13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-171

Sudden cardiac death in the young:
substrates and triggers

Gaetano Thiene, Cristina Basso, Domenico Corrado.
Department of Pathology and Cardiology, University of Padua Medical School, Padua, Italy.

Introduction

Sudden cardiac death in the young is ascribable to cardiac disease in nearly 85% of cases. Cerebral and respiratory sudden deaths account for nearly 8-10% of events, whereas in the remaining 5-7% the fatality remains unexplained even after autopsy. Thus the sudden cardiac death is by far the most frequent occurrence¹. In case of mechanical death by cardiac tamponade, the culprit should be searched for in the aorta, whereas in case of arrhythmic death the culprit should be searched for in the coronary arteries, myocardium and conduction system.

The abnormality (substrate) is there since long time and frequently since birth (congenital defect). Why the cardiac arrest occurs only in some circumstances is still unclear. Triggering mechanisms, usually neurovegetative influences, have been postulated².

The scope of this presentation is to demonstrate that acute damage may superimpose to chronic substrate in case of sudden cardiac death in the young, thus playing the role of trigger.