[Pathologic-anatomic findings in sudden heart death].

Sudden cardiac death can be caused by a large variety of pathological conditions detected morphologically. In most cases it is the result of coronary sclerosis. A coronary thrombus is not only found in myocardial infarction, but also frequently occurs in unstable angina without infarction. In most instances these thrombi develop following rupture of an atheromatous plaque. A higher risk of sudden cardiac death is associated with abnormalities of the coronary ostia, most commonly an anomalous origin of the left coronary artery from the right sinus. HOCM is the most important cardiomyopathy causing sudden cardiac death in young athletes. Furthermore, myocarditis, pathological changes of the conduction system, and other rare conditions can lead to sudden cardiac death. A particular set of diseases contributes to sudden cardiac death in the young. Occasionally, disturbances in the texture of the ventricular septum can be found that have so far not been described in the literature. Acute arrhythmias hold a key position among the pathophysiological mechanisms leading to sudden cardiac death.