Dead on arrival and sudden death due to ischemic heart disease.
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概要
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More than half of the cases of sudden death are known to be caused by ischemic heart disease. Among the 215 cases of dead on arrival and sudden death referred to us, we analyzed 119 cases in which the cause of death was identified and 49 cases in which the cause of death was strongly suspected. Cardiovascular diseases were the cause of death in 54 cases (32%), and acute myocardial infarction (AMI) was the cause in 30 (56%) of them. Twenty-three (77%) of the AMI patients had experienced pre-myocardial infarctional (pre-MI) angina, the de novo type in 22 of them and the worsening type in one of them. Only 2 of the 12 patients who suffered AMI within 24 hours of the first attack of pre-MI angina had consulted doctors, whereas 10 of the 11 patients who suffered AMI over 24 hours after pre-MI angina had. Among the 12 patients who were examined, 6 were diagnosed as having angina and were treated with medication. In the remaining 6 cases, not even a diagnoses of angina had been made. None of the patients were advised to undergo any further examinations, including coronary angiography. It is important to educate the public to recognize that angina, especially de novo type angina, can be life threatening, and to consult a doctor immediately. It is also necessary to educate physicians that administration of drugs to treat patients with de novo type angina is inadequate. By consulting the doctor as soon as possible after the first attack of angina, and by undergoing coronary angiography to determine which treatment is most appropriate, sudden deaths caused by ischemic heart disease can be reduced.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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