In a 2,000-bed neuropsychiatric hospital, one to two cases of sudden, unexpected death occur per year in patients in whom the postmortem examination reveals no obvious cause of death. Serial electrocardiograms revealed some disorder of electrical activity rhythm and conduction. Between the years 1957 to 1962, small heart sections did not adequately explain abnormal ECGs. Four patients receiving tranquilizers who died suddenly and unexpectedly during 1964 and 1965 were studied. The hearts of 49 nontranquilized patients were compared. Histochemical techniques were used. Lesions were in the intramyocardial arterioles (40μ -80μ ) and the arteriolarcapillary bed (14μ-40μ). Acid mucopolysaccharide was in and about these altered arterioles and degenerating myocardial muscle. The lesions were subendocardial in the right and left atrioventricular conduction bundle and papillary muscles.
Richardson HL, Graupner KI, Richardson ME. Intramyocardial Lesions in Patients Dying Suddenly and Unexpectedly. JAMA. 1966;195(4):254–260. doi:10.1001/jama.1966.03100040060017
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: