Survivors of prehospitalization sudden death. Characteristic clinical and angiographic features

Abstract

Cardiac catheterization and angiography were performed in 57 survivors of prehospitalization sudden cardiac death (PSD); 52 had coronary artery disease. The disease was severe with almost universal involvement of the anterior descending artery. Associated left ventricular dysfunction was common. Although the majority of survivors had severe coronary artery disease, only 16 patients had an acute myocardial infarction associated with the PSD event and the extent of their coronary artery disease generally was less severe than those who died suddenly of an arrhythmia and no myocardial infarction. Cardiovascular symptoms of long duration prior to sudden death were not uncommon, although sudden death was the initial cardiac symptom in some. Others had crescendo angina as the initial symptom and a few had a clinical history compatible with Prinzmetal''s angina. Although severe coronary artery disease was the most common underlying abnormality, PSD may be an expression of multiple causes.