Sudden Cardiac Death

05/10/2013

If you've ever heard of or known someone who suffers a "sudden death", it can be quite a disturbing story. Many times, what seems to be a relatively young and healthy person can just "drop dead".

Known as sudden cardiac death (SCD), it is a sudden, unexpected death caused when the heart stops functioning. The cause of approximately 325,000 adult deaths in the US each year, it is the largest cause of natural death and responsible for 50% of heart disease deaths in the US.


The demographics of the most frequent cases of SCD are in adults aging from their mid-30s to mid-40s, with men twice as likely as women to be affected. Children are rarely affected, at a rate of 0.0015%.


An SCD is not a heart attack, which can sound confusing. With heart attacks, there is a blockage of blood flow to the heart. The lack of blood causes damage to the heart muscle, resulting in the heart attack.


With an SCD, the electrical system that powers the heart stops operating properly, and the heart begins to beat extremely quickly. Because of how fast the heart is beating, it's not getting blood out to the body - often times resulting in unconsciousness because blood isn't getting to the brain. And if it's not treated very quickly, the victim will pass away.


When it comes to risk factors, some are universal, and others are age specific.


There are way too many stories of younger people suffering SCD while engaged in athletic activities. You may have heard of 'enlarged hearts' - the fancy phrase hypertrophic cardiomyopathy, where the heart muscle grows abnormally thick, making it more difficult for the hear to pump blood. It is the most common cause of SCD in athletes and often goes undetected.


Other younger people risk factors include heart arteries that have grown abnormally that create difficulties. Also, heart rhythm disorders can lead to rapid heartbeat patterns, causing fainting and possibly SCD.


But in general, the risk factors for SCD are:

  1. A previous heart attack (especially within the six months after a heart attack)
  2. Coronary artery disease (brought along by smoking, family history, high cholesterol...)
  3. History of fainting
  4. Family history of SCD
  5. Obesity
  6. Diabetes
  7. Recreational drug use
  8. Heart failure (extremely weak pumping from heart)

When it comes to treatment for SCD, knowledge really is power.


First and foremost, if you can eliminate certain risk factors from your lifestyle (obesity, drug use, etc.), that will go a long way. But also, if you feel you are at risk of experiencing SCD, talk to your family and your co-workers - make sure they know the importance of immediate action.


What do they need to know?

  1. To call 9-1-1 right away. Do not pass Go. Survival can be as high as 90% if treatment is initiated within 5 minutes of the cardiac arrest. That goes down 10% for every minute after.
  2. Proper performance of CPR. It's a life-saver. There are classes all over the area where you can learn, ask us here at the hospital (or police or fire departments), and we'll be able to get you set.
  3. If available, know where an AED (Ambulatory External Defibrillator) is and how to use one. Particularly at athletic venues or in the workplace.
  4. And trust your emergency workers. They are specifically trained in the actions required to help in this situation because of how time-sensitive it is.

Along with the knowledge, there is also the option to have an ICD implanted. ICD is 'Implantable Cardioverter-Defibrillator', and it is a preventative treatment (can also be used for survivors). The electronics monitor the heart rate, and when it senses an extremely rapid heart rate, it will deliver a shock to the heart and get it back in step. An interesting note is that the ICD keeps a record of these incidents, and that info can be viewed by the doctor.


Surgeries can also be performed to help improve blood flow to the heart.


So in a nutshell when it comes to SCD, know your risk factors. Know your family history. Inform those around you of what to do. And make the changes necessary to reduce your personal risk.


- Dr. William Fonbah