What likely caused my 25 year-old friend to die in his sleep today?

Factual Questions
1

I’m not sure if this thread will be an exercise in in futility but feel free to let me know if this query is just too vague.

I just learnt that my friend Malcolm (age 25) apparently died in his sleep last night. I haven’t yet been able to get in touch with his family so all I have to go on is second-hand info but the police were willing to subtly confirm that my friend is indeed deceased.

I was wondering if anyone could help me understand a few of the **statistically most likely medical scenarios **given the following few pieces of information:

  • 25, no diagnosed medical conditions
  • not suicidal
  • not a recreational drug user
  • no known allergies
2

IANAD, and it’s going to be pretty useless to speculate, but is it possible he had an underlying heart condition that was undiagnosed?

I’m so sorry for your loss.

3

thanks ivy.

I’ve been googling for death tables organized by age but so far haven’t found any useful ones. I figure that this sort of thing is mercifully so rare that there are perhaps just a handful of likely scenarios but I could be wrong.

4

Cardiac arrhythmias can kill otherwise healthy young people. One that springs to mind is Long QT Syndrome.

5

Pulmonary embolism? Can strike anyone at at Pulmonary embolism - Wikipedia 15% of all cases of sudden death are attributable to PE.(that statistic has a citation itself.)

6

Alcohol?

7

I had a mild brain hemorrhage in my sleep in October. A major one could strike anybody anytime.

8

Sorry for your loss - what a shock. A girl I was at school with died like this, she was around 20. I can’t remember what the cause turned out to be, probably one of things mentioned above.

9

I got my medical degree from watching documentaries, so consider that in my responce:

In one doc I was watching, it involved someone who just dropped dead. The narrator mentioned that when that happens, it’s usually one of three things, "something hit the heart (like an MI), something hit the brain (like a stroke), or something hit the lung (like a PE).

And it could be none of those. I have a friend whose 16-year-old died during sleep a couple of years ago from a previously undiagnosed heart defect, to add one more anecdote.

10

I am also sorry for your loss. It always sucks to have someone close to you die. And it can be much more of a shock for some one so young.

You can see a 2004 CDC list of causes of death by age category here. As you can see just about anything can affect a 25 year old. They even have a single identified case of fatal Alzheimer’s.

Best guesses given your caveats? Undiagnosed cancer, undiagnosed cardiovascular disease, accidental poisoning (including carbon monoxide).

Ignoring your caveats, these round out the major killers for 25-34 year-olds: Accidents (especially automotive), suicide, homicide, HIV/AIDS, other infectious diseases.

11

Could be a stroke from undiagnosed sleep apnea.

12

Sudden death in the young sometimes remains unexplained, even with an autopsy. When it is, the cause is usually presumed to be a primary arrhythmia. Examples of primary arrhythmias that show up only special testing when the patient is alive include prolonged QT syndromes–there are a variety of these.

Sometimes sudden death in the young can be due to unrecognized disorders such as arterial aneurysms (especially of the brain and coronary arteries–these latter can be due to various things including Kawasaki disease as a youngster), or connective tissue disorders such as Marfans (which can cause a great vessel to tear spontaneously) or structural abnormalities of the heart such as hypertrophic cardiomyopathy or valvular disease.

Pulmonary emboli is always a suspect cause. Infections can kill rapidly, but most of the time will be suspected unless the person was totally alone for a period of many hours before death.

Toxicities including deliberate or accidental poisoning come to mind. And this time of year carbon monoxide poisoning is always a consideration, although usually it’s obvious as a cause.

There are many many other causes. Most of them would be ruled out with a good post-mortem (normally required in this sort of circumstance).

13

I am really sorry about your friend.

I have no idea what happened, but many years ago, a friend of mine died–not in her sleep, but very unexpectedly. She was 26, had no known health issues, and seemed to be in pretty good shape.

My last conversation with her, just the day before, she was bitching about the manicure she’d gotten, which wasn’t up to her usual standards, and complaining about a stuffy nose.

So, she had a slight cold and a bad manicure.

She didn’t show up to meet another friend for lunch, and that friend eventually talked her apartment manager into opening the place up, so my other friend actually found her, and the police were called.

What they think happened: That she had undiagnosed asthma, had an attack, and just couldn’t breathe. There was some evidence that she was attempting to leave her apartment, and the cops suggested she was going out to get some help, but then she had a lunch date–except they think she was trying to get out much earlier (like 6 a.m., which would indeed have been very unlike her).

So short answer: nobody ever knew for sure, and the people who were in the best position to know couldn’t even be sure about the time of death.

The bottom line, our friend was gone. And it still makes me sad to think about it, but indeed she is forever in my memory.

Sometimes shit just happens.

14

Two friends (not related to each other) of the Husband’s family have died in their sleep, each having an allergic reaction to cough syrup leading to suffocation. The Husband is understandably cautious about cold medication.

Sucks.

Hugs to you and the family of your friend.

15

The first thing I would suspect is an aneurysm in the brain. If there is bleeding inside the skull and there is pressure on the stem then breathing will stop and the person will die.

Of course, it could be a heart or lung problem but the with an otherwise young, healthy individual with no prior history, that is where I would start.

16

A coworker in good health in his 30s lay down for a nap, and never got up. No one knew until the autopsy that he had an enlarged heart.

17

We weren’t specifically told “stroke,” but “sleep apnea” carried off a young co-worker of mine.

18

I had a teacher at my High School who died on the netball court, when she was in her late 20s. It was some brain problem that she was, I believe, unaware of (an aneurysm, I suppose), and just struck her at a random time.

19

That may have been due to profound/severe Down’s Syndrome. Down’s folks almost all get Alzhimers in their 30s-40’s.

20

It could be as simple as untreated H1N1.