A consultant physician and cardiologist at the University of Nigeria Teaching Hospital, Enugu, Prof. Benedict Anisiuba, discusses sudden cardiac death with DOLAPO AKITOYE
~Punch Nigeria. Sunday, June 10, 2018.
What is sudden cardiac death?
within one hour of the outset of symptoms in an apparently healthy individual. However, if the death occurs when nobody is present, this definition can also be extended to when the person was in good health 24 hours before being discovered to be dead but if the death is witnessed within one hour of the outset of symptoms, it is sudden cardiac death.
What can cause sudden cardiac death?
It seems that most abnormalities in the body can cause sudden death, whether cardiac or non-cardiac but generally, cardiovascular diseases - diseases of the heart and blood vessels - are more notorious in causing sudden cardiac death but apart from that, diseases of the respiratory system, of the brain and of course, poisoning can also be responsible for it. With regards to the cardiovascular system, the most common disease that causes sudden cardiac death is hypertension and its complications. Hypertension is the leading cause of sudden cardiac death. With most people that die from sudden cardiac death, there is evidence of hypertension in about 70 per cent of them.
Hypertension tops the list followed by heart failure and also, thickening of the walls of the heart which is called left ventricular hypertrophy in medicine. This can result from many causes such as hypertension, sub-congenital diseases and myocardial infarction (heart attack). Heart attack means that the blood vessel taking blood to the heart is blocked. It is also one of the important causes of sudden cardiac death. So, part of the heart dies when the blood supply to it is blocked. It is one of the most important causes in the developed world.
It is catching up in our own part of the world but not as much as in the developed world. For the respiratory diseases, the one that comes easily to mind is acute bronchial asthma. Severe bronchial asthma can definitely lead to sudden death including blockage of the blood vessels going to the lungs referred to as pulmonary embolism.
Diseases of the central nervous system, especially the brain, can also lead to sudden cardiac death especially sudden bleeding in the brain due to abnormal blood vessels which can be congenital (before birth) or acquired (developed along the line). The most obvious cause is severe chemical or drug poisoning. If somebody either intentionally or accidentally takes a dangerous chemical, the person will, of course, die suddenly. This is in addition to drug overdose which can be intentional or accidental.
What are the symptoms that can lead to sudden cardiac death?
By definition, the person is not supposed to have any symptom until one hour before the outset of cardiac death but as can be seen from the causes of sudden cardiac death, there is always some subtle abnormality that is present which is ignored by the doctor, individual or society. However, nobody is to blame. Some of these symptoms are common in the environment that they can always take people to the theatre and start exploring the heart or the brain but generally, the symptoms that precede sudden cardiac death include sudden outset of breathlessness. This can occur either from heart failure or from pulmonary embolism. Breathlessness is a very important symptom leading to sudden cardiac death.