Sudden Cardiac Death In Athletes
Sudden cardiac death is a natural unexpected death from a cardiac arrest , and usually it occurs during exercise. As scary as it is seeing somebody like Fabrice Muamba collapse in the middle of a Premier League football match, it is very rare.
Usually it is caused by either an inherited heart condition or cardiovascular disease even if the person is physically fit.
It is important to remember that sudden cardiac death is extremely rare, but if you are concerned, please speak to your doctor. This is especially important if you have a family history of cardiac problems or unexplained collapses. Often, there are no preceding symptoms but there does appear to be a link in some athletes who experience fainting or near fainting during exercise. If this is the case or you are concerned please see your doctor for advice.
For nearly all individuals, regular exercise is very beneficial to the health of the heart, resulting in better heart health. However, as illustrated by Hannahs story and those of athletes who suffer sudden cardiac death, heart disease can affect the young as well, so it is important to be aware of the signs and symptoms.
Heart Attack Symptoms In Women Vs Men
Women are more likely than men to have silent heart attacks and heart attacks without chest pain. Heart attacks are also more likely to start when a woman is at rest or experiencing mental stress.
That means its especially important for women to watch out for symptoms like shortness of breath, extreme fatigue, nausea or vomiting, or pain in the jaw, arms or back.
Also, we now know that young women are particularly prone to a type of heart event called a spontaneous coronary artery dissection , which we talk about in more depth below.
Complications Of A Heart Attack
Complications of a heart attack can be serious and possibly life threatening.
- arrhythmias these are abnormal heartbeats. 1 type is where the heart begins beating faster and faster, then stops beating
- cardiogenic shock where the heart’s muscles are severely damaged and can no longer contract properly to supply enough blood to maintain many body functions
- heart rupture where the heart’s muscles, walls or valves split apart
These complications can happen quickly after a heart attack and are a leading cause of death.
Many people die suddenly from a complication of a heart attack before reaching hospital or within the 1st month after a heart attack.
The outlook often depends on:
- age serious complications are more likely as you get older
- the severity of the heart attack how much of the heart’s muscle has been damaged during the attack
- how long it took before a person received treatment treatment for a heart attack should begin as soon as possible
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Female Heart Attacks Symptoms Are Subtler
Women need to be aware of the more vague symptoms they often get that indicate a heart attack. Other common symptoms you might experience include pain or discomfort in areas surrounding the chest, such as the neck and jaw, arm, shoulder, upper back, or stomach.
You might also experience vomiting and nausea, shortness of breath, sweating, indigestion, and unexplained fatigue. Your symptoms might feel more similar to what youd expect from the flu or acid reflux than a heart attack.
Causes Of Heart Attacks
The most common cause of a heart attack is coronary heart disease . Plaque builds up over time along the walls of the artery, causing the blood vessel to narrow. Eventually, the narrowing becomes severe enough to reduce the blood flow to the heart or block it altogether. A traveling through the blood vessels can also cause a heart attack by plugging the artery and blocking the blood flow.
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What Does A Heart Attack Feel Like
Some of the sensations you may feel during a heart attack include:
- Chest pain that can range from mild to severe, or an uncomfortable pressure, tightness, squeezing or heaviness in your chest. The discomfort can last more than a few minutes at a time and sometimes goes away for a short time but returns later.
- Pain or a sensation of being squeezed that starts in the upper back.
- Pain that starts from your left shoulder and arm, and goes into other areas such as your back, jaw, neck or right arm.
- Pain that feels like heartburn or indigestion.
How Is A Heart Attack Diagnosed
To diagnose a heart attack, a doctor will ask you about your symptoms, your health, and your family health history. The doctor will also order tests.
Doctors often use these types of tests to diagnose a heart attack and choose the best treatment.
- Blood tests. During a heart attack, heart muscle cells die and burst open. This process releases proteins into your blood. Heart attack blood tests measure the amount of these protein “markers” of heart damage. Common heart attack blood tests include:
- Cardiac troponin . This is the most common blood test. This marker is released from the injured heart muscle. It is not found in the blood of healthy people. Troponin levels go up three to six hours after your heart attack starts, so the test may not find a heart attack right away.
- Creatine Kinase-MB . The CKMB test measures the amount of damage to the heart because of blocked blood flow. The test can tell whether treatments to restore blood flow to the heart are working. CKMB levels rise about four to six hours after a heart attack starts and peak 24 hours later.
- Myoglobin. This test helps diagnose a heart attack in the very early stages. After a heart attack, myoglobin levels rise within one to four hours but peak after 12 hours.
