Today morning my wife saw a notification in her face book from one of her college friends
“ Hey I heard news that our best friend is no more do u have any information”.
Seeing that we both had complete pause and a synchronous answer followed ….what……..?
She was the best friend of my wife Sikha during her college days. In fact she spoke to her hardly a month back and it was unbelievable and unacceptable to hear that she is no more. The next question we asked each other was what must have happened and how can such a good girl who loves every one can leave us so prematurely. She had a wonderful family her Husband, in-laws and parents. Sikha got a call from her husband and all hell break loose to hear she had a sudden death due heart attack.
Being a doctor I know this is rare but can happen. I am writing this post so that my friends and readers be aware of this dreaded possibility and what could have saved my wife’s best friend.
What Could be the cause of Sudden death in Young people (Younger than 35Yr)?
It’s mostly due to heart defects which may be congenital or some undetected and unattended abnormality. Usually its precipitated with physical activity like we may read in news paper a football player succumbed in field.
What are the causes of Sudden death in young People?
More than 2/3rd of the people die of Heart disease.
• Structural heart defect — causes the heart to beat out of control. This abnormal heart rhythm is known as ventricular  fibrillation.
• Hypertrophic cardiomyopathy (HCM): Heart muscle (myocardium) becomes abnormally thick, making it harder for the heart to pump blood. Hypertrophic cardiomyopathy, while usually not fatal in most people, is the most common cause of heart-related sudden death in people under 30.
• Coronary artery abnormalities: Sometimes people are born with heart arteries (coronary arteries) that are connected abnormally. The arteries can become compressed during exercise and not provide proper blood flow to the heart.

• Long QT syndrome (LQTS):Long QT syndrome (LQTS) is an inherited heart rhythm disorder that can cause fast, chaotic heartbeats.

• Unrecognized congenital heart disease
• Genetic connective tissue disease:These are inheritable conditions affecting the structures that give support, strength and elasticity to the walls of the major blood vessels and, to a lesser extent, the heart muscle – for example Marfan’s Syndrome and Ehler-Danlos. These can cause sudden death by arrhythmias or due to the sudden rupture of a major blood vessel such as the aorta (the major blood vessel that leaves the left side of the heart and supplies blood to the body).
• Viral Myocarditis
• Mitral valve prolapse: The mitral valve can sometimes be ‘floppy’ in appearance. It is usually an asymptomatic and benign condition. In some rare cases mitral valve prolapse can be inherited in a family and can then be associated with arrhythmias and sudden death.
• Brugada syndrome
• Blunt blow to the chest — such as being hit by a baseball or hockey puck which can trigger ventricular Fibrilation.
• Sudden Arrhythmic Death Syndrome (SADS): In around 1 in every 20 cases of sudden cardiac death – up to 500 every year in the UK – no cause can be found, despite examination of the heart by an expert cardiac pathologist. The cause of death is therefore described as ‘unascertainable’. This is called Sudden Arrhythmic Death Syndrome, or SADS.
• Medication-related causes: Prescription, over-the-counter and illegal drugs can have potentially dangerous but usually rare side effects, particularly if too much is taken (an overdose). These effects include arrhythmias (disturbance in the heart’s rhythm) and sometimes a sudden death

When should we consult a doctor/ What are the symptoms where we should immediately consult a doctor to avoid such situation?
• Unexplained fainting (syncope)
• Unexplained seizures
• Family history of sudden cardiac death: Sudden death before 50yrs
• Shortness of breath or chest pain also may be a sign that you’re at risk of sudden cardiac death
• History of smoking, High Blood Pressure
What are the symptoms of sudden cardiac arrest?
• In sudden cardiac arrest, the heart stops beating, and blood is not supplied to the body.
• Almost immediate loss of consciousness occurs, and the affected person will not be able to be aroused.
• The person will fall or slump over. No pulse will be able to be palpated, and there will be no signs of breathing
What is the treatment for sudden cardiac arrest?
• The definitive treatment for this is defibrillation using electricity to shock the heart back into a regular rhythm.
• Communities which institute public CPR education and rapid activation of emergency medical services have dramatically increased survival rates from sudden cardiac arrest. Unfortunately, because the brain is so sensitive to the lack of oxygen and blood flow, unless treatment occurs within four to six minutes, there is a high risk of some permanent brain damage.
• ABCs of resuscitation will be re-evaluated. Airway, Breathing, and Circulation (heart beat and blood pressure) will be supported.
• Immediate hospitalization and ICU care may be required.
What could we the common non medical people can do so that we can save some one?
• Take a basic course of Cardio Pulmonary Resuscitation so that any such situation can act immediately without waiting for ambulance.
• Always have the number of emergency service.
May be some alertness and training of common man about how to react to this kind of situation could save anyone.

Related articles

• Smoking, Even Moderately, is Associated With Sudden Death in Women, Shows Study (webpronews.com)
• Fish oil prevents sudden cardiac death, mercury cuts the benefit (foodconsumer.org)
• Preventing Sudden Cardiac Arrest in Children (liheart.org)
• Risk factors for sudden cardiac death in postmenopausal women (foodconsumer.org)
• New Hope for Stopping Sudden Cardiac Deaths (ivanhoe.com)
• http://www.dnaindia.com/entertainment/1842083/report-tv-actor-abir-goswami-dies-of-heart-attack