Sudden death related to small coronary artery disease

Two cases of sudden death of young people in apparently good health are rep orted. The only pathologic change found was a fibromuscular dysplasia of th e artery supplying the conduction system of the heart with an important nar rowing, of the lumen and strong, thickening, of the arterial wall. The firs t case was of a 12-year-old girl who died suddenly while skiing; the second was of a 32-year-old man who died while talking to his wife. No other path ologic changes were found at autopsy, and the results of toxicologic analys is were negative. There was no individual or family history of cardiac dise ases. These cases illustrate the importance of an analysis of the conductio n system, including examination of the intramural coronary arteries supplyi ng the conduction system.