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If you are male, congratulations on making it back
to work today. You survived the bank holiday weekend, three days when your
chance of a heart attack is at its height, according to French research. By
studying death records over a decade, scientists have suggested that among men
aged 35 to 54, weekends are the peak slots for suffering heart attacks.
The paper, in Heart, suggests that the exertions of weekend sports or DIY might
be factors, as might heavy weekend drinking. But an inability to leave the
worries of work behind may also be a factor. When all age groups and women are
taken into account, heart deaths peak on a Monday.
Few people under the age of 65 die suddenly and unexpectedly due to heart
defects. Those who do, such as 20-year-old Thomas Staniforth, the Sheffield
Wednesday player who collapsed during a night out with friends ten days ago,
attract a lot of publicity precisely because they are so rare and occur without
warning. In cases of sudden death, a cardiac abnormality is discovered during a
post-mortem in 95 per cent of cases. The triggers could be extreme stress or
physical exertion, but remain under investigation. The most common identifiable
cause is cardiomyopathy, a disorder of the heart muscle. The best-known example
is hypertrophic cardiomyopathy, in which the heart muscle becomes abnormally
thick and disturbs heart rhythm. It can cause palpitations and breathlessness
but, equally, can be symptom less.
There is some confusion over what the term Sudden Adult Death Syndrome (SADS)
embraces. Even though cardiomyopathy is sometimes cited as a cause of SADS,
because it does cause sudden death, the British Heart Foundation uses the term
SADS to describe only those cases where no cause is found at post-mortem.
In these cases, the blame is pinned on one of three disorders that interfere
with electrical function. The most common is called Long QT syndrome, when the
heart takes an abnormally long time to recover between contractions. The other
two are Brugada syndrome and idiopathic ventricular fibrillation. Long QT, the
most studied of the three, is estimated to affect one in 10,000 adults, and
symptoms normally appear by adolescence. These include fainting at times of
extreme emotion or exertion.
Treatment can include beta-blockers, and even the fitting of a pacemaker or
defibrillator. Cardiomyopathy and these three electrical disorders claim at
least 200 lives each year.
Death by overwork, The Times 28th
August 2001
British Heart Foundation: www.bhf.org.uk
Cardiac Risk in the Young: www.c-r-y.org.uk
http://www.timesonline.co.uk
© The Times, London, 2001
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