Sudden cardiac death
One of the most serious consequences that can be promoted by high blood pressure is undoubtedly sudden cardiac death (SCD) sometimes also called sudden death. In the vast majority of cases it is fatal. Only about 2 to 5 percent of those affected reach the hospital alive. Even then, about half of those patients die.
Sudden cardiac death means a natural death that has a cardiac, i.e. heart-related, cause. An existing heart condition may be known, but the timing and circumstances of death are unexpected. Sudden cardiac death is triggered by a sudden loss of consciousness and occurs within one hour after the onset of acute symptoms.
In about half of cases, symptoms can be noticed some hours, sometimes days or weeks beforehand. These can include chest pain, shortness of breath, clouding of consciousness up to fainting, or palpitations. However, many cases (the other 50 percent) occur without prior warning.
In about half of cases, symptoms can be noticed some hours, sometimes days or weeks beforehand. These can include chest pain, shortness of breath, clouding of consciousness up to fainting, or palpitations. However, many cases (the other 50 percent) occur without prior warning.
What happens?
In all cases of sudden cardiac death there is a change in the electrical properties of the heart muscle cells, which leads via arrhythmias, electromechanical dissociation or immediate asystole (cardiac standstill) to sudden cardiac death.
Usually three factors are needed for this:
- a structural heart disease,
- a transient trigger, and
- An arrhythmia mechanism.
In 10 to 15 percent of cases there is a cardiomyopathy that is not due to CAD.
The remaining cases are due to other, rarer causes.
Transient triggers can include changes in electrolytes (blood salts), lack of oxygen, drugs, electrical injury, but also stress or a strong vagotonic reaction or vagus nerve stimulation, and similar factors.
Arrhythmia mechanisms are defects or problems in the hearts conduction system that disrupt the hearts normal activity.
Often the cardiac event begins with a ventricular tachycardia. That means one or both ventricles beat too fast, which then degenerates into ventricular fibrillation. The heart can no longer pump blood into the circulation. As a result, no oxygen is delivered to the cells. This leads to asystole: the heart stops. In rarer cases, asystole develops from bradycardia a too slow heart rate.
What to do?
The first step is to call emergency services on 112 immediately ideally, if you can tell, stating that the patient needs resuscitation. To give the person a chance of survival, cardiopulmonary resuscitation must be started right away. If available, using an AED (automated external defibrillator) can dramatically increase the chance of survival. However, it does not replace CPR; it is a tool that can restore a normal heart rhythm. The emergency dispatch center can give you telephone guidance on these measures until the ambulance arrives.
Sources:
This article comes from BloodPressureDB – the leading app since 2011 that helps hundreds of thousands monitor their blood pressure every day.
Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2024).
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as in outpatient care, and has led BloodPressureDB's specialist editorial team since 2015. Thanks to her extensive additional qualifications as a paramedic, first responder and in various therapy and emergency areas, she provides solid, practical and reliably reviewed information.
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