HYPOPLASTIC CORONARY-ARTERY DISEASE WITHIN THE SPECTRUM OF SUDDEN UNEXPECTED DEATH IN YOUNG AND MIDDLE-AGE ADULTS

The etiology of sudden unexpected death in young and middle age adults is frequently listed as undetermined, thereby causing much grief and fear among family members. When careful, methodical autopsies were per formed, a significant number of cases of hypoplastic coronary artery d isease (HCAD) were found where no other etiological factor could accou nt for the deaths or where there was a solo coronary occlusion proxima l to the hypoplastic coronary artery. This is in marked contrast to th e small number of cases that have been reported, indicating that HCAD is more common than is generally realized. A representative series of seven cases of sudden death due to HCAD is presented, possible mechani sms of death in HCAD are fully discussed, and recommendations for an a utopsy checklist for investigating sudden cardiac death at autopsy are presented.