[Pathology of sudden extra-hospital death. 1. Obstructive lesions of the coronary arteries and myocardial scars].

The coronary arteries and myocardium were examined morphologically by special unified methods in 127 cases of prehospital sudden coronary death among Kaunas male population from 45 to 65 years of age. Obstruction of at least one of four major coronary arteries was severe (75% or more) in 90% of patients and moderate (50--75%) in the remaining 10%. In most cases one or two coronary arteries had severe obstruction (77% of cases) located predominantly in the proximal and middle segments of the left anterior descending and right coronary arteries. Post-infarction scars and small foci of myocardial sclerosis were found in 72% of hearts any may be considered as special "morphological catamnesis" of past acute coronary events. In 85% of cases the heart mass was more than 400 g. The data presented indicate the undoubted role of coronarogenic factors in the development of an acute terminal episode such as sudden death, the unexpectedness of which is only imaginary.