The Sudden Death of Patients With Few Symptoms of Heart Disease

The sudden death of a patient with disease of the coronary arteries is rarely instantaneous in the sense that the person appears perfectly well one minute and is dead the next. It is instantaneous in the sense that a person with few or many symptoms suddenly ceases to live. The absence of a gradual decline in strength that might indicate a fatal outcome contributes to the unexpectedness of this type of death. In the first few hours or days after the appearance of symptoms that should suggest interference with the coronary blood supply, myocardial insufficiency is seldom severe enough to cause fatal congestive failure, and warning of impending difficulty that is obvious to the casual observer is often lacking. The type of patient we wish to discuss belongs in a strictly limited group: He does not have the dramatically severe syndrome of excruciating thoracic and brachial pain with shock and