Sudden Cardiac Death is not Caused by Ischemia

Sudden cardiac death (SCD) is a major health problem with upwards of 500,000 cardiovascular deaths in the United States due to this problem each year. The SCD patients referred to here are those apparently healthy persons who drop dead suddenly without experiencing any symptoms or able to call for help [1]. The cause is usually sudden onset of ventricular fibrillation (VF). Survival is very poor with most studies showing about 15 % of successfully resuscitated patients leaving the hospital neurologically intact. The presumed cause of this sudden collapse is myocardial ischemia because the majority of these patients have coronary atherosclerosis on post mortem examination [1]. However, ischemia takes time to develop and SCD occurs too quickly to be caused by ischemia [2]. In addition many patients do not go on to show evidence of AMI if they are resuscitated, and rarely is there evidence of AMI on post mortem exam [3]. Acute obstructive lesions in the coronary arteries are rare