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Sudden death of 19 year old at Barmer Rajasthan
Dr KK Aggarwal,  10 March 2018
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#Cardiology #Multispeciality

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All such cases should end up with molecular autopsy

Dr KK Aggarwal

President HCFI and IPNP IMA

  1. When an adolescent dies unexpectedly, an assessment of the cardiac anatomy is essential via autopsy.
  2. Histologic examination can find cardiomyopathic conditions.
  3. Arrhythmia as a cause of death cannot be assessed on post-mortem examination.
  4. If a cardiac anatomic explanation for sudden death is not found (autopsy-negative sudden unexplained death), evaluation should include family screening and genetic testing; however, in the absence of an overt phenotype, genetic testing is typically negative.
  5. A detailed family history should be obtained. Further assessment of first-degree relatives (siblings and parents) is determined by the family history, autopsy results, and in selected cases, genetic testing
  6. Clinical studies that may be useful in family investigation include ECG, Echo, Holter, cardiac MRI, TMT and electrophysiology testing.
  7. A molecular autopsy includes post-mortem genetic testing for channelopathies and cardiomyopathies is useful in such cases
  8. Genetic testing may be targeted to identify mutations associated with long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia (including mutations in the KCNQ1, KCNH2, SCN5A, and RYR2 genes)

Can such people be saved: Yes. By bystander CPR and bystander public access defibrillator.


Comments

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  • Dr Raj Sharma 16 April - 20:52 hrs

    hi dr k.k.aggarwal. i am in dire need of some literature supporting the fact that " Arrythmia as a cause of death can not be assessed by postmortem examination". can u please help me. dr rajkumar sharma

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  • Dr rakesh kacker 15 March - 08:29 hrs

    Last lines of guidance are for all to understand and propagate. How one should diagnose or understand that such remedy is needed?

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    Dr Pravin Kumar Lonsare 15 March - 08:29 hrs

    If the person becomes unresponsive, connecting AED after initial 2 minutes of CPR in unwitnessed & out of hospital cardiac arrest, AED itself prompts whether the rhythm is shockable or not. Its very simple & can be learned through basic Life Support Training. Even you can view the Videos from AHA on


  • Dr Shrikrishna Kumar 14 March - 14:26 hrs

    Nice information sir

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  • Dr Bharari Patil 11 March - 15:03 hrs

    Good information

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  • Dr Pandarinathan Rameshbabu 11 March - 13:56 hrs

    Good guidance. Thanks.

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  • Dr Anuradha Manoharan 11 March - 12:18 hrs

    Useful information ; thank you !! Bystander CPR and availability of Defibrillator is so important .

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  • Dr Rohini Priya 11 March - 11:16 hrs

    Thank you sir... valuable information in forensic Pathology.

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  • Dr HARRY RALTE 10 March - 22:01 hrs

    Thanks!!

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    Dr Shrikrishna Kumar 10 March - 22:01 hrs

    Nice information sir