sudden cardiac death victims with hypertrophic cardiomyopathy compared to controls (55% vs 1%, P<0.001).
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