Abstract
In Japan, approximately 70, 000 people die suddenly from unknown causes every year. However, only about 10% of these causes undergo a postmortem examinations. This situation has hindered medical professinals from determining the cause of death in many cases and from formulating measures for the prevention and acute-phase treatment of fatal diseases. Japan's official death statistics were considerably influenced by a 1995 revision to the guidlines for preparing death certificates. These revisions were the first to be made in half a century. As a result, the incidence of heart disease has dropped, while that of cerebral vascular disease has risen. In particular, the incidence of “acute heart failure” is decreasing, while that of myocardial infarction is increasing. These revisions also pose new problems in evaluating the actual causes of sudden deaths. Sudden death is defined as death which occurs a short time after the onset of symptoms and for which clinical course and examination findings are scarce. In these situations, autopsies can be used to clarify the cause of death. However, number of autopsies performed in Japan is decreasing. This study attempts to probe the causes of sudden death using autopsy findings. Information from autopsies performed on patients who had died from cardiac arrest in our outpatient clinic within 24 hours of the onset of their symptoms was included in the study. Patients who lived outside of the Saku area were excluded from the study. The autopsies were performed by both clinicians and pathologists. Fifty-five cases of sudden death were investigated by autopsy. This number accounts for 25.3% of the total number of suden deaths. The main cause of death in the autopsied cases was myocardial infarction, accounting for 34.5%. Cardiovascular diseases, including myocardial infarction, aortic aneurysm, pulmonary thromboembolism and cardiomyopathy, accounted for 65.5% of the deaths. Myocardial infarction thus appears to be the main cause of sudden death. However, an autopsy is required to determine the exact cause of death in cases of sudden death.
