Sudden cardiac death

Sudden cardiac death is a disastrous surprise that can shake any family. It is especially tragic when it occurs in young people. This could be caused by abnormalities in the structure of the heart, its electrical wiring, or blood supply complications.

The basic electrocardiograph
There are actually some clues that can be occasionally picked up on the basic electrocardiograph (ECG). It records the electrical activity of the heart muscle that can be detected on the surface of the body. However, the ECG result may turn out completely ‘normal’. That does not necessarily imply that there is absence of heart disease. Instead, more sophisticated tests may be required. By the time ECG results are ‘abnormal’, there may already be severe complications.

Sound out with echocardiography
Abnormalities in the structure of the heart can be detected by echocardiography. This special ultrasound screening provides detailed pictures of the heart and most of its important structures. One drawback to this type of screening is that the coronary arteries of the hearth are too small to be seen on echocardiography, and other tests are needed to ensure that they are functioning as they should be.

Exercise stress testing
Exercise stress testing is one of the many ways to detect coronary artery disease. Essentially, exercise such as running on a treadmill is performed to see how the heart works in response. It is a relatively more useful way of detecting blocked arteries, though the method is not fail-proof.

New ways of finding the silent killer
Newer methods include computerised tomography (CT) scans and X-ray images of the blood vessels. A combination is usually used to ascertain if there is heart disease, its location, and severity. If a cardiologist needs to be absolutely sure, the most accurate way is coronary angiography. This is a minimally invasive procedure, performed under local anaesthesia by passing a very small tube through the artery in the wrist or groin to the heart. The heart specialist will then be able to take X-ray images of the blood vessels to determine how many arteries are narrowed, and its severity.

As sudden cardiac deaths are attributed to genetic factors, those with family history should be screened. Patients with risk factors for coronary artery disease should go for screening as well, to detect blockages before disaster strikes. Young people who are planning to participate in competitive sports should undergo exercise stress testing and echocardiogram, along with careful evaluation by a cardiologist.

Publication of article by courtesy of Dr Alfred Cheng, Cardiologist at Mount Elizabeth Hospital