An uncommon cause for a sudden postoperative death : a case report

Abstract

This case report highlights a rare cause of sudden postoperative death in a 24-year-old female who underwent a near-total thyroidectomy for a benign thyroid nodule. The patient experienced sudden cardiac arrest shortly after being transferred to the ward post-surgery, despite resuscitative efforts. The autopsy revealed a previously undiagnosed Arrhythmogenic Right Ventricular Dysplasia (ARVD), characterized by severe fatty infiltration of the right ventricular myocardium, which was the likely cause of her fatal arrhythmia. A small atrial septal defect (ASD) was also identified, though it was not considered a significant contributing factor. ARVD is an autosomal dominant condition that can remain undiagnosed until sudden death occurs, particularly in its concealed phase, making it challenging to detect in routine preoperative assessments. This case underscores the importance of histopathological evaluation in unexplained postoperative deaths and highlights the limitations of standard investigations in detecting ARVD.