Sudden cardiac death can happen to you

February is Heart Month. The theme this year asks the question: 'Sudden cardiac death ... can it happen to you?'

The answer: Yes, it can!

Sudden cardiac arrest (SCA) is a leading cause of athlete deaths in the United States (US) and Italy, killing more than 325,000 persons each year. This trend is increasing in the Caribbean as well, with the most recent being the death of a 16-year-old football player here in Jamaica.

According to the World Health Organization, cardiovascular diseases accounted for the death of approximately 17.3 million people in 2008, representing 30 per cent of all global deaths. This number is expected to reach 23.3 million by 2030.

The immediate cause of SCA, and therefore sudden cardiac death, is a severe disturbance of the electrical activity of the heart (an arrhythmia). Most people who experience SCA have underlying heart disease. The most common type of heart disease which leads on to SCA is coronary artery disease, where the blood flow to the heart muscle is reduced because of blockages or narrowing of the blood vessels of the heart. This is the type of heart disease that leads on to heart attacks.

SCA and heart attack are not the same thing. A heart attack can cause SCA but SCA can also occur without the person having suffered a heart attack. There are other less common types of cardiac diseases which can lead on to SCA, including diseases of the heart muscle, heart valve disease (often as a result of rheumatic fever in childhood), congenital heart disease (abnormal heart structure that you are born with and a cause of SCA in children), and abnormalities of the electrical system of the heart.

Making healthy lifestyle choices may not be foolproof, but for many it could mean the difference between experiencing a significant health issue and avoiding it.

Heart health is something every Jamaican should be concerned about. Fortunately, a healthy heart is often within your control.

ARE YOU AT RISK FOR SCA?

How do you know whether you are at risk for SCA?

Here are some risk factors:

- A previous heart attack

- A previous episode of cardiac arrest

- Underlying heart conditions such as coronary artery disease, congenital heart disease

- Severe heart failure

- A tendency to faint

- Hyperthyroidism

- Electrocution

- Drug abuse

- A family history of heart disease or stroke.

When SCA occurs, it is critically important that whoever is near the victim calls for medical help immediately, checks for signs of life, and if there are none, gives CPR and uses the nearest automated external defibrillator (AED).

This is lifesaving care that any layperson can provide. It is best to be trained in CPR and the use of AEDs, but even without formal training, the rescuer can push hard and fast on the victim's chest and follow the directions on the AED, while waiting for medical help to arrive.

WHAT NOT TO DO

The worst thing for an SCA victim is to do nothing. Sometimes people hesitate to help because they are afraid they might do the wrong thing and hurt the victim. But the SCA victim is clinically dead and cannot get worse. Your actions can only help.

Certain risk factors for heart disease, such as age and family history, can't be changed. But you can help limit hereditary risks as well as minimise other risk factors for heart disease with the right lifestyle choices. And there's a big bonus.

WHAT TO DO

With every action you take to protect your heart you will get a boost, too. Here's how:

1. Get moving: Although it can be tempting to veg out once in a while, being too much of a couch potato is a risk factor for heart disease. In fact, a Harvard study found that watching TV for two hours a day increased the risk of developing heart disease by 15 per cent, and additional TV time further increased heart disease risk. That means step one of a heart-healthy plan is to make time for physical activity.

2. Kick the habit: Smoking cigarettes is tied to a number of potentially fatal health problems, including cancer, lung disease, stroke, and heart disease. Even if you have no other risk factors, smoking raises your risk of developing heart disease by two to four times. Smoking causes plaque buildup and hardened arteries, both of which make your heart work harder.

3. Manage stress: Stress causes strain on the heart, which creates a higher risk for cardiovascular disease. Exercise is recommended for people experiencing mild to moderate stress. When people start to exercise and feel the endorphins, they start to feel better, both physically and mentally.

4. Maintain a healthy weight: Weight extremes can also increase your risk for heart disease. Maintaining a healthy weight is important to protecting your heart from damage or fatigue. When your weight is in a healthy range, your blood circulates more effectively and necessary fluid levels are managed, preventing strain on your heart.

5. Eat a healthy diet: The foods you eat play a huge role in whether you gain too much weight and develop high cholesterol, both of which can increase your risk for heart disease. The quality and quantity of the types of food you put into your body are important.

6. Manage a high blood presure: About one in three adults in Jamaica has high blood pressure, but many aren't aware of it. Uncontrolled high blood pressure is one of the most deceptive risk factors for heart disease because there aren't any physical symptoms - you need to have your blood pressure checked to know if you're in the heart-healthy range.

Left untreated, high blood pressure can cause damage to arteries and organs like the heart. The good news is that high blood pressure can be managed.

7. Manage high cholesterol: Too much bad cholesterol and not enough good cholesterol can result in plaque building up on the walls of arteries. Over time, arteries harden and become narrower, which can lead to heart disease. If diet and exercise aren't enough to control your high cholesterol, your doctor can outline a plan that includes medication.

8. Control diabetes: Diabetes is an example of how one health condition can start a chain reaction of other medical issues, such as high blood pressure and high cholesterol. As these conditions develop, so does the risk for heart disease. Managing diabetes is important not only for heart health, but also for good health in general.

If you have one or more of these risk factors, you may be a candidate for SCA. If you think you may be at risk, you should see a cardiologist for an evaluation.

The Heart Foundation offers a screening programme for cardiovascular disease and for sudden cardiac arrest and also CPR courses. Do not delay - get screened today.

The Heart Foundation of Jamaica, 28 Beechwood Avenue, St Andrew; email: yourhealth@gleanerjm.com