Acute myocardial ischaemia presenting as sudden death in the Lothian and Borders regions of Scotland, 1987 and 1997

• Published in: Journal of clinical forensic medicine 1999-12, Vol.6 (4), p.228-232
• Main Authors: Gregoriades, M.L., Squires, T.J., Busuttil, A.
• Format: Article
• Language: English
• ISSN: 1353-1131; 1532-2009
• DOI: 10.1016/S1353-1131(99)90002-0

Objectives: To profile deaths from acute myocardial ischaemia presenting as sudden unexpected death in the years 1987 and 1997, and to review the diagnosis of those patients who sought medical attention. Design: A retrospective study using data obtained from autopsy and police reports held in the Forensic Medicine Unit of the University of Edinburgh. Results: Cardiovascular pathology was present in a significant proportion of cases. Clinically ‘silent’ events presenting as a sudden, unexpected death were common, comprising more than one-half of the events observed in 1987 and one-third of those in 1997. For symptomatic cases, respiratory and upper gastrointestinal symptoms were the most common presentation. The majority of patients seeking medical advice were misdiagnosed as either having a chest infection or indigestion. Conclusions: Doctors in the primary care setting should include acute myocardial ischaemia as a possible differential diagnosis of a number of symptoms which initially do not suggest a myocardial origin.