PMID: 1182972Dec 1, 1975Paper

Anatomical pathology of sudden unexpected cardiac death.

Circulation
C J Schwartz, R G Gerrity

Abstract

Approximately one-third of patients dying suddenly exhibit occlusive coronary artery thrombi, in contrast to the high frequency (90%) associated with transmural myocardial infarction. Such a discrepancy, along with other considerations, indicates that not all cases of sudden cardiac death are simply the result of myocardial ischemia or infarction in the traditional sense, and does, we believe, justify a rigorous search for alternative pathophysiological mechanisms. Some alternative mechanisms have been discussed, including disturbances in the cardiac conducting system, and the potentially very important role of platelet microembolism or microthrombosis in the genesis of focal ischemia and the lethal arrhythmias. Additionally, not all disturbances leading to the development of lethal arrhythmias may be reflected in light microscopic changes. There is a need for more sophisticated methodological approaches to the detection of early ischemia or other changes at a subcellular level. Although existing studies have provided a useful initial approach to an understanding of the pathology of sudden cardiac death, more questions remain unanswered than answered. In particular, no definitive comparison of deaths occurring in or out of hosp...Continue Reading

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