Sudden cardiac death

There a sudden cardiac death occurs around 150,000 times a year in Germany, it is one of the most common causes of death. Sudden cardiac death is particularly tragic among young people and also affects healthy people, such as athletes. In the following, sudden cardiac death is described in more detail, what causes it can have, how it is diagnosed and how it can be treated and prevented.

What is sudden cardiac death?

A is defined sudden cardiac death as a death that occurs unexpectedly and from the heart. It is often associated with a heart disease and is associated with a loss of consciousness.

In 80% of cases, sudden cardiac death occurs after intense physical exertion. According to statistics, sudden cardiac death is ahead of cancer and strokes as the most common causes of death.

However, this cause of death is too much underestimated in public. Sudden cardiac death is more common with age, with men more often affected than women. Most of the time, a cardiovascular disorder or a cardiac arrhythmia has already occurred before sudden cardiac death.

The heart can no longer receive regular impulses and can increase to an abnormally high number of beats per minute (up to 500). This leads to ventricular fibrillation, which in turn leads to heart failure. Without treatment, the circulation breaks down after a few seconds and loss of consciousness occurs after about a minute. After about 10 minutes the patient can be declared as brain death.

causes

A sudden cardiac death has various causes. Most often the cause is cardiac arrhythmia. Risk factors that could favor sudden cardiac death are, for example, coronary heart disease, past heart attacks, cardiac output weaknesses during exercise or even at rest, earlier cardiovascular arrest, (additionally) older age, high blood pressure, diabetes mellitus, smoking and heavy alcohol consumption as well as insufficient exercise.

In young adults, however, other causes are more prominent, such as hereditary factors or myocarditis. If the risk factors mentioned already exist, excessive stress can also trigger sudden cardiac death, even though the person is doing enough physical activity.

Such cases are known from the media. Known soccer or ice hockey players fall in the middle of the game and cannot be revived. The reason is usually insufficient bed rest or recovery from simple colds with fever, which can subsequently lead to heart muscle inflammation with additional physical stress (e.g. training despite the flu). If this heart disease is not discovered or is not taken seriously, it can sooner or later lead to sudden cardiac death.

Symptoms, ailments & signs

In the case of sudden cardiac death, those affected lose consciousness and die within a few minutes. Before that, however, there are warning signs that indicate a serious illness. In half of those affected, cardiac arrest is announced by chest pain. Breathlessness, severe palpitations and flu-like symptoms are also possible signs.

People who have ever had a heart attack often experience a rapid heart rate in the hours and minutes before the cardiac arrest. Many people experience an unusual feeling of tightness in the chest, accompanied by shortness of breath and general weakness. Spells of dizziness and fainting round off the symptom complex of sudden cardiac death.

The symptoms usually become noticeable a few hours to days before sudden cardiac death. Most of the time, the signs appear multiple times, increasing in intensity and duration. If these warning signs are ignored, cardiac arrest will eventually occur. At this point, the pulse can no longer be felt and the person affected no longer reacts to external stimuli. The pupils are dilated and the skin on the mucous membranes and fingernails takes on a dark gray color. Already after 30 to 60 seconds the patient stops breathing and finally dies for seconds.

Diagnosis & course

There a sudden cardiac death If the cardiovascular system comes to a standstill, the diagnosis can be made on the basis of unconsciousness and no pulse.

There is thus an emergency in which immediate resuscitation must be carried out. If sudden cardiac death occurs, it is very rare that an EKG machine is nearby to detect a cardiac arrhythmia.

According to statistics, sudden cardiac death shows a rather unfavorable course. The survival rate is around 3 to 8%. The course depends primarily on how quickly the immediate life-saving measures can be taken. Since there are defibrillators in many public institutions in America, for example, the survival rate there is considerably higher.

Complications

Sudden cardiac death is usually a complication in itself and usually leads to the death of the person affected if the patient is not treated quickly and immediately. Those affected suffer from severe heart pain and a feeling of oppression. It is not uncommon for dizziness or shortness of breath to occur.

Disturbances in consciousness can also be associated with cardiac death, so that the person concerned completely loses consciousness and possibly injured if they are stubborn. Likewise, cardiac death without treatment leads to respiratory arrest. If the person concerned is still not treated, death usually occurs or the internal organs and the brain are irreversibly damaged.