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Heart Disease Among Men And Women
The prevalence and incidence of diagnosed ischemic heart disease and heart failure are consistently higher among men than women . The difference by sex is more pronounced for the occurrence of acute myocardial infarction. On average, men are about 2 times more likely than women to have a first acute myocardial infarction. In addition, the gap between men and women in the overall number of acute myocardial infarction occurrences is steadily increasing over time. There were close to 80,000 more occurrences among men than women in 2000/01, compared to just over 200,000 occurrences in 2012/13.
Figure 1: Age-standardized prevalence of ischemic heart disease and heart failure , and acute myocardial infarction occurrence , by sex, Canada,* from 2000/01 to 2012/13
Age-standardized to the 2011 Canadian population. *Data from Yukon were not available. Notes: The 95% confidence interval shows an estimated range of values which is likely to include the true value 19 times out of 20. : Public Health Agency of Canada, using Canadian Chronic Disease Surveillance System data files contributed by provinces and territories, May 2016.
Figure 3: Age-standardized all-cause mortality rates among those with diagnosed ischemic heart disease and heart failure , and those who had an acute myocardial infarction , by sex, Canada,* from 2000/01 to 2012/13
Heart pain image via shutterstock
How Are Heart Attacks Treated
Treating a heart attack means restoring blood flow to the affected heart muscle as soon as possible. This can happen in a variety of ways, ranging from medication to surgery. Its extremely likely that treatment will use several of the following methods.
People having trouble breathing or with low blood oxygen levels often receive supplementary oxygen along with other heart attack treatments. You can breathe the oxygen either through a tube that sits just below your nose or a mask that fits over your nose and mouth. This increases the amount of oxygen circulating in the blood and reduces the strain on your heart.
- Anti-clotting medications: This includes aspirin and other blood-thinning medicines.
- Nitroglycerin: This medicine relieves chest pain and causes blood vessels to widen so blood can pass through more easily.
- Thrombolytic medications: Providers use these only within the first 12 hours after a heart attack.
- Anti-arrhythmia medications: Heart attacks can often cause malfunctions in your hearts normal beating rhythm called arrhythmias, which can be life-threatening. Anti-arrhythmia medications can stop or prevent these malfunctions.
- Pain medications: The most common pain medication given during heart attack care is morphine. This can help alleviate chest pain.
Percutaneous coronary intervention
Coronary artery bypass grafting
Does Taking Birth Control Pills Increase My Risk For Heart Disease
Taking birth control pills is generally safe for young, healthy women if they do not smoke. But birth control pills can pose heart disease risks for some women, especially women older than 35 women with high blood pressure, diabetes, or high cholesterol and women who smoke. Talk with your doctor if you have questions about the pill.
If youre taking birth control pills, watch for signs of trouble, including:
- Eye problems such as blurred ordouble vision
- Pain in the upper body or arm
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Why Are Heart Attacks Striking Younger People
Most people in their thirties and forties dont worry about having a heart attack, especially if they are fit and healthy, but heart attacks among adults younger than 50 years of age are on the rise, according to researchers at Brigham Health.
Results from their study were presented at the American College of Cardiology meeting and showed that among individuals who suffer a heart attack at a young age, 1 in 5 were 40 or younger and that number has risen 2 percent each year for the past decade.
In a related study published in a recent issue of Journal of the American College of Cardiology, these Brigham investigators showed that patients who suffered a heart attack before 50 may have a genetic disorder that results in high cholesterol, known as familial hypercholesterolemia .
In fact, about 10 percent of patients who suffer a heart attack before 50 had FH, and many continued having high cholesterol levels a year after their first heart attack.
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Tips For Heart Attack Prevention
The goal after your heart attack is to keep your heart healthy and lower your risk of having another heart attack. Take your medications as directed, make healthy lifestyle changes, see your doctor for regular heart checkups, and consider a cardiac rehabilitation program.
Why do I need to take drugs after a heart attack?
You might take certain drugs after a heart attack to:
- Prevent blood clots
- Prevent plaques by lowering cholesterol
Know the names of your medications, what theyâre used for, and when you need to take them. Go over your medications with your doctor or nurse. Keep a list of all your medications, and take it to each of your doctor visits. If you have questions about them, ask your doctor or pharmacist.
It sounds like a no-brainer, but don’t skip your medications. Many people don’t take their medications the way their doctor told them to. Figure out what keeps you from taking your medicine — it could be side effects, cost, or forgetfulness — and ask your doctor for help.
What lifestyle changes are needed after a heart attack?
To keep heart disease from getting worse and to head off another heart attack, follow your doctor’s advice. You might need to change your lifestyle. Here are some changes you can make that can cut your risk and put you on the path to a healthier life:
Why should I take part in cardiac rehabilitation?
What Can I Do To Recover After A Heart Attack
Take our quiz to see how much you know about cardiac rehabilitation.
