Levels of carboxyhemoglobin that would ordinarily cause little or no noticeable symptoms or other effects proved fatal in individuals suffering from atherosclerotic coronary artery disease. All such deaths that occurred in the Cuyahoga County during a period of 23 years were studied. The pathophysiologic mechanisms that may be operative in these deaths are discussed. The importance of being aware of this fact, while one determines the cause and manner of such deaths, is stressed.

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