Sudden death is a rare event, particularly in the young. A traditional comprehensive autopsy often reveals diseases
that were not recognized prior to death. For a significant proportion of sudden deaths in the young, there is no clear
etiology following autopsy. These unexplained sudden deaths are often secondary to primary arrhythmogenic diseases,
where there is a defect in the structure or function of the channels that regulate the ion movement responsible for the electrical
activation of the heart. As a group, these diseases are known as channelopathies. Channelopathies are often secondary
to genetic mutations which may be inherited and place surviving relatives at risk. While these conditions cannot be
detected by the traditional comprehensive autopsy, there is increasing evidence that they may be detected by molecular
genetic analysis using blood or tissue from the deceased individual. There is no conclusive evidence to show the benefit of
systematic screening for channelopathies in sudden unexplained death; however, there is increasing circumstantial evidence
supporting the practice. There is currently insufficient infrastructure for the systematic implementation of such a
screening program, including insufficient financial resources. While no clear legal obligation exists, there is a moral obligation
to inform surviving family members of their potential risk. Strong consideration should be given to augmenting the
traditional autopsy with a molecular analysis in the presence of unexplained sudden death in the young.
Keywords: Autopsy, channelopathy, genetic, sudden infant death syndrome, sudden unexplained death syndrome.
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