Sudden adult death: A medico-legal series of 77 cases between 1995 and 2000

Among all the autopsies performed between 1995 and 2000 in our Department, 77 adult cases of sudden death were selected. Sex, age, place of death, circumstances of death, causes of death and heart weight were reported from these 77 post-mortem records. A complete forensic autopsy was performed in every case. Sudden death occurred more frequently in males at rest. Strenuous activity was rarely involved in sudden death and 72.7% of the cases died from cardiovascular disease, mainly coronary atherosclerosis. Non-cardiac causes were dominated by pulmonary and neurological diseases. Cardiomegaly was a frequent finding in cases who died from cardiac pathology. This study underlines the importance of complete medico-legal investigations in case of sudden death. Multiple heart samples are required in order to detect focal microscopic lesions, such as myocarditis and some forms of cardiomyopathy with minimal gross abnormalities. The post-mortem diagnosis of such cardiomyopathies is very important because the family of the deceased may undergo a possible screening. Toxicology is useful in the diagnosis of epileptic seizure and in identifying drugs like metamphetamine as a risk factor for some lethal cardiovascular pathologies such as aortic dissection. Molecular biology can also be helpful when limits of morphological diagnosis have been reached.