The Emerging Sudden Cardiac death Syndrome …

This post is inspired by the increasing accounts of sudden death cases I have encountered in recent times, especially among individuals in the young and middle aged group. Most of these stories have been recounted directly by bereaved loved ones, while others are simply stories splashed across social media platforms.  One thing is however unanimous, they all possess the make up of perfectly sad stories, with details that seem too strange to be true, as most of the victims were speculated to have been fit as a fiddle barely hours preceding their demise.

The phenomenon of sudden cardiac death (SCD) encompasses a variety of factors which cannot be fully discussed within the scope of a single post, hence it will be split into two (2) parts, with the first being an expose into sudden cardiac death, statistics, and causes. The second part will cover the prevention and recognition of early warning signs and symptoms and emergency resuscitation of victims of SCD. The author has attempted to succinctly summarise the concept into the simplest possible language for easy understanding. For further information and reading on the topic please see the reference list below for published papers.

What is Sudden Death Syndrome?

There are several definitions and schools of thought surrounding the concept of sudden death syndrome. The World Health Organisation defines sudden death as death occurring within 24 hours of an abrupt change in a previously clinical healthy status. It has also been described as a sudden, unexpected death occurring within 6 to 24 hours which may occur during sleep, wakefulness, during or after exercise. It usually occurs in younger individuals and has been attributed to several underlying heart conditions, earning its alias as ‘sudden cardiac death’. Majority of the cases of SCD occur outside the hospital environment, usually among individuals who are apparently in good health.

Statistics

Sudden cardiac death (SCD) remains a major cause of medical and public health concern in both developed and developing countries, owing to the ambiguity surrounding its causes and prevention.  In the United States, SCD accounts for 300 000 to 400 000 deaths annually .  In Asia, sudden death is estimated at 145 per 100,000 persons. A study on sudden death cases in Nigeria, discovered that complications from hypertension was responsible for 82% of cases. Out of sixty-eight cases which were brought into the hospital dead, 55.9% were found dead in bed having gone to sleep in apparently good health, the remaining 44.1% were reported to have suddenly collapsed during normal daily activities. 

Causes and Risk Factors

Cardiac Disease

SCD has been characterised by certain structural and functional abnormalities which form the basis of several cardiac diseases such as hypertension, coronary artery disease (CAD), left ventricular hypertrophy, diseases of the heart valves, cardiomyopathy (heart failure), and specific abnormalities of the electrical stimulation of the heart. Other underlying pathological causes include, elevated cholesterol, glucose intolerance, decreased respiratory function, smoking, and irregular heart rate rhythm identify individuals at risk for sudden cardiac death.

Most sudden cardiac deaths are caused by abnormal heart rhythms called arrhythmias (irregular heartbeat) this could be characteristic of either a slow or fast heartbeat. The most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganised firing of impulses from the ventricles (the heart’s lower chambers).

These various cardiac diseases would be discussed in detail in subsequent posts.

CAN SUDDEN CARDIAC DEATH BE PREVENTED?

Due to the ambiguity surrounding the causes of sudden cardiac death, prevention and prediction among at risk groups remains a challenge. However, most recommendations are targeted at risk factor identification and reduction by promoting healthy lifestyle choices, encouraging early and timely diagnosis of underlying conditions, and appropriate treatment and follow up care. These would be discussed in subsequent posts. Stay Tuned!
Juliet E
REFERENCES
  1. Virmani, Renu et al. ‘sudden cardiac death’ () Cardiovascular Pathology , Volume 10 , Issue (5) , pp. 211 – 218
  2. Zipes, D.P. and Wellens, J. J. “Sudden cardiac death’ (1998) Circulation, ,  

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