Natural Disease. We talked about the difference between sudden death, instantaneous death, and unexpected death. These are not synonyms. Sudden death is death that occurs within 12 hours of the onset of symptoms. Instantaneous death is really rare, and with the exceptions of severe violence leading to fragmentation or blunt impact with something really, really big (like a planet) there is always SOME time between onset and death. Unexpected death is one that comes out of the blue.
60% of people who come through a medical examiner’s office, more or less, have natural disease. A lot of those are due to heart disease. Fully 50% of people with hypertensive and atherosclerotic cardiovascular disease learn they have it when they drop dead. This makes treatment difficult. Some folks just don’t go to the doctor, even in Cleveland with a good county hospital system and a very active Free clinic. Some are Christian Scientists, and they will not have a PCP to sign their death certificate.
The heart, lungs, and brain are the organ systems most likely to be involved in natural death that brings you to coroner’s attention. We’ll talk more about this Wednesday.