Sudden cardiac death: what should we tell the family?

The sudden unexpected death of a child or a young person can have enormous implications for the surviving family members in addition to the immediate shock, sadness and sense of loss. The sudden loss of a sibling without any prior medical history may confront the family members with the question whether the sudden death was caused by a genetic condition and the fear that other family members may suffer the same fate. Increased awareness of these inherited cardiovascular conditions and the availability of genetic testing in the clinical arena make it possible to identify genetically affected individuals before they have symptoms or experience sudden cardiac death. In particular, when routine cardiovascular autopsy findings do not provide a diagnosis, molecular testing is advocated. The development of such tests has been paralleled by the emergence of preventative treatments, which provide a rationale for active screening of relatives of sudden or unexplained cardiac death victims in order to either confirm or exclude the presence of potentially lethal genetic disorders, the most important of which are cardiomyopathies and primary arrhythmia disorders. …