I could probably start this by talking a little bit about the issue of heart disease in the population.
Dr. Hall has had a lot more responsibility and experience in terms of the emergency ward. In my practice I haven't had a patient with a pulse since 1967, so I have to be careful what I say here.
There is a significant amount of coronary artery disease in the community. Professor Lapierre indicated what the statistics were of coronary artery disease. I'm going to make a parenthetical comment here, which Dr. Hall actually prompted me on. It is that in Professor Lapierre's statistics, there is no correlation between the coronary artery disease that was found in a very few people in the population and the fact that they might have been taking a drug. The drug is cocaine, and cocaine is very provocative in the background of coronary artery disease. It is a specifically provocative drug in terms of developing cardiac arrhythmias.
This is one of the big conundrums in this work. Dr. Hall, I think, has illuminated that and is certainly capable of developing the point better than I am.
There is not a lot of cardiac disease around that is identifiable at autopsy in the younger age group. Generally speaking, in terms of arrhythmias, there is a pathological or demonstrably anatomical background to the disease. That's because the largest cause of cardiac arrhythmias is the type of disease that Professor Lapierre spoke of, notably occlusive coronary artery disease, which, as I say, is aggravated by the use of cocaine.