Key Points
- To evaluate the circumstances, potential activity triggers, and postmortem pathological findings associated with out-of-hospital deaths from arteriosclerotic heart disease.
- Autopsy study analyzing 2,678 out-of-hospital deaths certified as arteriosclerotic heart disease across 1955, 1960, and 1964–1966 in the Stockholm region.
- Assessed circumstances, pre-death activities, and pathological lesions across 1,213 sudden death cases using forensic autopsy protocols and police records.
- Heavy physical exertion and mental stress combined preceded no more than 25% of male sudden deaths and an even smaller minority of female deaths.
- Autopsy identified recent myocardial infarction in 34% of men aged under 50 and approximately 20% of older men, with lower rates in women, who conversely showed an overrepresentation of myocardial ruptures.
- Documented prior symptoms of heart disease were absent in 37% of sudden cardiac deaths among men under 50 and in roughly 20% of older individuals of both sexes.
Structured PICO
PPopulation2678 deaths outside hospitals in the Stockholm region due to arteriosclerotic heart disease (ASHD) certified by autopsy, of which 1213 were considered sudden.
OOutcomeCircumstances of death (place and activity at time of death) and postmortem findings (recent myocardial infarction, myocardial ruptures).hard clinical
This historical autopsy study highlights that sudden death from arteriosclerotic heart disease often occurs without preceding heavy exertion or prior symptoms, and recent myocardial infarction is not universally present.