To the Editor: Epstein et al. (Aug. 3 issue)* state their belief that the chief mechanism for sudden coronary death in patients without earlier warning symptoms of ischemia is an acute occluding thrombus of a coronary artery complicating a mild, non-flow limiting coronary plaque. Before formulating this hypothesis, the authors should have talked to forensic pathologists. Asymptomatic persons in whom sudden unexpected cardiac death occurs undergo autopsy in medical examiners' offices, not hospitals. In our experience the finding of a thrombus occluding a coronary artery in these cases is uncommon. At most, only 10 percent of such people have a.
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