The stabilizing and unstabilizing influences of neurogenic and vascular activities of the heart as related to sudden cardiac death.

Despite the frequency with which sudden cardiac death occurs in affluent societies, little is known about the precise mechanisms by which it is caused. Practically nothing is known about why sudden cardiac death occurs in one but not another person. It is difficult to escape the conclusion that in many instances, the final events occur almost by chance. Therefore, it would appear that every effort should be made by the physician to assist in preventing the changes, that is, cardiomegaly and myocardial ischemia, that appear to be potential markers of sudden cardiac death in many persons. Attention should be directed toward identifying and facilitating stabilizing neurogenic and vascular activities and identifying, controlling and reversing unstabilizing influences likely to foster sudden cardiac death. In the absence of a more complete knowledge of precise mechanisms, the efforts of the physician should be directed toward behavior modifications that appear to reduce the clinical manifestations of coronary heart disease which contribute to the development of cardiomegaly and myocardial ischemia.