Karen Frazer, a 56-year-old woman with intellectual disability, schizophrenia, anxiety, hypertension, and COPD, died from cardiomegaly (enlarged heart with biventricular hypertrophy). She was found unresponsive on the toilet at her group home and could not be revived despite CPR. Autopsy revealed an enlarged heart with myocardial fibrosis and mild coronary artery disease—conditions commonly associated with her long-standing hypertension. The death was natural and sudden, likely a cardiac arrhythmia. No clinical errors were identified. The case highlights the importance of managing hypertension aggressively in vulnerable populations and recognising that sudden cardiac death can occur despite supportive care arrangements.
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