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Sudden Cardiac Death in HCM Often Preceded by Symptoms

A sizable number of cases had a known cardiac disorder before sudden cardiac death with hypertrophic cardiomyopathy

WEDNESDAY, Sept. 28, 2022 (HealthDay News) — A majority of cases of sudden cardiac death (SCD) with hypertrophic cardiomyopathy (HCM) present with possible cardiac symptoms before death, and a considerable proportion have a known cardiac disorder prior to death, according to a study published online Sept. 14 in PLOS ONE.

Erik Börjesson, M.D., from Sahlgrenska University Hospital in Göteborg, Sweden, and colleagues characterized family history, symptoms, hospital utilization, and electrocardiogram (ECG) changes before SCD among all patients who had SCD with HCM from 2000 to 2010.

The researchers identified 38 cases with HCM. Seventy-one percent of these cases presented with possible cardiac symptoms before death: chest pain (26 percent), syncope (22 percent), and palpitations (37 percent). Also, 69 percent received medical care within 180 days before death compared with 21 percent of controls. Most patients (68 percent) died during recreational activity or exercise/competitive sport (14 and 12, respectively). Overall, 39 percent (15 cases) had a known cardiac disorder before death. In nine cases, HCM was diagnosed premortem. Fifty-eight percent presented with abnormal ECG recordings premortem, and 50 percent had a positive family history for heart disease.

“These findings suggest it might be possible to predict, and possibly prevent, SCD in young individuals with HCM,” the authors write. “Improved strategies to detect those at high risk of SCD must be considered in this endeavor.”

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