Finding into death of Caine David Knight

26y · Male·Cardiomegaly in a man with Prader-Willi syndrome

Caine David Knight, aged 26, died from cardiomegaly with right ventricular hypertrophy in the context of Prader-Willi syndrome and severe obesity. He had a complex medical history including obesity hypoventilation syndrome, type 2 respiratory failure requiring BiPAP support, and recent presentations to ED with chest pain and dyspnoea. Cardiologists had diagnosed right heart failure and opted for conservative management with diuretics and non-invasive ventilation rather than invasive cardiac investigations due to anaesthetic risk. He collapsed suddenly at his residential care facility four days after a seizure-like episode at a cinema. The autopsy revealed significant cardiomegaly but no coronary artery disease. This case highlights the challenges of managing cardiac complications in Prader-Willi syndrome with severe obesity, where invasive investigation carries substantial anaesthetic risk and sudden cardiac death from arrhythmia remains a possibility despite conservative management.