Can sudden death be avoided or prevented? | Health & Wellness | The USA Print


A cardiologist reviews an EKG.
A cardiologist reviews an EKG.ALVARO GARCIA

The answer is that some sudden deaths can be prevented. Sudden death can be defined as one that occurs after the first hour from the onset of certain symptoms or as the unexpected death of an apparently healthy person who was well the previous 24 hours.

The causes that cause sudden death are many, but the vast majority, around 80%, are diseases of the cardiovascular system, the heart or the blood vessels: myocardial infarctions, brain hemorrhages, etc. It is estimated that in Europe there are about 300,000 out-of-hospital cardiac arrests per year. In Spain there is data from the Ministry of Health, from 2007, which speaks of between 20,000 and 25,000 per year, that is one every 20 minutes.

Sudden death is not only a major health problem, it can also generate a lot of social alarm, such as when it occurs in full view of a large number of people (in a football stadium, for example).

80% of these deaths are due to cardiovascular problems. And within them, heart disease and, specifically, myocardial infarction are the most frequent cause. So, answering the question, coronary heart disease can be prevented and diagnosed in most cases before it leads to sudden death. It is not always possible because sometimes it does not warn, but on many occasions it is possible. It is very important that if a person has symptoms that may suggest a heart problem, he consults his family doctor and that he performs an electrocardiogram. And it is also very important to control risk factors that impair heart function: high blood pressure, high cholesterol, diabetes or smoking. Controlling all these factors can prevent the development of cardiovascular disease. The support of primary care is essential, since family doctors can identify patients who are beginning to have symptoms related to angina pectoris, for example. When that happens, patients are referred to specialists so we can diagnose them and start treating them before sudden death occurs.

There are other diseases that also cause sudden death that are more difficult to prevent. For example, some congenital heart conditions (diseases that are present from birth). These are more difficult to diagnose because many have no symptoms, the first symptom may be sudden death. Some of these diseases could be diagnosed or at least suspected with an EKG. Fortunately, they are not frequent, but the problem is that they cause sudden death in young people. And also, in this case, the support of primary care is essential. It is recommended that from the age of 40 the family doctor begins to carry out regular check-ups with blood pressure measurements, blood tests and, if considered appropriate, an electrocardiogram. Thus, it would be possible to detect some of these diseases that you might not otherwise have suspected.

Due to age, sudden death in young people is much rarer. It is more frequent after 40 or 50 years of age, since, from these ages, it is when the risk of developing a cardiovascular problem begins to increase. It is estimated that, from the age of 50, the risk can grow up to 10% per year. However, below the age of 40, the risk is estimated at around 0.1% per year.

With regard to the sex of those affected by sudden death, it had always been considered that men were at greater risk than women. However, there is some recent work in which this relationship is not confirmed, even certain circumstances are described in which the affectation in women could be predominant.

As for sudden infant death, it’s a different problem. In most cases, the cause of death is not known. Fortunately it is rare. Some of these sudden deaths may be caused by congenital diseases related to alterations in the heart’s electrical system, but there are other causes: respiratory, metabolic diseases… Many times the cause of the baby’s death is not known. In these cases prevention is very difficult. There are some recommendations such as that the baby should not sleep on his stomach, that the mattress be firm, avoid smoking during pregnancy… When, for whatever reason, it is suspected that the newborn may have a congenital disease (because they are affected parents or siblings, for example) specific analyzes and studies can be carried out aimed at a specific disease, but today it is not possible to rule out all the diseases that can induce sudden death with a single test.

Paula Awamleh Garcia She is a medical doctor, cardiologist at the University Hospital of Getafe. Her research focuses on sudden death caused by diseases that affect the electrical system of the heart.

Question sent via email by Jaime Garcia

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The advice in this office is of a general nature and is not a substitute for medical advice. If you have questions about your specific problem, ask your doctor or pharmacist.


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