Mysterious Sudden Death

¹ Cardiovascular Research and Training Center, University of Alabama School of Medicine, Birmingham

For the sake of logical discussion the problem of mysterious sudden death is considered as most often due to lethal derangement of the electrical stability of the heart. The pathogenesis of such lethal derangement is first examined according to those factors which determine the normal electrical stability of the heart, then by an analysis of the ways in which this beautifully intricate system may become disorganized. The basis for the discussion is a continuing personal experience studying examples of naturally occurring mysterious sudden death in man and other animals, combined with investigation of the normal anatomy, pathology, physiology and pharmacology of the conduction system of the heart. As we increase our understanding of those events and processes which determine the electrical stability of the heart, it is reasonable to expect that the means for reversing or preventing electrical instability will be derived. Current pessimism about this therapeutic possibility should be dissplled by making the problem less mysterious.