SUDDEN DEATH AND CARDIOMEGALY UNASSOCIATED WITH CORONARY ARTERY DISEASE

猝死有很多原因，尸检通常允许 具体原因的描述。 在过去的8年里，我们 尸检时研究了6名患者，均为男性，在室外突然死亡 医院，虽然尸检显示心脏肥大， 具体死因不明。 某些临床和 描述了这6例患者的形态学特征。 所有6 病人死在医院外面。 的最可能原因 6例心脏肥大均为系统性高血压。 系统性 6名患者中仅3名可获得动脉压， 据说每一个都被抬高了。 6例患者中， 有任何心外膜冠状动脉狭窄，没有解剖 瓣膜、心肌、先天性或心包心脏的证据 疾病 无冠状动脉异常。 病态病例 肥胖（小于250磅）被排除在本研究之外。 虽然众所周知，全身性 高血压具有心房和心房肌频率增加， 与血压正常的人相比， 高血压合并左心室肥厚者， 与高血压相比，这些心律失常的频率更高 无左心室肥厚者， 全身性高血压患者在缺乏 1条或多条心外膜冠状动脉显著狭窄 据我们所知以前没有描述过。

Sudden death has many causes and necropsy usually allows delineation of the specific cause. During the past 8 years we have studied at necropsy 6 patients, all man, who died suddenly outside the hospital and although necropsy disclosed cardiomegaly, a specific cause of death was not discernible. Certain clinical and morphologic features in these 6 patients are described. All 6 patients died outside the hospital. The most likely cause for the cardiomegaly in our 6 patients is systemic hypertension. Systemic arterial pressure was available in only 3 of the 6 patients and in each it was stated to have been elevated. None of the 6 patients had narrowing of any epicardial coronary artery, none had anatomic evidence of valvular, myocardial, congenital or pericardial heart disease. None had a coronary arterial anomaly. Cases of morbid obesity (less than 250 pounds) were excluded from this study. Although it is well recognized that patients with systemic hypertension have an increased frequency of both atrial and ventricular arrhythmias compared with normotensive persons and that hypertensive persons with left ventricular hypertrophy have a higher frequency of these arrhythmias compared with hypertensive persons without left ventricular hypertrophy, the occurrence of sudden death in persons with systemic hypertension in the absence of significant narrowing of 1 or more epicardial coronary arteries has not been described previously to our knowledge.