June 24 , 2008
Sudden Cardiac Death (SCD)
Eric Steele, MD
Are you or a family member at risk to die the way NBC Meet the Press host Tim Russert did?
Russert died recently at the age of 58 from what medical experts call Sudden Cardiac Death (SCD). That means he suddenly developed an abnormal heart rhythm that stopped the heart’s pumping function – a cardiac arrest in medical terminology.
SCD kills about 300,000 Americans every year, and about 7,500 of those Americans had no idea they had heart disease. When we hear about anyone who is healthy one day and then suddenly dies during normal activities, SCD is often the culprit. The way it seems to come right out of the blue makes SCD especially devastating for families and friends of those who suffer SCD.
Random as it may seem, there are a few things to remember about SCD. First, those at highest risk for it can – to some extent – be identified. Most patients who suffer SCD have heart disease – they had had angina, congestive heart failure, etc. Those two types of heart disease in particular increase SCD risk. In fact, some of those patients are at such high risk of SCD that they have small defibrillators (devices that can shock someone out of the potentially fatal heart arrhythmia that causes SCD) implanted in their chests.
Other who are at higher risk of SCD are those at higher risk of heart attack - patients who smoke, are diabetic and / or hypertensive, do not exercise, etc. Sudden increases in physical activity among such patients may put them at higher risk for SCD, which is why it is always recommended those patients talk to a physician before starting a new exercise program.
A family history of SCD in a close relative (sibling or parent) also suggests a higher risk for SCD.
What can you do to assess your risk? First and foremost, talk to your physician about it. This is especially important if you have any of the diseases above, if you have not been exercising for a long time and now are planning to start an exercise program but have other health problems, or if you have had episodes of feeling faint and lightheaded with your heart pounding in your chest. That way you can not only get a sense of whether SCD is something you should be concerned about, but if it is then you can work with your physician to decrease your risk. You can also go to the Web and take a little Sudden Cardiac Arrest assessment at HeartHelp.com. It will ask you questions about your health and family history, then tell you whether your risk is low, medium, high, or indeterminate. Beware that this web site is sponsored by Medtronic, which makes and sells the implantable defibrillators described above.
How can you decrease your risk of SCD? Well, you cannot change your genes or your family, but you can change … you. First and foremost, you can decrease your risk by simply getting healthier. A healthy weight, regular exercise, good control of your blood sugar if you have diabetes, good control of your blood pressure if you have hypertension, not smoking, etc. are all ways to reduce risk. Exercise in particular is key – several studies have showed that regular exercise reduces risk of SCD.
The idea of exercise makes some wonder if it might cause SCD, and there have been cases of regular exercisers dying suddenly of SCD. That is extremely unusual; in a recent study from Harvard University researchers, it was estimated that SCD during exercise by people who exercise regularly occurs once in every 36 million hours of exercise, and most of those cases are in people who exercise less than 2 hours per week. Not exercising is far more deadly than exercising.
Finally, despite all of this and Tim Russert’s high profile death, remember that your risk of SCD is low. Among the general population the risk of SCD is only about 1 in 1,000 overall. Most of us can wear our seatbelts, look both ways before crossing the street, stop talking on our cell phones while driving, talk to our doctors about what you can do to get healthier, and then put worrying about SCD way, way down on our list of worries.