Sudden Cardiac Death - Medical Malpractice Lawyers

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Sudden Cardiac Death - Medical Malpractice

Sudden cardiac death is also referred to as SCD. It is an unexpected death because of a problem with the heart such that it stops beating relatively suddenly. A half of all deaths related to the heart are sudden cardiac death. It is usually caused by an arrhythmia of the heart which is usually a result of damage to the heart muscle, as in a heart attack. There are 325,000 sudden cardiac deaths in the US per year. This represents between 0.1 and 0.2 percent of deaths occurring in adults. The incidence is higher in those who have known cardiac history, such as a previous heart attack.

About 40 percent of cardiac arrests are unwitnessed and result in certain death. In those that are witnessed, most do die unless they have immediate cardioversion via an automatic external defibrillator. Only about twenty percent of all out of cardiac arrests survive to be seen in the hospital and only about 1.4 percent of patients survive to be discharged alive from the hospital. The worst complication of out of hospital cardiac arrests is cerebral anoxia. This is when parts of the brain die from lack of oxygen when the heart isn't beating or when the blood pressure is too low.

There is a higher rate of sudden cardiac death in blacks when compared to whites and a higher incidence in men when compared to women. The ratio is about 3:1. Older people suffer from SCD at a greater rate than younger people. This is because there is more coronary artery disease in older people.

The most common mechanism of action of cardiac arrest is a tachyarrhythmia or a fast heart rate, usually ventricular tachycardia. This is why cardioversion does such a good job of correcting sudden cardiac death. Unfortunately, having an external defibrillator around isn't all that common although they have been found at malls, airports and sporting arenas. Some people at serious risk of sudden cardiac death have implantable cardiac defibrillators.

Twenty to thirty percent of people with documented sudden cardiac death begin with brady-arrhythmias or slow heart beat. The heart beat can slow until there is asystole or lack of heart beat at all. A slow heart rate can provoke a heart attack, which then turns into ventricular tachycardia or ventricular fibrillation and sudden cardiac death.

Risk factors for SCD include atherosclerosis of the heart arteries, dilated cardiomyopathy and arrhythmias of the heart due to electrical problems. Myocarditis or an infection of the heart can contribute to sudden cardiac death. Some people are genetically prone to having sudden cardiac death. The strongest predictive factor in having sudden cardiac death is having considerable dysfunction of the left ventricle of the heart.

Doctors diagnose a person at risk for sudden cardiac death by evaluating the patient for the above risk factors. The heart is evaluated with an EKG or ECG and a stress electrocardiogram or echocardiogram can be done to see if there are significant arrhythmias of the heart. A regular echocardiogram of the heart can show if there is a low ejection fraction. Those lower than 30 percent are at greater risk for sudden cardiac death. Doctors also ask about smoking history, diabetes, high cholesterol, high blood pressure and sedentary lifestyle as risk factors for having sudden cardiac death. Previous heart attack, previous fainting spells, low ejection fraction and history of multiple premature ventricular contractions of the heart are also reasons to suspect that a person could have SCD.

Doctors have a scoring system that looks at blood pressure, time to restoration of cardiac function and neurological activity at the time they reach the emergency department. Those that score high on the scoring system based on these factors have a better chance of surviving to be discharged intact from the hospital. If the neurological system is not intact, doctors tend not to do too many invasive procedures to make sure another SCD occurs.

If a person survives their sudden cardiac death with an intact nervous system, doctors manage the underlying factors that led to the cardiac arrest and may use anti-arrhythmic medication to control arrhythmias. Patients with aortic stenosis causing SCD can get this corrected and all patients with SCD that is survived are considered for implantable defibrillators, which can send a jolt of electricity to the heart if an abnormal rhythm occurs.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here