Sudden Death From Coronary Disease—the Cardiac Conundrum

Abstract

Five hundred sudden deaths ascribed to coronary sclerotic heart disease after complete autopsy have been studied and analyzed. A broad range of morbid cardiovascular and anatomic changes was observed. Approximately one-third of the hearts showed “new” disease in the form of acute thrombotic coronary occlusion, acute myocardial infarct, or both. The remainder of the victims died suddenly of the chronic disease without the participation of any recent recognizable change in the heart. A physiologic mechanism based on differential myocardial oxygenation is postulated as the death factor in these instances. The frequent finding of an entirely normal myocardium with “fatal” coronary disease raises the issue of “hearts too good to die” and points up the advisability of instituting positive action to restore the heart beat.