Sudden death is targeting young people. Pay attention to these symptoms! What medical tests can help predict it?

In recent years, news about "cardiac arrest" has frequently become a hot topic. From young people who stay up late to work overtime to athletes who seem to be "in great shape", "cardiac arrest" is becoming younger, causing deep concern among the public about their health.

Many young athletes have experienced cardiac arrest

01 Do only heart disease patients suffer sudden death?

In fact, poisoning, suffocation, and severe trauma can all cause sudden death. However, sudden cardiac death (sudden death caused by heart problems) accounts for more than 80% of all sudden deaths, and has obvious characteristics:

In the absence of obvious causes, sudden fainting , loss of consciousness , abnormal breathing or cessation , and loss of pulse . Therefore, when athletes such as Erickson suddenly fall to the ground and faint on the field, the first thing to consider is cardiac arrest.

Although the mortality rate of cardiac arrest is very high, it is still possible to successfully rescue it. In this year's European Cup schedule, we even saw Eriksen play again and score a goal.

Eriksson's rebirth from the brink of life and death to football｜Source: Wenhui Daily

02 How to determine cardiac arrest?

In addition to cardiac arrest, other physical or psychological problems such as low blood pressure, low blood sugar, heat stroke, epileptic seizures, and high tension may also cause fainting. Therefore, when someone suddenly faints , make the following two judgments while ensuring that the environment is safe:

1) Determine consciousness: Pat and call again. Pat the patient’s shoulders gently with both hands and call loudly in their ears. If there is no response, they can be judged as unconscious.

2) Determine breathing and heartbeat: Use the “listen, look, and touch” method to check the patient’s breathing and carotid pulse (on both sides of the Adam’s apple, you can practice by touching it on yourself), the time is about 10 seconds.

Image source: Doctor Youlai

If there is unconsciousness, no breathing or pulse, or gasping breathing (exhalation is greater than inhalation), it indicates that cardiac arrest has occurred.

03 What may cause cardiac arrest?

Cardiac arrest is most often caused by a fatal arrhythmia, such as ventricular fibrillation.

Organic diseases of the heart itself may induce cardiac arrest, especially hypertrophic cardiomyopathy, coronary heart disease, severe arrhythmia (such as long QT syndrome, etc.), myocarditis, cardiac concussion (sudden and severe impact on the heart), etc.

However, although it is rare, young people and even children can suffer sudden cardiac arrest without any warning . They may have no symptoms at all and routine physical examinations may not detect obvious problems. But again, it is very rare for young people to have sudden cardiac arrest, and its incidence is much lower than that of the general population.

04 What are the signs before cardiac arrest?

Although cardiac arrest during exercise has received more attention, in fact, more cardiac arrests occur in daily life or even in sleep. Cardiac arrest usually has no signs. However, in some cases, some warning symptoms may appear in advance: for example: extreme fatigue, severe breathing difficulties, palpitations, chest pain, severe nausea or extreme dizziness.

Image source: iStock

If these symptoms occur during exercise or without obvious cause, you should rest immediately and inform your companions as much as possible.

05 What behaviors can prevent cardiac arrest?

As mentioned above, organic diseases of the heart itself may induce cardiac arrest. Therefore, measures to prevent hypertension and coronary heart disease can greatly reduce the risk of cardiac arrest.

For example: healthy diet, quit smoking and drinking, control blood pressure and blood lipids, regular physical examinations , etc. Controlling these basic diseases is to reduce the risk of cardiac arrest.

iStock

06 Is there any medical test that can predict the risk of cardiac arrest ?

For middle-aged and elderly people, or people with underlying diseases such as hypertension and coronary heart disease, routine physical examinations such as blood pressure, blood sugar, blood lipids, electrocardiogram, chest X-ray, etc. can determine the severity of the underlying disease.

For young people without underlying diseases, proper self-assessment is a very important predictive tool:

1) Family history. Has any relative ever suffered from heart disease, cardiac arrest, or unexplained sudden death under the age of 50?

2) Do you usually exercise? Do you experience palpitations, severe breathing difficulties, chest pain, severe dizziness, etc. during exercise?

If so, it is recommended to consult a doctor and undergo further examination.

It is worth noting that routine electrocardiograms , cardiac ultrasounds or other tests are difficult to predict the risk of cardiac arrest . Even if the test results are normal, the possibility of cardiac arrest cannot be ruled out. In addition, some "positive" results may not mean organic problems, but may bring unnecessary anxiety or restrict normal exercise.

Cardiac arrest is very difficult to predict and is also difficult to prevent in young people without underlying diseases. Therefore, the focus of its treatment is on first aid measures once it occurs .

Timely identification , regular and effective cardiopulmonary resuscitation and early defibrillation assessment/treatment can greatly improve the success rate of treatment. For cardiac arrest, time is life. The golden rescue time for cardiac arrest is only 4 minutes!

Author: Zhu Renqing, MD, PhD, Neurosurgeon, Children's Hospital, Fudan University

Planning & Editing: Little Dandelion