Problems in forensic cardiovascular pathology.

Do we have a magic yardstick that will establish whether SCD of the patient is definitely caused by the presence of an underlying abnormality? We are afraid that in most cases of cardiac disease the cause of death is at best probable, or even presumed. It has always been that circumstantial evidence has helped us establish that the cause of death is related to the anatomic abnormality. Even the presence of severe coronary artery disease in a patient who dies suddenly, especially in the absence of a thrombus, cannot be stated categorically to be the cause and effect. With the knowledge we have today, establishing cause and effect are difficult in most cases of SCD.