Preventing sudden death: the role of the internist

Many physicians take a rather fatalistic view of sudden death. Internists, dealing as they do with a wide range of diseases, may feel that sudden death as a mode of leaving this life is much preferable to the drawn out suffering seen in many conditions. Over the last few decades, however, the epidemiology of sudden death has been better defined and there are now undoubted therapeutic interventions that can prevent sudden death in at risk groups. These interventions are covered comprehensively by the European Society of Cardiology (ESC) task force report on sudden cardiac death (SCD) published last year. The document prepared by the ESC clearly underlines the concept that prevention of SCD starts with primary prevention of coronary artery disease.