Increasing cardiac symptoms, healthcare use could be warning signs of sudden cardiac death

In patients with heritable cardiac disease arrhythmogenic right ventricular cardiomyopathy (ARVC), mounting cardiac symptoms and healthcare use seem to precede sudden cardiac death (SCD), a recent study has found.

Researchers conducted a medical record review of 22 deceased patients with autopsy-confirmed diagnoses of ARVC; all patients had died of SCD. Data collected included anatomopathological findings, autopsy reports, medical and family history, and circumstances of death. Findings were compared against age-, sex-, and geography-matched controls.

In the 6 months before SCD, 68 percent (n=15) of patients experienced symptoms of cardiac origin. These were mainly syncope or presyncope (54 percent), though cases of chest discomfort (27 percent) and seizures (14 percent) were also reported. In turn, 36 percent (n=8) of patients sought medical care for these symptoms.

In addition, 45 percent (n=10) of patients had a family history of SCD, though only two such episodes occurred in first-degree relatives. Most participants were physically active, with 23 percent participating in competitive sports and 55 percent in recreational sports. Death was exercise-related in 41 percent of cases.

“The most important finding in this nationwide study is that most young patients who died of SCD because of ARVC had experienced cardiac symptoms during the last 6 months preceding death,” the researchers said.

The present findings “emphasize why early recognition of the disease in patients seeking medical care with alarming symptoms and family history is critical, as SCD can be the first disease manifestation, often before detectable structural changes occur,” they added.