sudden cardiac death


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Sudden Cardiac Death

 

Definition

Sudden cardiac death (SCD) is an unexpected death due to heart problems, which occurs within one hour from the start of any cardiac-related symptoms. SCD is sometimes called cardiac arrest.

Description

When the heart suddenly stops beating effectively and breathing ceases, a person is said to have experienced sudden cardiac death.
SCD is not the same as actual death. In actual death, the brain also dies. The important difference is that sudden cardiac death is potentially reversible. If it is reversed quickly enough, the brain will not die.
Sudden cardiac death is also not the same as a heart attack. A heart attack (myocardial infarction) is the result of a blockage in an artery which feeds the heart, so the heart becomes starved for oxygen. The part that has been starved is damaged beyond repair, but the heart can still beat effectively.

Causes and symptoms

Sudden cardiac death is usually caused by ventricular fibrillation (the lower chamber of the heart quivers instead of pumping in an organized rhythm). Ventricular fibrillation almost never returns to normal by itself, so the condition requires immediate intervention. Ventricular tachycardia can also lead to sudden cardiac death. The risk for SCD is higher for anyone with heart disease.
When the heart stops beating effectively and the brain is being deprived of oxygenated blood, a medical emergency exists.

Diagnosis

Diagnosis of sudden cardiac death is made when there is a sudden loss of consciousness, breathing stops, and there is no effective heart beat.

Treatment

When sudden cardiac death occurs, the first priority is to establish the flow of oxygenated blood to the brain. The next priority is to restore normal rhythm to the heart. Forcing air into the mouth will get oxygen into the lungs. Compressing the chest simulates a pumping heart and will get some blood flow to the lungs, brain, and coronary arteries. This method is called cardiopulmonary resuscitation (CPR). When trained help arrives, they will attempt to establish a normal heart beat by using a device called a defibrillator.
When If sudden cardiac death occurs outside the hospital setting, cardiopulmonary resuscitation (CPR) must begin within four to six minutes and advanced life support measures must begin within eight minutes, to avoid brain death. CPR requires no special medical skills and training is available for the ordinary person nationwide.

Key terms

Defibrillator — A device which delivers a controlled electric shock to the heart to return it to normal beating rhythm.
Ventricular fibrillation — When The lower chamber of the heart quivers instead of pumping in an organized way.
Ventricular tachycardia — A rapid heartbeat, usually over 100 beats per minute.

Prognosis

Sudden cardiac death is reversible in most people if treatment is begun quickly. However, of the people who are resuscitated, 40% will have another SCD within two years if they do not receive appropriate treatment for the underlying cause of the episode.

Prevention

When In order to prevent sudden cardiac death, underlying heart conditions must be addressed. Medications and implantable cardioverter-defibrillators may be used.

Resources

Organizations

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. http://www.americanheart.org.

sudden cardiac death

Death within one hour of onset of witnessed cardiac symptoms, usually due to ventricular dysrhythmia in those younger than age 30 and to vascular changes in those older than 30. Electrical instability (e.g., long-QT syndrome) plays a major role and may be linked to sudden death in diabetes, obesity, epilepsy, alcohol, and idiopathic.

Incidence
80–120/105/year in developed countries.

Sudden cardiac death, aetiology in young patients
Atherosclerosis, cocaine abuse, congenital heart disease, coronary anomalies, coronary dissection, coronary embolism, coronary vasculitis, dilated cardiomyopathy, HOCM, myocardial bridging, myocardial fibrosis, myocarditis, right ventricular cardiomyopathy, sarcoidosis.

sudden cardiac death

Cardiology Death due to cardiac disease ≤ 1 hr after onset of Sx Public health A nontraumatic, nonviolent, unexpected event due to sudden cardiac arrest within 6 hrs of a previously witnessed usual state of normal health; SCD is the most common COD in the US–±400,000 deaths/yr, primarily of ♂ age 20-64; 75% are due to sustained ventricular arrhythmias Etiology Anomalous aortic origin–LCA or circumflex from right sinus of Valsalva–SOV; RCA from left SOV; CA origin from pulmonary artery, myocardial bridging, ostial stenosis, coronary arteritis or AV fistula, coronary artery dissection, embolism, hypoplasia, or spasm, idiopathic arterial calcification of infancy, fibromuscular dysplasia. See Sudden unexplained nocturnal death.
References in periodicals archive ?
Sudden cardiac deaths account for 30 to 50 percent of deaths in patients with heart failure
By measuring blood pressure, cholesterol, and noting smoking and diabetes, they were able to calculate an estimation for the risk of sudden cardiac death.
Also, the lower risk of sudden neurological death compared to sudden cardiac death among males and whites, and a corresponding trend toward increased risks in women and the fast-growing population of Asians and Hispanics, may justify follow-up studies to evaluate whether greater vigilance is warranted for specific demographics, continued Kim, an associate professor of neurology at UCSF.
Among 2,303 deaths over follow-up, 780 were attributed to cardiovascular disease, among which 431 were classified as coronary heart disease deaths, including 187 sudden cardiac deaths.
Current smokers were more than twice as likely to experience sudden cardiac death during the study than people who had never smoked, the researchers report.
This new study shows that sleep apnea does indeed increase the overall risk of sudden cardiac death independently of other important risk factors.
All this said, the researchers believe the study was strong and are convinced that the connection between AF and sudden cardiac death is very real and cause for concern.
51 times more likely to suffer sudden cardiac death than men with normal blood sugar.
The researchers defined sudden cardiac death according to terms set out by the International Classification of Diseases and the World Health Organization.
We are delighted to be taking part in the ESCAPE-ICD registry and to have performed the first ICD implantation on a patient who was at risk of sudden cardiac death.
The more you adhere to this healthy lifestyle, the better you are in terms of your risk of sudden cardiac death," said Stephanie Chiuve from Brigham and Women's Hospital in Boston, the lead author of the study.
Every year, hundreds of thousands of people around the world die from sudden cardiac death - many of them young and fit.