Risk Factors of Sudden Cardiac Death in Egyptian Patients Younger than 40 Years of Age from 2010 to 2020
Authors: Ali Hend , Nabil Ahmed , Eldamanhoury Hayam , Aboulmaaty Mervat 
Published: August 2023

Abstract

Background
Sudden cardiac death in young people is devastating problem. The causes are well known; however, its causes may not be discovered before the episode of sudden death. A challenge for the future is identification of those patients at risk before an episode of sudden cardiac death. Development of preventive and educational program require identification of sudden cardiac death/sudden cardiac arrest risk factors, causes and characteristics.

Aim of the Work
To study the characteristics of SCD/SCA in a cohort of young Egyptian population.

Patients and Methods
This study included 246 patients of SCD/SCA who were collected from 5000 records of arrhythmia patients from January 2010 till January 2020. The records of the specialized arrhythmia clinic were reviewed to collect the families of SCD/SCA. The families were contacted by phone and were invited to the clinic for further work flow. All patients and/or their first-degree relatives were subjected to thorough history taking and clinical evaluation and investigations. The data of the families and victims was secured and was hidden during publishing of study results.

Results
Males constituted 57% of the study population, also they constituted 59.8% in the age group between 12-40 years. The mean age was 26±12 years. BMI was 24.17±6.42 kg/m2. Family history of similar cases in the family was present in 202 (82.1%) cases. Sixty one percent of the cases (61.3%) had history of syncopal attacks. Cardiovascular risk factor was found as 8% of the cases were hypertensives, 3.2% were diabetics, 4% were smokers and 0.4% were addicts. Fifty percent (50.4%) of SCD/SCA cases occurred mostly during non exertion or sleep, while 15.4% cases developed SCD/SCA during practicing exercise. patients with positive consanguinity, significantly higher in the age group between 2-12 years than in the age group between 12-40 years (61.7% vs 35.7%). Investigating the etiology of SCD, hypertrophic cardiomyopathy was the most common cause of SCD/SCA which represented 20.3%, followed by dilated cardiomyopathy (19.1%), long QT Syndrome (11.4%), complete heart block (8.5%), Brugada syndrome (6.8%), Wolf Parkinson white syndrome (6.1%), Not diagnosed (6.1%), Arrhythmogenic right ventricular cardiomyopathy (5.7%), Catecholaminergic polymorphic ventricular tachycardia (5.7%), Idiopathic ventricular tachycardia (4.3%), Primary ventricular fibrillation (2.8%), Concealed Anteroseptal accessory pathway (1.2%), Premature ventricular complexes (1.2%), Ischemic heart disease (0.8%) Mitral annular disjunction (n = 2) 0.8%, and left ventricular non compaction (0.8 %). Long QT syndrome was the third common cause of SCD and was the first common cause of SCD in the age group between 2-12 years.

Conclusion
The most common cause of SCD was hypertrophic cardiomyopathy, followed by dilated cardiomyopathy. This was true for the age group between 12-40 years. Their incidence was significantly higher than that of the age group between 2-12 years. Long QT syndrome was the third common cause of SCD and was the first common cause of SCD in the age group between 2-12 years. Incidence of Brugada syndrome was significantly higher in the age group between 12-40 years than the age group between 2-12 years.