Sudden death in ischemic heart disease.

Sudden death, defined as the death that occurs naturally, unexpectedly and instantaneously or within the first hour of the onset of premonitory symptoms, is one of the most important challenge of the modern cardiology. This is due to both, its elevated incidence (400,000 to 500,000 cases per year in United States alone) and its dramatic presentation (many of the victims are relatively young and have an acceptable quality of life). We have studied de Holter tapes of 233 patients who died suddenly and we can demonstrate that 80% of cases were due to ventricular tachyarrhythmias (ventricular fibrillation 60% and torsades de pointes 20%) and the rameinens 20% were due to bradyarrhythmias. It is well known that ischemic heart disease is the leading cause of sudden death, being responsible for more than 80% of cases. In the present article we will analyze the relationship between sudden death and the different types of ischemic heart disease: stable angina pectoris, unstable angina pectoris, acute myocardial infarction and postinfarction and silent myocardial ischemia.