Sudden Cardiac Death in Apparently Normal Young Adults

Most people who die suddenly from cardiac disease are elderly and develop symptoms prior to the fatal event. This review deals with apparently fit and healthy young adults who die suddenly and unexpectedly. The underlying cardiac causes are discussed. Many of the causes of sudden unexpected death discussed in this article do not cause abnormal physical findings and the subjects may be asymptomatic. Screening asymptomatic young adults for potential causes of sudden death remains controversial. Screening should pay particular attention to the subject's family history, particularly if there are any relatives who have experienced sudden unexpected death. A resting ECG can reasonably be expected to be a cost effective screening tool but routine echocardiography for individuals with no symptoms and no physical findings is not recommended. Understanding the molecular basis for cardiac repolarisation will give better insight into the underlying mechanisms of arrhythmias. There has been progress in this direction in recent years and hopefully new therapies will be discovered.