Sudden card iac death is defined as death from a cardiac cause occurring immediately or up to one hour after the onset of symptoms in a person with previously known or unknown heart disease.
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Causes of sudden cardiac death
Nearly 80% of the causes of death are ventricular fibrillation. The remaining cases are bradyarrhythmias and electromechanical dissociation. The incidence of sudden cardiac death is approximately 0.1-0.2% and increases with age and the severity of ischaemic heart disease. The risk ofsudden card iac death increases 10-fold in people with multiple risk factors for ischaemic heart disease. The incidence of sudden death is 5 per cent per year in people after a myocardial infarction and as high as 30 per cent per year in people with ventricular tachycardia or ventricular fibrillation suffered in the remote phase of a myocardial infarction.
Risk factors
Risk factors largely coincide with risk factors for ischaemic heart disease. Another group of factors are congenital genetic anomalies, which include prolonged QT syndrome, Brugada syndrome, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and catecholamine-triggered multiple ventricular tachycardia.
A significant decrease in parasympathetic activity and an increase in sympathetic activity is thought to be a significant risk factor for sudden cardiac death. The exercise stress test plays an important role here. A slowing of the heart rate by less than 10/min after the first minute of cessation of exercise indicates an impairment of parasympathetic activity.
Heart attack, photo: pantherstock
How to counteract?
Prevention of sudden cardiac death is extremely important. Lifestyle factors need to be modified - stop smoking and alcohol. Adequate lipid levels and hypertension must be prevented. Weight should be kept at a healthy level. Appropriate diet and physical activity can therefore significantly reduce the risk of not only sudden cardiac death, but also many heart diseases.
