Case | Sex | Details of death* | Cardiac findings* | Medications† | Neuropsychiatric | Comments | |||||||
Age (years) | Cause | CHD | History of arrhythmia | ECG | SZ | MR | Seizure disorder | ||||||
Findings | QTc (ms) | QRS (ms) | |||||||||||
1 | F | 18.1 | Shock secondary to acute pancreatitis after ERCP | None | No | Normal rhythm | Normal‡ | Normal‡ | QuetiapineSertralineEthosuximideLamotrigine | Yes | No | Yes | |
2 | M | 22.9 | Severe congestive heart failure, pulmonary haemorrhage | Major: Unrepaired TOF/PA, severe AS (mean gradient 41 mm Hg), moderate AR, moderately reduced RV dysfunction, O2 saturations 80% | No | Sinus tachycardia | 488 | 104 | QuetiapineCitalopramASAAllopurinol | Yes | Mild | No | |
3 | M | 23.7 | Sudden, presumed arrhythmia | Major: Repaired TOF, hypoplastic right heart, pulmonary homograft and cavopulmonary shunt, residual severe PR, moderate TS (mean gradient 7 mm Hg) | Atrial flutter | Sinus rhythm | 471 | 160 | DigoxinAldactazideCoumadin | No | No | No | Collapsed |
4 | F | 27.8 | Heart failure | Major: Repaired TOF/absent PV, pulmonary xenograft and modified cavopulmonary shunt, preserved biventricular systolic function, residual moderate PR, mean pulmonary valve gradient 31 mm Hg, moderate AS (mean gradient 25 mm Hg) | No | Sinus tachycardia | 547 | 154 | FluoxetineDomperidoneDivalproex | No | Mod-severe | No | |
5 | M | 33.2 | Sudden, presumed arrhythmia | Major: Repaired TOF/PA, RV to pulmonary artery conduit, repair of left PS, mild LV systolic dysfunction, mild PR, mean conduit gradient 19 mm Hg | No | Sinus rhythm | 417 | 86 | ASARamipril | No | No | No | Mild HTNFound dead in bed |
6 | F | 38.2 | Suicide | None | No | N/A | N/A | N/A | RisperidoneBupropionL-thyroxine | Yes | No | No | |
7 | M | 44.8 | Sudden, unexpected | Repaired ASD, no residual RV dilation or systolic dysfunction | No | Sinus rhythm | 469 | 115 | ClozapineRisperidoneGabapentinDiltiazemFurosemideL-thyroxineClopidogrelSalbutamolMontelukastRabeprazole | Yes | No | No | Smoking, asthma, HTN.Found dead beside bed |
8 | F | 45.8 | Sudden, unexpected | Repaired ASD, no residual RV dilation or systolic dysfunction | No | Sinus rhythm | 440 | 80 | OmeprazoleSalbutamol | Yes | No | No | Smoking, asthma. Found dead in bed |
9 | F | 48.8 | Sudden, unexpected | None | No | N/A | N/A | N/A | L-thyroxineCimetidine | No | No | No | Smoking, asthma. Found dead in bed |
10 | F | 52.5 | Sudden, attributed to acute bronchopneumonia | Secundum ASD (0.2 cm) | Supra-ventricular arrhythmia | Sinus rhythm | 411 | 76 | LoxapineClonazepamBenztropineDiltiazemOxybutyninSalbutamolAdvair | Yes | Mild | No | Smoking, asthma. Found dead in bed in hospital 1 h after admission for respiratory distress |
11 | F | 56.2 | Sudden, unexpected | None | Atrial flutter | Sinus rhythm | 401 | 78 | RisperidoneBenztropineMetoprololCarbidopa/ levodopaPulmicort | Yes | Mild | No | Found dead in bed. Asthma |
12 | F | 68.6 | Stroke | None | No | LVHSinus rhythm | N/A | N/A | NitropasteFelodipinePrazosinAmitriptylineL-thyroxine | No | No | No |
AR, aortic regurgitation; AS, aortic stenosis; ASD, atrial septal defect; ERCP, endoscopic retrograde cholangio-pancreatogram; HTN, hypertension; LV, left ventricular; LVH, left ventricular hypertrophy; MR, mental retardation; N/A, not available; PA, pulmonary atresia; PR, pulmonary regurgitation; PS, pulmonary artery stenosis; PV, pulmonary valve; RV, right ventricular; SZ, schizophrenia; TOF, tetralogy of Fallot; TS, tricuspid stenosis; VSD, ventricular septal defect.
*Cases 1, 2, 3, 5, 6, 7, 8, 9, 10 and 11 were coroner’s cases. Cases 2, 3, 6, 7, 10, and 11 had autopsies, none of which showed evidence of coronary artery disease.
†All patients were taking calcium and vitamin D supplements recommended for 22q11.2DS.
‡No ECG was available for review but a clinical note from a cardiologist stated the ECG was normal.