Etiopathogenesis of Sudden Autopsy-Negative Death Across Different Age Groups: A Literature Review

Sudden unexplained death presents a significant diagnostic challenge in forensic practice. At the current stage, the etiology and pathogenesis of sudden autopsy-negative death remain incompletely understood. The interpretation of structural changes in the heart of unknown significance, deviations in the structure and functioning of regulatory systems in the brain, and the appropriateness of using modern molecular genetic methods of post-mortem investigation (“molecular autopsy”) in deceased individuals continue to be major unresolved diagnostic issues.

The aim of this review is to systematize contemporary understandings of the etiopathogenetic mechanisms of sudden autopsy-negative death across different age groups, with an emphasis on the significance of applying molecular autopsy in forensic practice to establish precise causes of death.

The analyzed literature sources confirm the exceptional importance of a comprehensive approach to establishing a post-mortem diagnosis in cases of sudden autopsy-negative death. Standard pathological or forensic autopsies are often insufficient for determining the cause of death; therefore, modern research protocols should be expanded to include additional methods. Given the heterogeneity of the group experiencing sudden autopsy-negative death, a multidisciplinary approach involving experts, geneticists, and cardiologists is recommended for determining the cause of death. The integration of high-tech methods into forensic practice allows for overcoming the limitations of standard research protocols and getting closer to understanding the true causes of sudden death, as well as providing an opportunity to prevent such deaths in the families of the deceased.