Original Article: PDF OnlyIschemic Heart Disease Related Sudden Cardiac Death in Autopsied Cases An Egyptian perspectiveFnon, Nora F. PhD*; Hassan, Hanan H. MD, PhD*; Ibrahim, Mahrous A. MD, PhD†,‡Author Information From the *Forensic Pathology Department, Forensic Medicine Authority, Ministry of Justice, Cairo, Egypt †Forensic Medicine and Clinical Toxicology, College of Medicine, Jouf University, Aljouf, Saudi Arabia ‡Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Suez Canal University (SCU), Ismailia, Egypt. Manuscript received January 7, 2021; accepted April 13, 2021. The authors report no conflict of interest. Reprints: Nora F. Fnon, PhD, Forensic Pathology Department, Forensic Medicine Authority, Ministry of Justice, Byrum Al-Tonsy Street, Al-Sayeda Zeinab, Cairo 11617, Egypt. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: June 5, 2021 - Volume - Issue - doi: 10.1097/PAF.0000000000000694 Buy PAP Metrics Abstract Diagnosis of the underlying cause of sudden unexpected death in a previously healthy individual remains one of the important challenges in forensic practice. Ischemic heart disease is the most common cause of sudden death. The current study aims to investigate the incidence and pathology of sudden ischemic cardiac death in Egypt. All cases of sudden cardiac death (SCD) examined by different forensic departments throughout Egypt during the period of January 2010 through December 2014 were included. Cases underwent complete autopsy examination including a thorough gross and microscopic examination of the heart and great blood vessels. Of 535 cases of SCD diagnosed during the period of the study, coronary atherosclerosis was the principle finding in 420 (78.5%) cases. The highest numbers of deaths were reported in fifth and sixth decades with male preference. Other causes of SCD included myocarditis, cardiomyopathies, valvular heart disease, and hypertensive heart disease (7.8%, 4.1%, 4.1%, and 2.8%, respectively). There was severe stenosis (>75%) of at least 1 coronary artery in 74% of cases. Type VI atherosclerosis was found in 40.7% of cases. The left anterior descending branch was the most affected artery by atherosclerosis. Acute coronary pathological events were demonstrated in 27.6% of cases. Recent myocardial infarction was evident in 55.5% of cases, whereas old infarcts were demonstrated in 44.5% of cases. Features of hypertensive heart disease were present in 18.3% of cases. In conclusion, ischemic heart disease is the leading cause of SCD in Egypt. © 2021 by Lippincott Williams & Wilkins.