- LONDON (Reuters Health) -
Many apparently healthy adults may be dying unexpectedly in a grown-up
version of the "cot death" phenomenon, British researchers said
on Friday.
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- The British Heart Foundation said a study showed that
the number of adults who collapse and die suddenly without explanation
could be "much greater than is recorded in official statistics."
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- Like sudden infant death syndrome, such deaths should
be labeled "sudden adult death syndrome," said Dr. Tim Bowker,
the charity's associate medical director and lead researcher of the study.
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- The study, published in the Quarterly Journal of Medicine,
examined the frequency of sudden unexpected cardiac or unexplained death
in a sample of cases investigated by coroners in England during the 1990s.
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- The study included white people aged 16 to 64 years who
had no history of cardiac disease on whom autopsy found either a cardiac
or no identifiable cause of death.
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- Most of the 692 people investigated died from heart-related
causes. But in 4.1 percent of the cases, no cause could be found despite
a full post-mortem examination.
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- "It has long been recognized that there are occasions
when an apparently previously healthy adult dies suddenly and unexpectedly
and any abnormalities found at post-mortem are minimal or non-existent,"
Bowker said in a statement.
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- "In such cases it can be very difficult to identify
a precise cause of death. This leads us to question whether these deaths
are rare or represent the tip of a larger iceberg," he said.
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- "If the condition is more frequent than we suspect
-- particularly if across the country pathologists and coroners are using
different words to describe the cause of death -- we need to give the condition
a 'name' to help us gain a greater understanding of the scale of the problem,"
Bowker said.
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- Bowker added, "Not until it is accepted practice
to identify all these unexplained deaths and to label them as such will
it become possible to study them systematically, identify their causes
and find ways of preventing them from occurring."
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- The charity said experience with "cot deaths"
indicated that this approach could have a major impact.
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- "Once cot death became officially labeled as the
'sudden infant death syndrome,' it was possible to collect and collate
the relevant data, identify possible causes and take steps to protect infants
from such tragedies, resulting in a 70 percent fall in the number of deaths
over a period of 10 years."
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- The new study estimates that in England, 3,500 apparently
healthy adults die suddenly from cardiac or unexplained causes each year.
In about 150 of these deaths, no cause can be identified.
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- The charity said many of these deaths might be due to
electrical abnormalities of the heart, some of which are inherited. It
pointed out that electrical measurements of the heart can only be made
when a person is alive.
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- "Because the 'alarm bells' only start ringing after
the death of a seemingly well adult, we hope our new findings will encourage
people to look back into their family's medical history and to think about
whether any close relatives may have died young from unexplained causes,"
said the charity's medical director, Professor Sir Charles George.
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- SOURCE: Quarterly Journal of Medicine 2003;96:269-279.
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