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November 18, 1974

Sudden Death: A New Syndrome?

JAMA. 1974;230(7):1018. doi:10.1001/jama.1974.03240070052033

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In a brief report in Science (185:1062, 1974), Pirkle and Carstens describe the pathologic findings in six patients (five women, one man) who died suddenly from what appears to be a new syndrome—platelet aggregates in small pulmonary arteries and arterioles. The patients' ages ranged from 17 to 40 years, and their clinical histories had nothing in common except the absence of noteworthy antecedent disease. In three instances, the terminal episode was observed and was marked by extreme respiratory distress lasting from less than 1 minute to about 30 minutes. Since five of the patients were women in the child-bearing age, the question of antiovulatory medication arose. This was definitely excluded in three cases and could be neither excluded nor established in the other two cases.

Microscopical findings in all cases were identical. Small pulmonary arteries and arterioles were almost universally plugged by platelet aggregates. In a few areas the aggregates