If youve had a heart attack, your heart may be damaged. This could affect your hearts rhythm and its ability to pump blood to the rest of the body. You may also be at risk for another heart attack or conditions such as stroke, kidney disorders, and peripheral arterial disease .
You can lower your chances of having future health problems following a heart attack with these steps:
- Physical activityTalk with your health care team about the things you do each day in your life and work. Your doctor may want you to limit work, travel, or sexual activity for some time after a heart attack.
- Lifestyle changesEating a healthier diet, increasing physical activity, quitting smoking, and managing stressin addition to taking prescribed medicinescan help improve your heart health and quality of life. Ask your health care team about attending a program called cardiac rehabilitation to help you make these lifestyle changes.
- Cardiac rehabilitationCardiac rehabilitation is an important program for anyone recovering from a heart attack, heart failure, or other heart problem that required surgery or medical care. Cardiac rehab is a supervised program that includes
- Physical activity
- Education about healthy living, including healthy eating, taking medicine as prescribed, and ways to help you quit smoking
- Counseling to find ways to relieve stress and improve mental health
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Heart Attack Risk Factors For Women
There are several factors that increase your chance of developing heartdisease. Almost 50% of all Americans have at least one of three major riskfactors for the condition:
- High blood pressure: Women can develop high blood pressure as a side effect of birth control pills or during pregnancy. All women over 65 are more likely than men are to have high blood pressure.
- High cholesterol: Estrogen seems to protect women against unhealthy levels of cholesterol. But after menopause, estrogen levels drop and high cholesterol becomes more likely.
- Smoking: Although men are slightly more likely to smoke, the gap in cigarette usage between genders is smaller than ever and women are less likely to be able to quit successfully.
Additional risk factors include:
- Excessive alcohol use
The Burden At A Glance
In Canada, heart disease is the second leading cause of deathFootnote i after cancer, and a leading causeof hospitalization.Footnote ii Ischemic heart disease, the most common form of heart disease, is the first cause of years of life lostFootnote iii and the second leading cause of disability-adjusted life years lostFootnote iv .
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Strong Family History Genetic Factors Increase Heart Disease Risk
Having a strong family history of heart disease is partly due to genetics and partly due to other factors. Approximately 10% to 15% of the U.S. population has a strong family history of heart disease. The risks in this group can include family traditions such as preferring sedentary instead of active family time or eating meals that typically include more unhealthy than healthy options.
Additionally, certain conditions that affect heart disease risk, such as high blood pressure or diabetes, tend to run in families. In others, the risk factor levels are OK and individuals are leading a healthy lifestyle, but there still are premature heart attacks in a family. These are the most challenging situations that can benefit from evaluation by a specialist. In fact, if both of your parents had a heart attack before they turned 50, you are seven times more likely to have one yourself.
Our health is strongly tied to our environment if we have been taught or cornered into a certain way of life, it can become “the norm.” Breaking that cycle can be a tough, but it’s absolutely possible with a support network and the guidance of a preventive cardiologist.
It seems illogical that a healthy person who is active and strong can have a heart attack. But it happens, and when it does, the cause almost always is a genetic condition that runs in the family.
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Stress Is Likely A Major Factor
Dr. Chugh and his team studied data available from the Oregon Sudden Unexpected Death Study, which began in 2002.
For the analysis, the investigators looked at the data collected from emergency medical reports in 20042014. During this time, 1,535 adults had sudden cardiac arrests and died as a result.
Of these people, note the authors, only 13.9 percent died between 12 a.m. and 6 a.m. Contrary to older research and an ensuing widespread belief, the study found no evidence of a higher prevalence of sudden cardiac arrests on Mondays.
While there are likely several reasons to explain why more cardiac arrests happen outside of previously identified peak times, stress is likely a major factor, explains Dr. Chugh.
Because sudden cardiac arrest is usually fatal, we have to prevent it before it strikes, he adds.
We now live in a fast-paced, always on era that causes increased psychosocial stress and possibly, an increase in the likelihood of sudden cardiac arrest.
Dr. Sumeet Chugh
Dr. Chugh also shares some directions for future research, explaining, Our next steps are to conclusively determine the underlying reasons behind this shift, then identify public health implications as a result.
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You Had A Heart Attack Now What
Its no surprise that many people feel scared, confused and overwhelmed after a heart attack. A heart attack represents a life-changing event.
After your treatment for heart attack, you likely received instructions and a lot of information from your doctor. With time to reflect, you may be trying to understand what happened. Youre sure to want to know what you can do to avoid heart problems in the future.
Navigating the road to recovery isnt easy. Questions, confusion, uncertainty and even fear are common. Get answers to your questions and learn more about what to expect.