Sudden cardiac death is sudden and unexpected with death occurring within minutes after collapse. It is more common to older folks with serious heart ailments although it sometimes does happen to those young and healthy people with no outward sign of heart disease.
It is not the same as heart attack but a heart attack may actually cause sudden cardiac death either during the first few hours of the heart attack or many years after the attack. To differentiate the two, one can think of sudden cardiac death as an electrical malfunction and heart attack as one that is caused by blocked arteries (plumbing malfunction). To be more precise, sudden cardiac death arises when millions of ?short-circuits? occur in the heart, causing the heart pump to fail and cease to deliver life-sustaining blood, oxygen and nutrients. The person thus becomes unconscious. Death can occur just within minutes if the situation is not remedies.
The only chance of survival for a victim of sudden cardiac death is to ?re-start? his or her heart by an electrical shock from a machine known as a defibrillator. There are few types of defibrillators, namely manual external defibrillators (MED), automatic external defibrillators (AED), and implantable defibrillators (ICD).
Only trained personnel such as doctors, nurses, or paramedics can operate MED whereas AED can be operated by lay persons with minimal training. These machines automatically recognized heart rhythms that are treatable by electrical shock, and prompt the user to press the ?shock? button. The machines are easy to operate and have been used successfully in airports, casinos and other public places to resuscitate victims of cardiac arrest.
ICD is implanted into a person's body by surgery. It is fully automatic, and it can recognize and treat ventricular tachycardia and fibrillation without any external intervention, usually even before the person has lost consciousness.
In order to prevent sudden cardiac death, it is necessary to take a complete medical history, including a detailed family history of any cardiovascular disease, and carry out a thorough physical examination. If any symptom of heart disease, such as palpitations, fainting spells, chest pain, or breathlessness on physical exertion, is evident, and then further investigation that includes an electrocardiogram and echocardiogram is compulsory.
Nonetheless, sudden cardiac death is not common in athletes at all, according to research conducted in United States.
Besides hypertrophic cardiomyopathy, scarring of heart and serious blockage of a few blood vessels supplying blood to the heart that can make athletes die instantly, there are also other rare causes including congenital abnormalities, congenital long QT syndrome, arrhythmogenic right ventricular dysplasia, and commotion cordis.
- Congenital Abnormalities These abnormalities are due to the heart arteries arising from the wrong position (right artery from the left sinus, or left artery from the right sinus).
Detection of this condition is not easy unless with the help of echocardiography, angiogram, CT scan or MRI scan.
Once detected, it should be corrected surgically before the athlete is allowed to participate in competitive sports.
- Congenital Long QT Syndrome This occurs when the electrical activity in the heart that corresponds to the phase of muscle relaxation is too long. The condition is genetically determined.
In certain forms of this disease, exercise is actually a trigger for ventricular tachycardia or fibrillation, lethal arrhythmias which may cause sudden cardiac death.
The condition can be diagnosed by an electrocardiogram.
As a precaution, all other family members of a person, who is found to have this condition, should go for a medical scan.
- Arrhythmogenic Right Ventricular Dysplasia This is also a genetic condition in which the muscle in the right lower chamber is replaced by fat and scars. The scars predispose the sufferer to ventricular tachycardia and fibrillation.
Again, this condition is very difficult to diagnose unless MRI scan is employed.
- Commotio Cordis This cause of sudden cardiac death occurs in the absence of any heart disease, and is due to a blunt blow to the part of the chest overlying the heart (such as that caused by base ball, hockey puck, or even an innocent slap on the chest) at the precise moment of the heart’s relaxation. This is the time when the heart is most vulnerable to ventricular fibrillation.
It may sound incredible, but commotio cordis happens in about 2 percent of all athletes who die suddenly.
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