Sudden cardiac death: improving our pathological diagnosis--are we there yet?

This editorial refers to ‘The importance of specialist cardiac histopathological examination in the investigation of young sudden cardiac deaths’ by S.V. de Noronha et al ., doi:10.1093/europace/eut329. Any truth is better than indefinite doubt. Sherlock Holmes Sudden cardiac death (SCD) is by nature unexpected and not infrequently present in a person without pre-existing heart disease. The abrupt and unexpected presentation carries a significant burden on family members leading to great anxiety and the need to demand answers regarding the cause of the unexpected loss. Sudden cardiac death is defined as a death occurring within 1 h of an acute change in clinical status, or an unexpected death that occurred within the previous 24 h.1–3 The specificity of this definition is questionable, and the final diagnosis derived from autopsy reports also varies significantly.1The incidence of SCD is widely variable and in the USA ranges between 180 000 and 450 000 cases annually.4 Recent studies in different geographical regions including the USA,5,6 the Netherlands,7 England, and Ireland,8–10 and China11 indicate …