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Every week in the UK, 12 apparently fit and
healthy people, all aged 35 and under, die from a previously undiagnosed
heart condition. Often they show no symptoms and are at the peak of
their lives.
but the simple act of walking into a cold shower,
hearing the doorbell ring or playing sport can be enough of a shock to the
heart to kill them instantly.
The post-mortem of Boyzone singer Stephen Gately,
who passed away aged 33, at his house in Majorca last week, revealed he died
from a build-up of fluid on his lungs known as acute pulmonary oedema.
The obscure cause of death is often linked to the
presence of underlying heart complaint and Gately's family believe he died
from a previously undetected, hereditary condition.
According to the UK charity Cardiac Risk in the
Young (CRY), young people can walk around with no knowledge they are at risk
from heart problems.
"Many are affected while playing sport, where the
exertion is enough to exacerbate a pre-existing and cardiac condition," says
the charity's founder and chief executive Alison Cox.
The UK charity CRY reckon that sudden cardiac
death kills over 600 people aged 35 and under a year - although experts
believe the number is higher as many sudden death cases are wrongly recorded
as asthma, epilepsy or even drowning.
Gately was certainly the most recent high-profile
victim of what is known as Sudden Cardiac Death (SCD) - an umbrella terms
for a number of a different heart conditions that affect fit and healthy
people which, is not treated, can result in spontaneous death.
"The effect on families and loved ones is immense,
compounded only by the fact so many of these cases could have been prevented
if detected early by a simple test," says Cox.
WHAT IS IT?
SCD is a term used to describe a sudden death
within 12 hours of usual, normal health, says leading expert Dr Sanjay
Sharma, consultant cardiologist and physician at King's College London.
"The commonest cause of SCD in older people, say 50 to 70, is coronary
artery disease, which is usually due to smoking or high cholesterol and
causes blocked arteries in the heart," he says.
"In young people under the age of 35, sudden
cardiac death is due to either a structural problem or an electrical fault
in the heart and is usually inherited."
Hypertrophic Cardiomyopathy ((HCM), a
so-called structural problem, is the most common cause of sudden death in
young people, affecting some 10,000 in the UK, according to CRY. Gene
abnormalities cause the heart muscle to become thick and render it
vulnerable to potentially fatal rhythms.
Electrical faults with the heart, however, such as
Long QT syndrome, are caused by rare disorders in the body's sodium,
potassium and calcium channels, which are responsible for regulation of the
flow of electrical currents to the cells.
But in one in 20 cases of SCD, no recognised cause
can be found, even after post-mortem. This is referred to as Sudden
Arrhythmic Death Syndrome (SADS).
Whatever the heart condition, young victims
usually have no symptoms, says Cox. "In 80% of cases, there are
usually no signs anything is wrong - the first symptom is usually sudden
death."
WHO DOES IT AFFECT?
SCD is most common in adolescents and young
adults, when the body is most sensitive to adrenaline. In fact, the
condition is thought to be stressed by a sudden surge of adrenaline to the
body. As a result, athletes are at the highest risk of SCD, as
"exercise is a trigger in causing rhythm imbalances in people harbouring
faults in the heart", says Dr Sharma.
Cardiac Risk in the Young is a genetic - not
lifestyle - condition. Delving into your own family's health history
is therefore key to understanding your own risk.
Stephen Gately for example, is reported to have
had an undiagnosed heart condition that ran in his father's side of the
family.
"When someone dies suddenly, as Stephen did, alarm
bells ring about the history of death in the family," says Cox. "Think
of your family and any sudden deaths, including cot deaths, that
suggest there may be an underlying inheritable condition."
Knowing such particulars could save your own life,
says Cox, who saw one family lose two children in two weeks to SCD.
DIAGNOSIS
A simple medical examination can help find any
inheritable structural heart disease. But further tests, such as an
ECG (which takes electrical readings of the heart), echocardiograms
(ultrasound looking at heart structure), and exercise tests can also help
determine the presence of a heart condition.
TREATMENT
Treatments range from lifestyle modifications to
surgery. "If you suffer from Long QT syndrome you have to avoid
strenuous exercise loud pop concerts, certain antibiotics, and refrain from
using substances that increase adrenaline into the bloodstream, such as
ecstasy or cocaine."
Medication such as beta blockers can help.
An ICD (Implantable Cardioverter Defibrillator) may be fitted in the chest.
PREVENTION
Screenings are only provided for those who have
symptoms or a family history of SCD. But CRY has announced the first
initiative in the UK to screen every 14-year-old - the earliest age
proactive screening is viable - across the south east of England from early
2010. The screening initiative is hoped to help lay the foundations
for a national programme.
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