[Sudden cardiac death]

Sudden death occurs unexpectedly, within 24 hours after the onset of subjective symptoms with or without known preexisting conditions. According to Framingham Heart Study, during a 20-year follow-up, 13% of deceased have died of sudden death. Most frequently it occurs in the first 6 months in infants and in the period 45-75 years of age. In more than 80% of cases sudden death is caused by coronary disease, while in 5% of cases the cause is cerebrovascular insult. The mechanism of sudden death is ventricular fibrillation in 65-85%, ventricular tachycardia in 7-10% and electromechanical dissociation in 20-30%. Sometimes sudden death may be caused iatrogenically, by drug intoxication, catheterization and reflex mechanisms--vasovagal reflex and sinus caroticus reflex. Pathoanatomical finding can be positive on myocardium like fibrosis, edema, individual necrosis, cell infiltration or it can be unchanged. In cases of heart failure, resuscitation is performed: airway maintenance, artificial respiration, artificial circulation, drug therapy and electrotherapy. Prevention of sudden death means detection of high-risk patients and application of medical treatment in order to postpone it. Coronary patients with sustained myocardial infarction and ejection fraction lower than 30% and registered tachycardia represent high-risk patients.