Sudden Unexplained Death in the Community

With approximately 250,000 US lives lost to this condition on a yearly basis, sudden cardiac death (SCD) is a public health problem of significant magnitude.1,2 In most cases, an associated cardiac disease condition leading to the fatal event can be identified, but for a distinct subgroup of cases, SCD can remain completely unexplained.3 The postmortem examination is negative, with a structurally normal heart and no other identifiable etiologies of sudden death. Most commonly, this form of SCD is referred to as sudden unexplained death syndrome (SUDS), but other terms such as sudden arrhythmic death syndrome and idiopathic ventricular fibrillation have also been used.13-5 The vast majority of cases have some form of primary electrical disorder of the heart leading to a fatal cardiac arrhythmia. Since this syndrome mostly afflicts younger adults and there are significant limitations for predicting risk in family members who are left behind, SUDS is a devastating manifestation of heart disease.6 The goal of this review is to discuss the magnitude of the problem, age-and gender-related prevalence, diagnostic considerations, and clinical/research implications of these observations.