When people die suddenly, all I hear most times is ‘he died from a heart attack’. That phrase ‘heart attack’ has been used too many times that seriously, it doesn’t mean anything anymore. Yes, the heart has to die from an attack before a person is pronounced dead even if the cause of death was from diarrhea. Some of these ‘heart attacks’ are preventable. Let’s discuss some top 6 causes of sudden death and what you can do to prevent it.
- Hypertrophic cardiomyopathy (HCM)
This is a disease that causes the thickening of the heart muscle. Usually, the patient will have no complaints and would just drop dead suddenly playing soccer or basketball. Contact sports especially those that involve start and stop frequently have been linked to men who died suddenly from HCM. But many also die just chatting with a colleague. HCM is common in young adults and children but can be present in all age groups and both sexes without favor.
Many people’s first sign of this disease is sudden death but others may have noticed earlier that they have had sudden unexplained fainting in the past (syncope), dizziness, chest pain and easy fatigability.
Lesson: A good pointer is a family history of sudden death. If you have family members who died suddenly you should check yourself out.
- Prolonged QT Syndrome
The best way I can describe this is to think of it as a heart that is not wired correctly. This leads to irregular heartbeats causing poor blood flow from the heart to the body. It may be triggered by exercise, loud noise, and emotion
There are two types: those that just happen and the ones that are caused by something we can identify and prevent. It also runs in families.
It can be caused by low magnesium, low potassium, tumor in the adrenal gland (on top of the kidney) , heart infarction, inflammation of the heart muscle or heart failure.
Of note is that it can be caused by medications that we use. This is especially important in developing countries where people self-diagnose and treat themselves. The patronage of people who are not doctors or pharmacists is a serious problem in these places.
Some of the drugs that can cause QT prolongation include Antihistamines like Diphenhydramine, Anti-malaria like quinine, Antibiotics like Septrin/Bactrim, Zithromax/Azithromycin, Erythromycin, Levofloxacin and other quinolones. Antifungals like Ketoconazole, Fluconazole, Itraconazole. Psychotropics like Amitriptyline, Haloperidol,Risperidone. Antimigraine like Naratriptan, Zolmitriptan, Sumatriptan and many others
Lesson: It is advised that no contact sports for Long QT syndrome patients. Use medicines only if prescribed by a doctor.
3. Subarachnoid Hemorrhage (SAH)
This is the rupture of a blood vessel in the brain area. It can be caused by head trauma but non-traumatic SAH can occur from an overstretched brain vessel that has burst under the brain.
The risk is higher if there is a family history of SAH. It is also increased in patients with polycystic kidney disease, hypertension, alcohol use, disorders of collagen and connective tissue, cocaine, methamphetamine, tobacco use.
A warning sign is if you have a thunder clap headache, the ‘worst headache of your life’ or if it is worse with straining to defecate or cough, or it wakes you from sleep.
Lesson: Don’t ignore or self- treat a sudden, severe headache. See a doctor. Your survival depends on the doctor finding and repairing the blown out brain vessel before it bursts.
- Aortic dissection (AD)
This is the commonest tragic event involving aorta (the biggest blood vessel from the heart). If untreated 33% will die in the first 12 hours, 50% will die in 24hours, 75% in 2 weeks and 90% in 3 months.
The risk factors for AD include hypertension, congenital heart disease, trauma, connective tissue disease and Pregnancy.
About 80% of people with AD will usually complain of a sudden onset excruciating chest or back pain described as ripping or tearing in nature.
Lesson: if you develop a sudden and excruciating pain in your chest or back please see a doctor immediately.
- Acute Myocardial Infarction (AMI)
This is another common cause of sudden death. Common in patients with a high cholesterol. The high cholesterol develops plaques within arteries which eventually rupture and block blood flow to the heart causing death of the heart muscle. Damage to the conduction pathways within the heart can lead to disorganized heart rhythms that kill.
Sudden chest pain that radiates to the arm is a common complaint but patients may present without it. Dizziness, difficulty breathing, fainting, stroke-like symptoms, weakness, nausea and abdominal discomfort are atypical symptoms a victim may have.
Lesson: check your cholesterol level yearly, if high, start medication to lower it. Reduce your weight if obese, exercise, control your blood pressure, avoid smoking.
Time is key and the earlier your doctor discovers the AMI the better. You can chew a 300mg of Aspirin so long, it helps.
- Pulmonary Embolism (PE)
PE is blood clot traveling to the lung vessels to cause obstruction. It is common in patients who recently underwent surgery, patients on birth control pills or other estrogen-containing medications, those immobile for a long time and those who have had a deep venous thrombosis (DVT) or PE before.
Three things accelerate the formation of a PE.
- Stasis of blood flow (from prolonged air travel or bed admission);
2. A hypercoagulable state (from birth control pills, hormone replacement therapy, smoking and inherited causes);
3. Vascular injury (trauma).
Patients with PE may complain of difficulty breathing, cough blood, and chest pain. They might have a noticeable swollen, painful leg from a deep venous thrombosis (DVT).
Lesson: Time is muscle here. See a doctor if you notice difficulty with breathing with or without chest pain. Do not lie down in bed for prolonged periods without exercise. If you must, make sure your doctor puts you on a blood thinner. If you travel long distance in the air, take regular walks/leg exercises on the plane to prevent stasis of blood.
