Post-mortem imaging adjudicated sudden death : causes and controversies

Sudden cardiac death (SCD) is a catastrophic complication of many cardiac conditions often occurring without warning. In these cases, a post-mortem examination is required to elucidate the cause of death and is regarded as the ‘gold standard’. However, in circumstances of certain religious/cultural beliefs and advanced body decomposition an alternative non-invasive approach would be preferred. Although a developing field, post-mortem imaging using computed tomography (pmCT) or magnetic resonance imaging (pmMR) provides a non-invasive and accurate alternative to traditional post-mortem in specific circumstances. In particular, pmMR has an important role in younger decedents while pmCT is more suited to examination of adults with SCD. Despite encouraging results from several preliminary studies, more research is needed to determine the most appropriate role for post-mortem imaging in the clinical algorhythm for investigation of SCD.