Article Molecular autopsy in sudden cardiac death
Cause of death in SUCD remains elusive
Molecular autopsy is far fetched
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Autopsy series suggest that in people under 35 years of age, 24–31% are due to coronary artery disease, 17–37% are associated with cardiomyopathy and in 31–35%, no cause is found by gross and histological examination and the death is presumed to be arrhythmic. I think a phenotypic approach to molecular autopsy based on a multidisciplinary group that includes clinical and laboratory genetics, forensic medicine and cardiology is important and necessary, especially in cases of negative autopsy (30-35%). Family studies suggest that an inherited arrhythmogenic cardiac disorder can be found in around 53% of families identified through a sudden cardiac death with negative autopsy and this has led to the proposal that a molecular autopsy, where a DNA sample from the deceased is analysed for mutation in genes known to predispose to arrhythmia, should become part of the standard of care for such families along with cardiac evaluation of at risk relatives. So, it is important to establish the risk to prevent morbidity and mortality in relatives.
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