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E1848. Imaging of the Young Adult with Risk of Sudden Cardiac Death
Authors
  1. Juliana Sitta; University of Mississippi Medical Center
  2. Candace Howard; University of Mississippi Medical Center
Background
Sudden cardiac death (SCD) is a rare cause of mortality in young adults, with an incidence rate estimated to be 1-4/100,000 per year. Although rare, its occurrence carries significant trauma and burden for the families and people involved. Identifying patients at risk is a challenge, since most of them are typically asymptomatic, and, currently, there are no standardized screening protocols. Preventative measures such as implantable cardiac defibrillator (ICD) and surgery can be potentially life-saving when appropriately applied. The etiologies of SCD can be categorized in heritable and acquired cardiomyopathies, channelopathies, structural congenital heart disease, myocarditis, and coronary abnormalities. Echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) play an essential role in the depiction, characterization, and risk stratification, as well as the surgical and medical management, and follow-up.

Educational Goals / Teaching Points
Review the etiology and physiopathology of SCD in young adults. Discuss available imaging techniques and specific clinical indications. Analyze imaging findings and risk stratification. Learn from a multimodality case-based review of cardiac structural abnormalities that can lead to SCD in young adults.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This presentation will focus on structural causes of sudden cardiac death in young adults, such as anomalous coronary artery, primary cardiomyopathy, valvar disease, and congenital heart diseases. We will include an anatomic review and criteria along with tools for risk stratification and correlation with imaging findings on CT and MRI. Finally, we will present a case-based overview that includes common and uncommon pathologies such as the spectrum of anomalous coronary arteries and hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy, noncompaction cardiomyopathy, mitral valve prolapse, aortic stenosis, transposition of great vessels and tetralogy of Fallot.

Conclusion
In young adults, sudden cardiac death requires a multispecialty systematic approach for accurate identification, characterization, risk stratification, appropriate management, and follow-up. The growing advance in imaging techniques allows radiologists to accurately depict and to stratify structural and functional cardiac abnormalities, an essential step to prevent tragic outcomes.