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The Rise of Sudden Cardiac Death in Teens


By Lisa Hurt Kozarovich

drkoop.com Health Correspondent

 

 

If you think heart attacks don’t strike young people, think again. In fact, there’s been a surprising increase in the number of teenagers and young adults dying from sudden cardiac deaths in the past decade, according to the U.S. Centers for Disease Control and Prevention.

 

In the first national study on the issue, the CDC found that the number of 15- to 34-year-olds dying from sudden cardiac death jumped 10 percent from 1989 to 1996. Even more disturbing is that among young women, there was a 30 percent increase in the same period.

 

“The results were really a surprise to us,” says Dr. Zhi-Jie Zheng, M.D., Ph.D., lead author of the study, which was presented to the American Heart Association this spring. The study examined national death certificate data of the 23,320 people, ages 15 to 34, who died from sudden cardiac death between 1989 and 1996. Of those victims, 21 percent were under 24-years old, and the remaining 79 percent were 25 to 34.

 

There is no easy explanation as to why it’s happening, researchers say.

 

“We don’t have any definitive answer to that. We speculated that it may be related to the increase in obesity among adolescents,” Zheng says. Neither can researchers explain why the number of women dying from sudden cardiac deaths increased so dramatically, but they believe it may be linked to the fact that more young women began smoking during that same time period, he says.

 

Risk Factors See No Age

 

The fact is the same things that put older adults at risk of having a cardiac arrest, such as obesity, smoking, family history, diabetes and high blood pressure also put young people at risk. And, Zheng says, more and more children and teenagers are being diagnosed with those conditions.

 

Still, because those factors typically lead to coronary heart disease, which isn’t usually the underlying cause in young people who die from cardiac arrest, researchers may have to look elsewhere for answers.

 

One explanation may be the use of drugs, like cocaine and dietary supplements, Zheng says, particularly if young adults are using those drugs and then engaging in physical activity.

 

Vanderbilt University’s Mary Fran Hazinski, R.N., M.S.N., agrees that an unhealthy lifestyle and drug use could be factors. Then again, she says, without further research it’s hard to know if there are more young people dying from sudden cardiac deaths or if awareness of the problem simply means that it’s being reported more accurately.

 

If there are indeed more deaths, part of the reason may be that young athletes are training more vigorously than ever, which is dangerous for someone who doesn’t know they have an underlying heart condition, she says.

 

Or maybe, Hazinski says, more teenagers are being diagnosed with familial arrhythmia, an irregular heartbeat that runs in families and can suddenly cause the heart to stop beating.

 

That’s why it’s particularly important for athletes, especially those with a family history of a heart condition, to be thoroughly evaluated on a regular basis, says Hazinski, a spokeswoman for the American Heart Association. In fact, the AHA has published guidelines to help physicians properly examine young athletes, and encourages parents to ask their physicians if they are using those guidelines.

 

Improving Chances of Survival

 

Meanwhile, the AHA is focusing its efforts on saving victims following an attack. And there are two simple ways to dramatically improve a person’s chance of survival, Hazinski says.

 

“If CPR is started immediately and defibrillation is given within three minutes, the survival rate goes up to more than 75 percent -- that’s virtually unheard of,” she said.

 

Immediate attention is particularly important when you consider that with every minute that passes, the victim’s chance of survival drops 7 to 10 percent, and that an estimated 95 percent of patients die before reaching the hospital.

 

That’s why the AHA has undertaken two public initiatives. The first is to encourage public areas, such as airports, casinos, sports arenas, colleges and large high schools, to train employees how to operate the user-friendly defibrillators and have the machines easily accessible to the public. The second is that all high school teachers train their students in CPR and then have those students go on to train younger students. Simply having a bystander that can perform CPR doubles a person’s chance of survival, Hazinski says.

 

Facts About Sudden Cardiac Death

 

Sudden cardiac death results from a sudden loss of heart function in a person who may or may not have a diagnosed heart disease.

 

Although the terms “heart attack” and “sudden cardiac arrest” are frequently used interchangeably, there is a difference. During a heart attack, blood flow to the heart muscle is temporarily blocked. During a cardiac arrest, the heart stops pumping, causing the person to immediately lose consciousness.

 

Death occurs instantly or shortly after symptoms appear if the person is not immediately treated.

Adrenaline released during intense physical activity often acts as a trigger for sudden death when a heart abnormality is already present.

 

Under certain conditions, various heart medications and other drugs, as well as illegal drugs, can lead to abnormal heart rhythms that can cause sudden death.

 

All known heart disease can lead to cardiac arrest and sudden death.

 

Cardiac arrest can be reversed in most victims if it’s treated within a few minutes with an electric shock to the heart to restore the normal heartbeat. This process is called defibrillation.