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Wednesday, December 8th, 2021

Sudden Death

invc.. Sudden cardiac death is an instant unexpected death, which occurs within one hour of the onset of cardiac symptoms.Over 24-lac people die in the country of sudden cardiac deaths and 17 lac of them die suddenly before reaching the hospitals. 12 lac of them can be revived if the general public is taught basic cardio brain pulmonary chest resuscitation, said Dr K. K. Aggarwal, President, Heart Care Foundation of India and Editor eMedinewS. The main cause of death in such situations is generally an irregularity of the heart rhythm called ventricular tachyarrhythmia. The underlying pathology is usually coronary heart blockages in middle aged and elderly persons, but can also be one of the familial well defined heart enlargement (hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia). In children and young athletes, two main causes of sudden death are long QT syndrome (abnormal ECG) and hypertrophic cardiomyopathy (commonest cause of deaths during sports). Such patients are advised to avoid competitive sports.Family history of sudden cardiac death should encourage the physician to examine the patient's relatives.About half of all deaths from coronary heart disease are sudden and unexpected, regardless of the underlying disease. The term "massive heart attack" is often mistakenly used in the media to describe sudden death. The term "heart attack" or myocardial infarction refers to death of heart muscle tissue due to loss of blood supply, not necessarily resulting in the death of the heart attack victim. While a heart attack may cause cardiac arrest and sudden cardiac death, the terms are not synonymous. In people without organic heart disease, recreational drug abuse is an important cause of sudden cardiac death.There are numerous contributors to cardiac arrest, but most important ones are: 1. A previous heart attack: 75% of the people who die of SCD show signs of a previous heart attack. 2. Coronary artery disease: 80% of sudden cardiac death victims have signs of coronary artery disease. This is a condition in which the arteries that supply blood to the heart are narrowed or blocked. 3. Other parameters are low heart functions and high resting heart rate. Hypertensive urgency must be distinguished from emergency. Urgency is defined as severely elevated blood pressure (i.e. upper systolic >220 mm Hg or lower diastolic >120 mm Hg) with no evidence of target organ damage. Hypertensive emergency on the other hand requires immediate therapy to decrease blood pressure within minutes to hours. A hypertensive emergency is a condition in which elevated blood pressure results in target organ damage. No evidence suggests a benefit from rapidly reducing blood pressure in patients with hypertensive urgency. In fact, such aggressive therapy may harm the patient, resulting in cardiac, renal, or cerebral hypo perfusion.

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