Aleksander Kojic, 46 years old, collapsed at a supported residential service for people with intellectual disabilities and died from cardiomegaly (enlarged heart weighing 802g with biventricular dilation). The autopsy found no evidence of trauma, infection, or toxicity contributing to death. Cardiac enlargement of this magnitude predisposes to spontaneous lethal arrhythmia. The death was entirely natural. No clinical errors, delays in emergency response, or preventable factors were identified. Emergency services responded appropriately and initiated resuscitation immediately. This case highlights that sudden cardiac death from structural cardiomyopathy can occur without warning signs in supported care settings.
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