Sudden death is characterized by cardiac collapse or arrest secondary to arrhythmias, in people with or without heart disease, which, if not treated within minutes, leads to death.
Some of these patients experience symptoms shortly before the event, but to establish a definitive diagnosis of a sudden death episode, the symptoms must last less than one hour.
Most cases are secondary to myocardial infarctions and occur outside the hospital setting.
Causes according to age groups
In victims over 35 years of age, coronary artery disease (blockage of the arteries that carry blood to the heart) is responsible for the majority of cases.
In victims under 35 years of age, the main reported causes are: hypertrophic cardiomyopathy (thickening of the walls of the heart), congenital alterations of the coronary arteries, or arrhythmic diseases such as long QT syndrome, Brugada syndrome, Wolff-Parkinson syndrome. White, ventricular tachycardia (VT) or ventricular fibrillation (VF).
In the population between 35 and 45 years of age, a higher incidence of dilated cardiomyopathy (dilation of the heart chambers) secondary to obesity, as well as the use of illicit drugs, has been detected.
Treatment
The treatment of cardiac arrest secondary to ventricular fibrillation or tachycardia is ventricular defibrillation, and the earlier it is performed, the greater the possibility of saving life.
At the first minute, the success of ventricular defibrillation is very high, and decreases progressively if cardiopulmonary resuscitation (CPR) maneuvers are not performed. The basic chain of survival must be carried out when faced with a patient in cardiac arrest. This chain involves early detection of the patient and activation of the medical emergency system, early CPR, early defibrillation, early advanced care and early post-resuscitation care. By performing all links in the survival chain within the first 5 minutes of collapse, survival rates for these patients are significantly improved.
The placement of automatic external defibrillators in public places along with the performance of basic CPR maneuvers has been shown to significantly improve survival, which is why the placement of automatic external defibrillators and training the public in basic CPR maneuvers is widely recommended. schools, airports, gyms, companies and strategic places in the community with high population density.
Messages to take home
Sudden cardiac death continues to be a public health problem worldwide.
The largest number of cases occurs in the general population, at an out-of-hospital level and in people who were not known to have heart disease, where only cardiovascular risk factors for ischemic heart disease have been found.
The control of these risk factors and the prevention of ischemic heart disease are the main measures to reduce the incidence of sudden cardiac death in the general population.
In a significant number of cases it is the first and only symptom of ischemic heart disease.
CPR and the use of automatic external defibrillators are measures that should be known by all health personnel and the general population to improve the survival of patients with sudden cardiac arrest.
It is essential to identify groups at high risk of arrhythmic death since they can benefit from the implantation of a defibrillator, a device that has been shown to reduce mortality due to malignant ventricular arrhythmias.