Sudden death from ischaemic heart disease: a review of five hundred consecutive cases.

The history and autopsy findings in 500 cases of ischaemic heart death investigated by the Perth City Coroner were examined. Pathology evidence of myocardial infarction was present in 105 cases (21%) and of coronary thrombosis in 108 cases (21-6%). The only structural pathological abnormality leading directly to death was cardiac rupture with tamponade, which occurred in 25 cases (5%). Strenuous exercise was directly associated with the onset of fatal symptoms only rarely (in 7% of cases). These findings indicate that functional rather than structural abnormalities are the major cause of death in ischaemic heart attacks.