It has been 100 years since the first description of SUNDS in 1917 in the Philippines. 3, 4, 5, 6, 7 Despite these multiple terms, the common characteristics (modalities) of these victims are sudden death of young healthy individuals (the vast majority are males) during nocturnal sleep and postmortem routine autopsy that cannot explain their deaths. SUNDS occurs predominantly in Southeast Asia and has different academic terms but similar definitions in different countries, such as bangungut in Philippines, Lai Tai in Thailand, Pokkuri Death Syndrome (PDS) in Japan, and SUNDS in the United States and China. Here, we focus on a specific SUD called sudden unexplained nocturnal death syndrome (SUNDS) and attempt to provide a comprehensive understanding of SUNDS. 1, 2 For these cases, a routine postmortem autopsy cannot explain their death, and these can be classified as sudden unexplained death (SUD). Only 1% to 2% of SCD in Western countries compared with 10% in Japan occurs because of rare inherited cardiac arrhythmias without obvious structural change in the heart. 1 Among these structural heart diseases, coronary heart disease, presumed to be the most common pathology underlying SCD, accounts for 75% of SCD in Western countries and 50% to 60% in Japan, followed by cardiomyopathies of 10% to 15% in Western countries and 30% to 35% in Japan. SCD mostly occurs in older adults with acquired structural heart disease. Sudden cardiac death (SCD) is a leading cause of mortality worldwide with an estimated 15% to 20% of all deaths. Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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