Natural Causes of Sudden Death: Noncardiac

AbstractSudden death is a devastating complication of many underlying disorders. Although cardiovascular disease accounts for most of these episodes of sudden natural death, many other causes contribute. Every organ system may be responsible for sudden death. Respiratory causes are considered focusing on the major causes such as pneumonia and pulmonary embolism. Rare but potentially fatal events, such as amniotic fluid embolism and fat embolism, are stressed too. Sudden deaths from hematological disorders include both hemoglobinopathies and leukemia. Sometimes no satisfactory cause of death could be found from the necropsy; the review of the medical history became of paramount importance. We refer to sudden and unexplained deaths in young patients with Type 1 DM. There is growing evidence of the so‐called dead‐in‐bed syndrome with diabetes. Other rare metabolic disorders, such as alcoholic ketoacidosis, hypoglycemia, thyroiditis are discussed. Sudden deaths also occurred in patients with a history of anaphylaxis in whom no satisfactory cause of death was found after extensive necropsy and toxicological examination. In these cases, no specific macroscopic or microscopic findings are detected at autopsy; so in the presence of a clinical history suggestive for anaphylaxis‐related death, postmortem measurement of serum tryptase levels can be a useful diagnostic aid. The role of massive adrenal hemorrhage (Waterhouse‐Friderichsen syndrome) in causing sudden death is also discussed.