Management of the Patient at High Risk for Sudden Cardiac Death
Can one protect the subject at high risk for sudden cardiac death? To be able to answer this question requires identification of the specific pathologic derangement contributing to the sudden fatality. However, in most victims of sudden cardiac death (SCD) no acute lesions are demonstrable. Autopsy studies document severe occlusive atherosclerotic disease of major epicardial coronary arteries.1,2 But acute arterial events such as thrombosis of diseased vessels, hemorrhage into a plaque, fracture of atherosclerotic lesion are observed in a minority of cases.3 Even if coronary occlusion is not demonstrable, this does not preclude the occurrence of myocardial infarction. But even with sensitive stains, a majority of patients dying suddenly exhibit no evidence of myocardial infarction. Reichenback and coworkers4 noted such findings in only 5% of sudden death victims.
KeywordsSudden Death Ventricular Tachycardia Ventricular Arrhythmia Sudden Cardiac Death Ventricular Fibrillation
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