Keen et al evaluated cases of sudden death for symptoms reported prior to the event. These can alert the clinician to an impending crisis. The authors are from University of North Carolina at Chapel Hill, Yale-New Haven Medical Center, Cone Health (Greensboro) and Appalachian Regional Hospital (Whitesburg).
Case selection: sudden death
28% of patients had 1 or more clinical encounters in the month prior to death. Of these
(1) about 60% (60% * 28% = 17%) had noncardiac symptoms
(2) about 40% (40% * (28%) = 11%) had cardiac symptoms
Cardiac symptoms included:
(1) dyspnea
(2) edema
(3) chest pain
(4) presyncope or syncope
(5) dizziness
(6) palpitations
Patients who had a clinical encounter were older with comorbidities.
Whether an intervention could have prevented the sudden death is debatable. However, a clinician should be aware that common symptoms may precede sudden death and look for other clues, such as decreased exercise capacity. It may also be prudent to ask if there is a family history of sudden death.
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