Abstract: Sudden cardiac death is the most common form of death occurring in the young, adult and elderly. The incidence of which is increasing worldwide.

Objective: Is to evaluate the cause of sudden cardiac death either ischemic (Atherosclerotic) or non–ischemic(non atherosclerotic).

Materials and Methods: this is a descriptive study conducted at the Department of Pathology, Bangalore Medical College and Research Institute which is attached to Victoria hospital (tertiary center) .The study was randomly chosen for a month of every year between 2013 to 2016. The autopsy cases were sent from the Department of Forensic Medicine , Bangalore Medical College and Research Institute. The heart was fixed in 10%formalin weighed and dimensions noted. The three major coronary arteries were dissected and then sectioned by multiple closely spaced cuts. The exposed arteries were carefully examined for any thickening, yellow streaks, acute plaque change or calcification. Routine processing and paraffin embedding, 4mm sections were taken. Sections were stained with Hematoxylin and Eosin stain and examined.

Results: In this study there were 70 cases of sudden cardiac death. The age ranged from 4yrs to 90yrs. Median age is 38yrs .Out of the 70 cases 58(82.9%)cases were males and 12 (17.1%)cases were females. Male to female ration was 8:1. About 58 cases (82.9%) were of ischemic etiology; 12cases (17.1%) were of non ischemic cause. The highest sudden cardiac deaths were reported in the age group of 21 to 30yrs constituting 23 cases(32.9%),followed by  in the age group of 31–40yrs i.e. 4^th decade of life where21 cases(30%) were seen. Only 1 case (1.4%) was seen in the age group of 0–10yrs suffering from Triology of Fallot. Similarly 1 case (1.4%) was in the age group of 80–90yrs.The most common lesion encountered was Coronary Artery Disease (41 cases) accounting for 58.6% followed by Myocardial Infarction (10 cases) accounting for 14.3% cases. The commonest major artery which was involved by atherosclerosis was Left Anterior Descending Artery (56.5%) followed by Right Coronary Artery was (30.5%) and Left Circumflex artery (13%). Lastly the involvement of coronary vessels in atheroma formation were single vessel 30 cases (42.9%), double vessel 34 cases ( 48.6%) and triple vessel in 6 cases (8.6%).

Conclusion: The formation of these lesions can be prevented by monitoring life style, dietary habits and health care programs.