"Sudden Death"-What Are We Talking About?

N RECENT YEARS "sudden death" has come into the focus of the discussion on ischemic heart disease (IHD). At autopsy, this condition has been considered responsible for some 90% of "medically unattended deaths" following the symptoms of a heart attack in an industrialized community.1 We would like to draw attention to some ambiguities of the concept of sudden death. At the present time, the meaning of the attribute "sudden" in this context is subject to considerable variation, ranging from death occurring within a few minutes2 to death within 24 hours3 of the onset of acute symptoms. If estimations of the number of cases of sudden death are to provide useful information for decisions concerning facilities for resuscitation of victims of acute heart attacks, death occuring within 15 min, or 1 hour, appears to be more meaningful than death within 24 hours. The latter concept, however, may well comprise a number of cases, where death was not sudden but "unexpected" (which is another element partly inherent in the word sudden). The accuracy of a statement of sudden death usually depends on the observer. From this point of view, it is important to note whether the preceding attack was witnessed