Donald B. Hackel and Keith A. Reimer. 160 pages. Durham, North Carolina: Carolina Academic Press; 1993. $75.00.

The unexpected sudden death of a previously healthy person is always tragic and frustrating, and clinicians could benefit from more accessible information on this phenomenon. Hackel and Reimer aim to offer a concise yet comprehensive text on sudden death for use by internists, pediatricians, and pathologists, but the book falls somewhat short on delivery.

Hackel and Reimer provide a fairly complete overview of the cardiac causes of sudden death, including pathology and possible mechanisms. Other interesting features of the text are chapters on sudden death in animals and medicolegal implications of these events. The chapter on noncoronary causes of sudden death discusses pulmonary embolism and intracranial hemorrhage but surprisingly omits asthma and epilepsy, which are both known to cause sudden death with brief or absent premonitory symptoms. Also lacking is discussion of preventive approaches and ways to deal with families affected by sudden death.

A particular limitation is the discussion of sudden death in childhood and adolescence. The authors see little difference in the causes of these events between the ages 1 to 18 years and 18 to 35 years, yet they focus on studies that were limited to cardiac-related deaths. Population-based research not considered by the authors has shown that infections are a leading cause of sudden death in childhood, particularly in children 0 to 4 years old. Such infection-related illnesses include septic shock, pneumonia, epiglottitis, and croup. Asthma and epilepsy are also frequent causes of death in adolescence.

Cardiovascular pathologists may find this book useful, but clinicians for adults or children will probably find it lacking.