We sometimes read/hear about instances school children, office going professionals and college students dying at a very young age. We may have also heard people quipping that the particular person did not have smoking/drinking habits. Other times we hear that he/she was a vegetarian or a very physically active person. How could he/she have died from a heart attack? Well there are medical reasons behind such sudden cardiac arrests.
What is sudden cardiac arrest? Sudden cardiac arrest (SCA) is a sudden, unexpected failure of heart function occurring due to fast fluttering action of the ventricles, which does not allow enough blood to be pumped out to the organs which include the brain and the heart itself. SCA is a medical emergency, which can be fatal if not treated immediately. Cardiac arrest is reversible if the victim is administered prompt and appropriate emergency care. This generally involves administration of cardiopulmonary resuscitation (CPR), shock treatment to the chest to reset the heart’s rhythm (defibrillation) and advanced life support.
SCA being the result of a disturbed rhythm pattern the only effective treatment is the delivery of an electrical shock.
| Sudden Cardiac Arrest claiming about 4,280 lives from every 1 lakh of population annually |
Medical reasons:
Sudden cardiac deaths in people under age 35 are quite rare. Most of the times sudden cardiac deaths occur due to heart defects that are either hidden or overlooked. The person is not aware that he/she is suffering from a cardiac abnormality. When sudden cardiac deaths do occur, this is most often due to Physical Activity such as a sporting event
What causes sudden cardiac deaths in young people?
For a variety of reasons, — such as a structural heart defect — causes the heart to beat out of control. This abnormal heart rhythm is known as ventricular fibrillation.
Some specific causes of sudden cardiac death in young people include:
Hypertrophic cardiomyopathy (HCM): Hypertrophic cardiomyopathy is a disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is thickened (hypertrophied) without any obvious cause. It is the leading cause of sudden cardiac death in young athletes. The occurrence of hypertrophic cardiomyopathy is a significant cause of sudden unexpected cardiac death in any age group and as a cause of disabling cardiac symptoms. Younger people are likely to have a more severe form of hypertrophic cardiomyopathy
HCM is frequently asymptomatic until sudden cardiac death, and for this reason some suggest routinely screening certain populations for this disease.
HCM is hereditary
Coronary artery abnormalities. Sometimes people are born with heart arteries (coronary arteries) that are connected abnormally. The arteries can become compressed during exercise and not provide proper blood flow to the heart
Long QT syndrome (LQTS). Long QT syndrome (LQTS) is an inherited heart rhythm disorder that can cause fast, chaotic heartbeats. The rapid heartbeats, caused by changes in the part of your heart that causes it to beat, may lead to fainting, which can be life-threatening. In some cases, your heart’s rhythm may be so erratic that it can cause sudden death. Young people with long QT syndrome have an increased risk of sudden death.
Other causes include inflammation of the heart muscle, which can be caused by viruses and other illnesses. In addition to long QT syndrome, there are other abnormalities of the heart’s electrical system, such as Brugada syndrome, which can cause sudden death.
There’s another rare cause of sudden cardiac death that can occur in anyone, though it’s usually heard about in young people who play sports. It occurs as the result of a blunt blow to the chest —being hit by a baseball/football— at just the right time. Its medical name is commotio cordis. The blow to the chest can trigger ventricular fibrillation if the blow strikes at exactly the wrong time in the heart’s electrical cycle.
There are no warning signs or symptoms for Sudden Cardiac Deaths, however there are two major symptoms to be watched out for
Unexplained fainting and Seizures: Breaking down/fainting/occurrence of seizures without any reason is a major symptom that suggests that one could be suffering from a heart defect
Family history of sudden cardiac deaths: The other major warning sign is a family history of unexplained deaths before the age of 50.
Important notice: If someone in your family dies of sudden cardiac death, it is very important that you conduct an autopsy to determine the cause of the death.
Non medical reasons:
Investigators from Finland have found that individuals under age 40 who smoke tobacco products have a five times higher chance of having a myocardial infarction (heart attack) than nonsmokers, and that smoking is the single most important cause of heart attacks in younger patients. They reached this conclusion by examining data from the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) database. In the MONICA project, information was collected on cardiac risk factors and subsequent cardiac “events” in populations of individuals from 21 countries in the 1980s and 1990s. It turned out that, of younger patients (less than 40 years of age) who had heart attacks, 80% were smokers. Furthermore, smoking was the only risk factor identified in over half of these young heart attack victims.
Since not all smokers younger than 40 have heart attacks, it is likely that many of these young heart attack patients have some unidentified risk factor -perhaps a clotting disorder or unidentified hypercholesterolemia – that predisposes them to premature cardiovascular disease. Under this theory, smoking would greatly accelerate effects of such risk factors, such that cardiac disease occurs more “prematurely” than it otherwise would.
This is nothing new, of course. Smoking greatly accelerates atherosclerosis (“hardening of the arteries”) in anybody, of any age. Thus, even smokers who survive past 40 without overt cardiac disease are very likely to develop heart attacks or strokes years – or even decades – earlier than they otherwise might.
(With inputs from scientific publications by Mayo Clinic)
