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Unravelling the Mystery of Sudden Cardiac Arrest

Imagine a seemingly healthy young person suddenly collapsing, unconscious, and fighting for their life. This frightening scenario is the reality of Sudden Cardiac Arrest (SCA), an unexpected and life-threatening event that occurs when the heart abruptly stops beating. In these critical moments, survival hinges on the swift actions of bystanders and emergency responders, employing crucial life-saving measures like CPR and automated defibrillators.

What sets Sudden Cardiac Arrest apart from a heart attack?

Sudden Cardiac Arrest (SCA) occurs when the heart’s electrical system goes haywire, causing an erratic heartbeat. This dangerous, rapid pace prevents the heart from pumping blood effectively, leaving the rest of your body starved for blood supply, resulting in death. 

Contrastingly, heart attacks strike when a blockage in one or more coronary arteries disrupts the flow of oxygen-rich blood to your heart. This can result in heart damage if oxygen-deprived blood can’t reach the heart muscle. While heart attacks can trigger a SCA, it’s crucial to understand that these two terms are not interchangeable. 

Causes of sudden cardiac arrest in young people

While the exact cause of sudden cardiac arrest (SCA) in young adults can sometimes never be known, several causative factors exist, such as: 

Hypertrophic cardiomyopathy

Often inherited and undiagnosed, hypertrophic cardiomyopathy is the most common cardiovascular cause of SCA in young people. Thickened muscle cells in the heart’s lower chambers can lead to abnormal heart rhythms, particularly during intense exercise. 

How can we prevent Sudden Cardiac Arrest in young people?

By taking proactive measures, families and communities can decrease the risk of sudden cardiac arrest (SCA) in young individuals: 

  1. Recognizing warning signs, understanding risk factors and obtaining accurate medical & family histories can significantly help in prevention efforts. Gathering  blood relatives’ heart health history and sharing it with your doctor is crucial. This information can guide essential questions during check-ups and sports physicals, ensuring nothing is overlooked. 
  • Conducting heart health diagnostics for those at higher risk can be helpful in prevention of SCA.. Heart health evaluation should include ECG , Echocardiogram and (in high risk individuals) TMT or Exercise stress test .

Risk factors for sudden cardiac death that should prompt comprehensive heart checks, even among younger individuals, include:

  • A family history of sudden death in an otherwise healthy family member under 50 years of age, which is unexpected or unexplained.
  • Having a family member with an inherited heart muscle or electrical problem.
  • Experiencing chest pain during exercise.
  • Having an abnormal heart rate or rhythm of unknown origin.
  • Fainting, passing out, or having a seizure without warning or during exercise.
  • Being born with a congenital heart defect, as well as those that have been surgically repaired.

Apart from the above situations, it is always advisable to undergo a complete heart check if you are an individual who lives in a high-stress environment or does high-intensity workouts so that any underlying or asymptomatic heart condition can be diagnosed before severe cardiac damage happens.

  • Medical consultation and check-ups are essential for all children and adolescents as well. These appointments provide an opportunity for thorough physical exams and health history assessments, helping to identify SCA risk factors much earlier. This is particularly crucial before starting any organized, competitive, or recreational sports or activities.

The American Association of Pediatrics has developed a policy statement recommending four screening questions for all children. These screenings should ideally be included into a child’s regular exam at least every two to three years, starting as they enter middle school. The simple yet vital questions ask if a child or teen has ever fainted, had an unexplained seizure, experienced chest pain or shortness of breath, and if family members have a history of cardiac conditions or death before age 50.

Since sudden cardiac death is a complex multifactorial event, we recommend that it is best to undergo a baseline health screening and continue to have an annual evaluation of your health status. This would help identify and mitigate health risks and prevent catastrophic events such as sudden cardiac death. Individuals with risk factors, family history, inherited conditions stressful lives, and those who are about to embark on high intensity exercise must be extra cautious in evaluating their heart health. 

Conclusion 

Sudden cardiac arrest in young people is an often overlooked condition, mainly due to lack of awareness. While the causes in younger individuals differ from those in older age groups (in older age groups, coronary artery disease and atherosclerosis are more common), lifestyle factors are increasingly putting young people at risk of coronary artery disease as well. To protect yourself from sudden cardiac arrest, it’s essential to prioritize regular heart check-ups from an early age as well as lifestyle management.

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