The patient's skin looks pale and the person concerned no longer moves. In the event of cardiac death, a defibrillator must be used to save the patient's life. There is also outpatient treatment, which usually ends in a surgical procedure. As a rule, it cannot be predicted whether this will lead to a positive course of the disease.

When should you go to the doctor?

Sudden cardiac death is a dramatic acute event that belongs immediately into the hands of a doctor. But even after a successful resuscitation there are reasons for numerous visits to the doctor.

First of all, the defibrillator, which is used in many cases after sudden cardiac death, is regularly checked for functionality. In addition, a visit to the doctor is always important if you experience unusual symptoms, especially if they are new or severe. The contact person in this context is the family doctor, but also the treating internist or cardiologist. In acute cases, go to the emergency department of the nearest hospital.

In many cases, surviving sudden cardiac death is also a great psychological burden for the patient. Therefore, psychological support is necessary in many cases in order to restore the quality of life to those affected. Talking to your family doctor can be just as helpful as referring to a psychotherapist. It can also help to regain confidence in the performance of your own body with dosed training. You can do this with sports and physiotherapists or as part of a special rehab group.

Hearts that are structurally sick are particularly susceptible to infections. Therefore, the flu or a similarly serious infection is a reason to consult a doctor in order to identify or avoid heart involvement.

Treatment & Therapy

A sudden cardiac death requires immediate life-saving therapy. Only in this way can the subsequent death be prevented. The defibrillator briefly puts the affected person under a strong electric shock, which causes the heart to “restart” and normal electrical cardiac activity can take place again.

Another option is cardiac massage, which everyone should do in an emergency. If this can prevent sudden cardiac death, the following therapy depends on the underlying disease. Often a stent or bypass operation is performed, which is intended to widen the narrowed vessels again.

prevention

A sudden cardiac death Can be prevented by paying particular attention to early symptoms and identifying risk factors, even if there is no known heart disease.

Because those who eat healthily, do adequate and appropriate exercise, are less likely to experience sudden cardiac death. Those who already suffer from heart disease should therefore pay more attention to risk factors such as smoking or an unhealthy diet.

There are also treatment options such as the implantable defibrillator, which can be considered for a cardiac arrhythmia. But such a method can also offer patients who have already suffered cardiovascular arrest a relatively high level of protection against the fatal outcome.

Aftercare

If a cardiac arrest patient receives medical help in good time and resuscitation is successful, follow-up care must take place. There is a risk that the life-threatening cardiac arrhythmias will lead to sudden death again. The doctor orders an EKG and uses X-rays to look for changes in the heart and lungs.

The question of an operative correction arises. Heart disease requires regular follow-up examinations to prevent possible complications at an early stage. The doctor and patient set an individual rhythm, according to which a resting and stress ECG is carried out.

Basically, the patient bears a high degree of personal responsibility to prevent another life-threatening situation. The doctor provides information about the extent to which the person concerned needs to transform his or her life. A change in diet and the reduction of excess weight are conceivable. But renouncing or reducing consumption of cigarettes and alcohol also contributes to recovery. Sometimes a change of profession is even advisable.

You can do that yourself

Sudden cardiac death is an event that the patient can hardly predict or influence. Even after surviving sudden cardiac death, the possibilities for self-help are very limited, as an implanted defibrillator usually offers a protective effect. However, there are some self-help options that the patient can take to heart. In the case of a serious clinical picture such as PHT, you should always be discussed with the treating cardiologist.

Heart disease self-help has a lot to do with a healthy lifestyle. This includes movement, the intensity of which is determined by the cardiologist. Sport and physical activity must be stopped immediately if a febrile infection develops. This could damage a heart and structural heart disease can lead to sudden cardiac death. Infections must also be cured with regard to the ability to work.

After a successful PHT, the function of the defibrillator, which is inserted into the patient's chest, must be checked regularly. In addition, heart examinations at the cardiologist must be conscientiously performed. The mental regeneration after the PHT is just as important as the physical component. The awareness of surviving cardiac death can be stressful. Psychotherapy can help with processing. Relaxation methods or yoga can effectively accompany self-help in everyday life. Exercise not only strengthens the body. It also serves to rebuild self-confidence in your own body.