A Sudden Death, Natural Disease, Infection And Autopsy 1.What is sudden death? The medicolegal term “sudden death” (sometimes called "sudden unexpected natural death"), refers to those deaths which are not preceded by signi icant symptoms. The term as used obviously excludes violent or traumatic deaths. There is no universally accepted de inition of sudden death, and time periods varying from 1 to 48 hours have been used in different places. The WHO's de inition is “death occurring within 24 hours of the onset of symptoms”. 2. 1 What are the usual causes of sudden death and how to identify them? Causes of Sudden Death Coronary Artery disease 2 Hypertensive heart disease (HT) 3 4 Aortic valve disease Cardiomyopathy 5 Myocarditis 6 Rupture of aneurysm 7 Pulmonary thromboembolism 8 Sudden death in epilepsy Identifying features More common in left coronary artery Thrombus and plaque may be seen along with narrowing of artery. Heart may rupture after 2 week of heart attack. Anyone with heart weight of > 450gm is a candidate for sudden death with or without coronary artery stenosis HT may kill by kidney failure, bleeding in brain or heart failure. Hypertensive hearts are generally 500 - 700gms by weight. Mostly seen in elderly men. Left side of heart is enlarged Victims are young adults Heart enlarged (left side more) Mostly of unknown origin. Should always be confirmed under microscopy. May be in abdominal aorta (major blood vessel coming out from heart) or in brain (young to middle age, which can cause subarachnoid bleed in brain) Generally happens about 2 weeks after injury or surgical operation. Thrombus generally originates from legs that may lodge in the lungs. When all investigations including toxicology, drug overdose are done and there is no significant finding on autopsy, epilepsy could be recorded as acceptable cause of death. Findings suggestive of fits (tongue/lip bite). Previous history of head injury/seizure. MEDICAL DIMENSION OF FREQUENTLY ENCOUNTERED CASES | 26