This study aimed at evaluating the epidemiological characteristics and pathological features of different types of cardiomyopathies in Egypt, highlighting the role of the forensic pathologist in identifying cases of cardiomyopathies and initiating for their families a possible genetic study aiming at prevention of sudden death. All cases with sudden cardiac death (SCD) due to cardiomyopathies during the period from the beginning of January 2010 until the end of December 2014 (5 years) were included in this study. All hearts underwent detailed gross and histological examination. Circumstances of death, medical history, and post-mortem pathological findings were thoroughly investigated. Out of 535 cases of sudden cardiac death, there were 22 cases (4.1%) diagnosed as having cardiomyopathies; sudden death was their first presentation. Eighteen cases (81.8%) were male, with the 4th decade (11 cases, 50%) being the most affected age; severe physical activity and exertion were evident in death circumstances of 14 cases (63.6%); pathological evaluation revealed that hypertrophic cardiomyopathy was the most frequent type, being diagnosed in 10 cases (45%). Cardiomyopathies are an infrequent cause of sudden cardiac death. Most deaths are in children and adults, so cases are of high social impact that demands multidisciplinary research and resources. In all cases of SCD, forensic autopsy should be done. Forensic study is the key to identifying an affected family and the starting point regarding assessing them.
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