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To the Editor:—
Currently there appears to be general agreement that true coronary thrombosis accounts for but few of the many sudden deaths attributable to heart attacks. This opinion is based on autopsy studies which show a low incidence of thrombosis in the coronary arteries in these cases. Cadaver blood from people who die suddenly from any cause is said to be noncoagulable due to increased fibrinolytic activity in these subjects as compared to those who die a more prolonged or lingering death. Since there must be a considerable lapse of time (hours) between the time of sudden death and the time of necropsy, it appears to me there could easily be a dissolving of the coronary thrombi which cause sudden death, and thereby gross underestimation of the importance of true coronary thrombosis in these cases. What is your opinion of this concept?
Rogers JH. Coronary Thrombosis and Sudden Death. JAMA. 1963;185(8):674. doi:10.1001/jama.1963.03060080070030