Sudden Cardiac Death without Warning

Sudden death or acute and extensive myocardial infarction are common presenting manifestations of coronary artery disease.1 , 2 In attempting to determine whether screening tests can identify persons at risk of sudden death, three studies in which asymptomatic subjects were followed prospectively after having undergone electrocardiographic exercise stress testing demonstrated a fascinating but disturbing fact.3 4 5 6 As expected, asymptomatic subjects with normal results on stress tests had a much lower mortality rate than asymptomatic subjects with abnormal results. However, the very large low-risk group with normal responses to exercise testing (constituting about 95 percent of the entire cohort) contained, in absolute terms, the . . .