Sudden cardiac death

Many medical trainees will encounter a case of sudden cardiac death (SCD) during their medical training and observe the unpleasant task of disclosing the tragic news to the family of the victim. Although the majority of deaths will affect middle-aged and elderly individuals, occasionally a young, apparently healthy person falls victim, making the experience even more poignant. The devastating impact associated with the missed opportunity to save a young life cannot be overestimated. The majority of SCDs in the young are secondary to previously quiescent, inherited cardiac diseases. However, a significant proportion may be preventable if the clinical symptoms, family history and electrocardiogram are interpreted appropriately. All clinicians should have a basic understanding of conditions predisposing to SCD in the young, and recognize the need to evaluate first-degree relatives who may be at risk in an effort to prevent further catastrophes. This article outlines the epidemiology of SCD and provides an overview of the commonest implicated cardiac pathologies, as well as the necessary investigations and management of surviving first-degree relatives when appropriate.