[Pathogenetic and morphological aspects of sudden cardiac death]

The epidemiology, risk factors, pathological anatomy, and pathogenesis of sudden cardiac death are characterized on the grounds of literature data and the results of the authors own study. The main attention was focused on sudden death in ischemic heart disease. Information on acute and chronic morphological changes in the coronary arteries of the heart, the myocardium, and the conducting system is given. The pathogenic importance of myocardial ischemia, local metabolic damages, and microcirculatory disorders in the heart muscle is discussed. It is indicated that the principal role in thanatogenesis is played by the electrical instability of the myocardium and disorders of cardiac rhythm caused to a definite measure by the structural and functional changes in the conducting system of the heart.