What is sudden death? – This refers to sudden, unexpected death occurring from natural causes within one hour of onset of symptoms in an otherwise healthy individual. This is often due to heart conditions that develop suddenly, resulting in inability of the heart to perform its function of pumping blood round the body. The affected persons usually have no prior warning signs of illness. This event may occur during sleep or during activities. 

What categories of people are mostly affected by sudden death?

Sudden death can occur in all categories of people. However, it has been noticed to be commoner in adult male above 35 years of age than other categories of people. 

What are the causes of sudden death?

The following are the common causes of sudden death:

1. Undiagnosed congenital heart disease – This may cause sudden death in teenagers and young adults, especially during physical activities such as sports and strenuous exercise.
2. Abnormal / irregular heartbeats (e.g. ventricular fibrillation, long QT syndrome) – These lead to ineffective heart beats that makes pumping of blood round the body by the heart impossible.
3. Excessively thickened heart muscles (hypertrophic cardiomyopathy) – This is a genetic condition which results in heart muscles growing excessively thick, making it difficult for the heart to pump blood efficiently.
4. Sudden narrowing / closure of the blood vessels supplying the hear (coronary spasm) – This reduces or temporarily cuts off blood supply to the heart, thus making it ineffective in pumping blood round the body.
5. Sudden forceful blunt trauma to the chest – Blunt trauma to the chest that may result in sudden death are those that occur at such a time when the heart is preparing for contraction (during the electrical activities of the heart). The trauma blocks the electrical wave spreading through the heart muscles, which is needed to generate contraction.
6. Acute asthmatic attack – Sudden constriction of the airway in persons with acute asthmatic attack may cut off oxygen supply to the blood through the lungs and inability to get rid of waste products of metabolism like carbon dioxide.
7. Intracerebral haemorrhage (bleeding into the brain) – This may be a complication of uncontrolled hypertension, leading to brain cell dysfunction.
8. Pulmonary embolism (blood clots in the lungs) – This causes ineffective blood circulation with the lungs and round the body.
9. Hypertensive crisis (sudden rapid rise in blood pressure) – This refers to sudden accelerated increase in blood pressure. The sudden nature makes it difficult for the heart to adjust and adapt to the situation as its own blood supply is also compromised and therefore not enough to match the expected work it has to do due to the elevated pressure.

What are the predisposing factors for sudden death?

Though sudden death often occurs in persons with no specific risk factors, certain conditions have been identified as predisposing factors. These include:

1. Obesity
2. Sedentary lifestyle
3. Family history of sudden death
4. Medical conditions such as high blood pressure, asthma, diabetes
5. Excess alcohol consumption
6. Tobacco use
7. Substance abuse

What are the symptoms of sudden death?

In most cases, sudden death gives no prior notice. So, there is no list of symptoms that can properly signal that someone is about to die suddenly. However, in some cases, the following symptoms may manifest before sudden death occurs, depending on the underlying cause:

1. Chest tightness / discomfort
2. Palpitations
3. Shortness of breath
4. Fainting episodes
5. Dizziness

How can sudden death be prevented?

Due to its sudden and unexpected nature, and occurring in apparently healthy individuals, it is difficult to predict and prevent sudden death. However, adequate management of predisposing medical conditions and lifestyle changes may help reduce the risk. The following measures may help in reducing the risk of sudden death:

1. Maintaining healthy weight
2. Engaging in regular exercise
3. Adequate treatment of medical conditions such as high blood pressure, diabetes, asthma etc
4. Reduction of alcohol consumption
5. Discontinuation / avoidance of tobacco use or substance abuse
6. Regular evaluation and check-up for those with family history of sudden death