Histopathological Changes in Sudden Cardiac Death: A Prospective Autopsy-Based Study at Bhopal Region

Abstract

Background: Cases of sudden cardiac death (SCD) and autopsy-revealed coronary artery lesions in central India have been reported in the literature. Aim: The purpose of this study was to assess cardiac histopathological lesions in sudden cardiac death and their correlation with age and sex. Methods: In this prospective autopsy study (01 March 2025–28 February 2026), a total of hundred sudden, non-traumatic deaths suspected to be cardiac were studied at Gandhi Medical College Bhopal. The heart and coronaries were examined grossly and histopathologically using standard parameters. Results: 73% of cases were males and half of cases aged 40-59 years. Among the participants, a significant 62% showed signs of coronary atherosclerosis, with a notable increase observed as age progressed. 46% had a myocardial infarction acute and/or healed and 35% had left ventricular hypertrophy. Myocarditis and cardiomyopathies together accounted for around 16% of cases, especially in youth. Conclusion: The major cause of SCD in this setting is coronary atherosclerosis which can or cannot have a myocardial infarction. Importantly, this is the case in middle-aged men. Myocarditis and cardiomyopathies are important minorities in younger victims. Carrying out systematic autopsy and histopathology is very important for establishing the cause of SCD. Thereby allowing an opportunity for implementing preventive measures.