Heart Disease in Arrest-Related Death

It is accepted that congenital and acquired heart disease increase the risk of sudden cardiac death. To our knowledge, there are no published studies on the types of heart disease in cases of arrest-related deaths. The goal of this study, therefore, was to consider a large body of autopsy reports of non-firearm arrest-related deaths to analyze the presence of heart disease with regard to numerous decedent variables and toxicology findings. We analyzed 1650 autopsy reports covering the years 2005-2024 and classified cardiac findings into larger subgroups. Most of the cases (95%) were men, and the mean age was 38 years, with a range of 14 to 95. The racial classification was black (40.2%), Hispanic (17.8%), and non-Hispanic white (38.8%). There was some type of cardiac abnormality described in 61% of the group. The most common were cardiomegaly (35.8%), cardiac hypertrophy (23.6%), moderate to severe coronary disease (15.0%), cardiomyopathy (14.5%), and hypertensive cardiac disease (12.2%). At 61%, the rate of any heart disease is significantly higher than the expected rate of 1% to 2% for this age group in living patients. The rates of specific heart diseases were also significantly higher. For example, the general population rate of dilated cardiomyopathy is estimated to be 0.4% and contributes to 0.2% of deaths, whereas in this group of autopsy-diagnosed young men, the prevalence was 4%. Our findings show a high rate of subclinical heart disease in people experiencing non-firearm arrest-related deaths. It is possible that these findings show an increased clinical risk in this population. The incidence of heart disease is increasing with time for this population.