[Sudden death caused by atheromatous coronary disease in the young].

INTRODUCTION AND OBJECTIVES: Atheromatous coronary disease (ACD) is the most frequent cause of sudden death (SD) in adults. Few studies have focused in SD due to ACD in those patients under 35 years old. The aim of this study is to analyze the incidence, and clinical and pathological characteristics of ACD as a cause of death in young people.

MATERIAL AND METHODS: We reviewed all SD cases in people from 1-35 years old which occurred in Bizkaia and in which there was a legal-medical autopsy from 1991 to 1998. A complete autopsy was performed in each case. SD due to ACD were analyzed, including pathological antecedents.

RESULTS: 19 out of 107 SD (18%) occurred by ACD. All of them were males from 27 to 35 years of age. According to the male population from 30 to 35 years, the incidence was 3.7/100,000/year. In two patients ACD was diagnosed before death. Coronary risk factors were obtained in 10 cases and prodromal symptoms were described in 5 (chest pain in 4). In 79% death occurred during routine activity. None of the 19 patients arrived alive to hospital. In 6 cases multiple coronary disease was observed; coronary thrombosis in 8; recent acute ischemic myocardial necrosis in 4 and old ischemic damage in 7. 18 cases showed cardiac hypertrophy.

CONCLUSIONS: ACD is an important cause of SD in young males, frequently being the first manifestation of the disease. As identification of groups at risk is so difficult and death occurs so quickly, primary prevention of ACD, rapid intervention of emergency services and educational programs in cardiopulmonar resuscitation for normal population are fundamental in reducing the mortality.