ArticleForensic science, medicine, and pathology2026
Cardiac deaths with structural heart abnormalities in the young (0-49 years): a ten-year forensic autopsy review.
Article in Forensic science, medicine, and pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe primary purpose of forensic autopsies is to assess third-party involvement in fatalities with a non-natural or undetermined manner of death. In a proportion of the latter, after completion of forensic examinations, a natural manner of death is ultimately attested. This study aimed to determine the proportion of natural deaths in individuals under 50 years of age, the frequency of cardiac deaths in this age group and the spectrum of causative structural cardiac pathologies.
methodsWe carried out a retrospective analysis of all autopsies performed at our institute of legal medicine in Germany (n = 9244). Individuals aged 0–49 years with a natural manner of death and a cardiac cause of death with structural abnormalities comprised 192 cases. Data on cardiovascular risk factors, symptoms prior to death, and activity at the time of death were systematically collected. A key methodological focus was the individualized assessment of heart weight using predicted values based on age, sex, height, and weight.
resultsIschemic heart disease was the most frequent cause of death (n = 76). Individualized comparison of measured and predicted heart weight demonstrated statistically significantly increased values, consistent with pathological cardiac hypertrophy. A high prevalence of clinically recognizable cardiovascular risk factors was observed.
conclusionWhile ischemic heart disease remains the leading cardiac cause of death in this young cohort, the principal contribution of this study lies in its comprehensive methodological approach, particularly the individualized quantification of cardiac hypertrophy. The high prevalence of identifiable risk factors underscores the importance of early clinical risk stratification and preventive interventions in young individuals.
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