Apelu, Faaee - Non-inquest findings
Deceased
Faaee Apelu
Demographics
41y, male
Date of death
2012-07-31
Finding date
2015-07-03
Cause of death
Myocardial infarction secondary to coronary atherosclerosis, resulting in sudden cardiac death from ventricular fibrillation
AI-generated summary
A 41-year-old man with multiple cardiac risk factors (hypertension, hyperlipidemia, obesity, obstructive sleep apnoea, family history) presented with chest pain and was diagnosed with acute coronary syndrome. Coronary angiography identified a 99% stenosis in the right coronary artery which was stented with excellent angiographic result. He was discharged the following day on dual antiplatelet therapy, statin, and ACE inhibitor. Four days later he suffered sudden cardiac death from ventricular fibrillation. Autopsy revealed severe multi-vessel coronary artery disease not detected on angiography, including critical LAD stenosis and disease upstream/downstream of the stent. The coroner concluded angiographic limitations (suboptimal opacification, streaming artefact) prevented detection of additional lesions. While discharge timing may have been somewhat premature, early discharge would likely have occurred regardless, and was not a significant factor in death. The primary cause was sudden cardiac arrhythmia secondary to recent myocardial infarction.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Clinical conditions
Contributing factors
- Severe multi-vessel coronary artery disease (left anterior descending and right coronary arteries)
- Critical left anterior descending coronary artery stenosis at origin not identified on angiography
- Suboptimal angiographic quality due to suboptimal opacification and streaming artefact
- Disease upstream and downstream of stented right coronary artery not identified
- Significant cardiac risk factors: hypertension, hyperlipidemia, obesity, obstructive sleep apnoea, family history of premature coronary disease
- Omission of beta-blocker from discharge medications (documented as error on discharge summary)
- Absence of post-procedural troponin and CK measurements
- Recent acute myocardial infarction (substrate for arrhythmia)
- Incomplete revascularisation
Coroner's recommendations
- No formal recommendations made; coroner found no further issues warranting investigation
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