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An Epidemiologic Study With Implications for Intervention Techniques

Arthur B. Simon, MD; Angelo A. Alonzo, MA

Arch Intern Med. 1973;132(2):163-170.

Abstract
Sudden death due to coronary heart disease in nonhospitalized patients in southeastern Montgomery County, Maryland, was investigated over one year to determine potential benefits from various intervention techniques. One hundred thirty-eight patients between the ages of 35 to 75 were studied. Fifty-seven percent had a history of heart disease. Premonitory symptoms were present in 65%; only 22% had chest pain. Three fourths died at home; 4% at work; 8% in the ambulance; and 8% in a hospital emergency room. Fifty (36%) died unwitnessed, but 15 of these had informed someone of acute symptoms before being left unattended. Previous symptomatic heart disease was associated with a more rapid demise. Based on the time of cardiac arrest and the call for emergency aid, no more than 22% could have been aided by mobile coronary care units.

Author Affiliations
Durham, NC; Greencastle, Ind

From the Field Epidemiology Research Section, Epidemiology Branch, National Heart and Lung Institute, National Institutes of Health, Bethesda, Md; the departments of medicine (cardiology) and community health sciences, Duke University Medical Center, Durham, NC (Dr. Simon); and the Department of Sociology and Anthropology, Depauw University, Greencastle, Ind (Mr. Alonzo). Dr. Simon is now at the Heart Station, University Hospital, Ann Arbor, Mich.

Footnotes
Received for publication Jan 27,1972; accepted June 16.

Presented in part before the 43rd Annual Meeting of the American Heart Association, Atlantic City, NJ, Nov 13, 1970.

Reprint requests to 1405 E Ann St, Ann Arbor, MI 48104 (Dr. Simon).

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