Causes of sudden death in the region of Murcia (Pheidippides study)

Background: Sudden Cardiac death is an important health care problem in European countries. Inherited cardiac diseases are common causes in young individuals. We aim to report the preliminary results from a regional programme of sudden cardiac death (Pheidippides study). Methods: We included 94 consecutive sudden death (SD) cases and resuscitated cardiac arrests (CA) evaluated from Jan 2009 to Jan 2013 at the Hospital. Postmortem study of SD cases and comprehensive clinical cardiac study in survivors of cardiac arrest were performed. Cases with known history of coronary artery were excluded. In cases with available tissue or blood sample genetic testing of related genes was performed. Results: 75 SD (67, 89% males, aged 39±15 years) and 19 CA (9, 47% males, aged 30±24 years). Diagnosis of the underlying pathology was achieved in 76 (81%), with 24 (31%) Hypertrophic Cardiomyopathy, 12 (16%) ischaemic coronary disease, 6 (8%) Arrhythmogenic Cardiomyopathy, 6 (8%) Idiopathic left ventricular hypertrophy, 4 (5%) long QT, 4 (5%) unclassified cardiomyopathies, 3 (4%) endomyocardial fibroelastosis, 3 (4%) aortic abnormalities, 2 (3%) Dilated Cardiomyopathy, 2 (3%) Chagas Cardiomyopathy, 1 (1.3%) cocaine abuse related SD, 1 (1.3%) Brugada syndrome,1 (1.3%) cardiac sarcoidosis, 1 (1.3%) coronary anomaly, 1 (1.3%) myocarditis,1 (1.3%) cathecolaminergic ventricular tachycardia, 1 (1.3%) conduction disease,1 (1.3%) malignant vasospasm, 1 (1.3%) malignant epilepsy and 1 (1.3%) Idiopathic ventricular fibrillation. Genetic diagnosis was achieved in 13 out of the 50 (26%) in which genetic testing guided by the pathology was carried out (ongoing study). Most prevalent genes were 5 desmosomal, 1 sarcomeric and 5 channels coding genes. Conclusion: There is a clear male predominance in SD and CA cases (80%) in our Region. Cardiomyopathies, in particular hypertrophic cardiomyopathy are the main cause of death. Despite postmortem in SD cases and dedicated clinical study in survivors a significant proportion (1 in 4) remain without a final diagnosis.