Table 2.
Causes of Presumed Sudden Cardiac Deaths, as Determined by Autopsy.*
| Cause | HIV-Positive (N = 47) |
Reference (N = 505) |
|---|---|---|
| number (percent) | ||
| Cardiac, arrhythmic cause | 22 (47) | 284 (56) |
| Acute coronary artery disease | 2 (4) | 51 (10) |
| Chronic coronary artery disease | 9 (19) | 111 (22) |
| Cardiomyopathy | 5 (11) | 50 (10) |
| Hypertrophy | 3 (6) | 43 (9) |
| Primary electrical disease | 2 (4) | 7 (1) |
| Mitral valve prolapse | 1 (2) | 2 (0.4) |
| Other | 0 | 20 (4) |
| Cardiac, nonarrhythmic cause | 1 (2) | 22 (5) |
| Acute MI with wall rupture | 1 (2) | 12 (2) |
| Acute MI with pump failure | 0 | 4 (1) |
| Chronic heart failure | 0 | 5 (1) |
| Pericarditis with bacterial pericardial effusion and tamponade† | 0 | 1 (0.2) |
| Noncardiac | 24 (51) | 199 (39) |
| Aortic dissection | 0 | 14 (3) |
| Aspiration or asphyxia | 0 | 5 (1) |
| Occult overdose | 16 (34) | 64 (13) |
| Gastrointestinal cause | 1 (2) | 14 (3) |
| Hypoglycemia, hyperglycemia, or DKA | 1 (2) | 9 (2) |
| Infection | 2 (4) | 21 (4) |
| Intracranial hemorrhage | 1 (2) | 18 (4) |
| Other neurologic | 0 | 11 (2) |
| Pulmonary embolism | 0 | 19 (4) |
| Renal failure | 3 (6) | 5 (1) |
| Other noncardiac | 0 | 19 (4) |
*
DKA denotes diabetic ketoacidosis and MI myocardial infarction.
†
This event occurred in a 66-year-old White female smoker who was found unresponsive 10 hours after she was last seen (at that time without symptoms). The autopsy revealed pericarditis with bacterial pericardial effusion and tamponade, severe pulmonary edema, pleural adhesions and effusions, and acute inflammation of the left ventricular septum.