Circulation, Vol 51, 606-613, Copyright © 1975 by American Heart Association
WB Kannel, JT Doyle, PM McNamara, P Quickenton and T Gordon
Precursors of sudden death were sought in men--1838 civil servants in
Albany, New York, and 2282 residents of Framingham, Massachusetts-- under
continuous surveillance for 16 years. In men 45-74 years old there were 234
deaths attributed to coronary heart disease (CHD) of which 109 occurred
within one hour of onset of symptoms. More than half of all deaths due to
CHD occurred outside the hospital and about 80 per cent of these were
sudden. Most were unheralded by prior symptoms of CHD. Persons at high risk
of death from CHD, including sudden death, can be identified long before
the terminal unexpected catastrophe. The same precursive stigmata exist in
persons subject ot coronary attacks whether or not immediately fatal. The
risk of sudden death in these two populations was positively correlated
with high blood pressure, the electrocardiographic pattern of left
ventricular enlargement, obesity, and heavy cigarette usage. Sudden death
is a common and possibly incidental expression of lethal coronary heart
disease. The potential candidate for sudden death cannot be confidently
distinguished from the individual who succumbs more slowly of myocardial
infarction. The inescapable conclusion is that the prevention of sudden
death requires the prevention of coronary attacks.
ARTICLES
Precursors of sudden coronary death. Factors related to the incidence of sudden death
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