Many individuals at risk for sudden death appear perfectly healthy and may show no obvious suggestion of risk until the first cardiac arrest or sudden death episode. Those with prior heart attacks or other cardiac disorders may have symptoms or signs of varying severity.

Who is at risk for sudden death?

Many times, individuals would have experienced chest pain or discomfort but not attended to or assumed to be of no significance until a major heart attack and/or cardiac arrest occurs. That is why we are steadfast in advocating, consistent with international best practices, that every chest pain is an emergency and must be treated as an emergency until proven otherwise. Lacklustre attention to cardiovascular symptoms and lack of urgency in addressing cardiovascular complaints in Jamaica are major risks to population health and can result in severe consequences.

Certain specific genetic profiles have been linked to increased risk of sudden death in individuals and families. Individuals with family history of sudden death or cardiac arrest in a first order relative are thought to be more at risk, especially if they are males. Risk is also thought to be higher in Asians and also in those with underlying heart disease and/or arrhythmias. Such individuals would benefit from close monitoring and further cardiovascular evaluation if indicated.

Recognising early symptoms of sudden death

Many individuals may have no premonitory or warning signs of an impending sudden death episode. For some people, early warning signs of an impending sudden death or cardiac arrest may include chest pain or shortness of breath, especially during exercise, feeling of fluttering in the chest or palpitations at rest or with exercise and recurrent dizzy spells or episodes of loss of consciousness. For others, it may be unexplained fainting episodes particularly following intense activity or exercise. Any one of these worrisome signs should be a reason to seek immediate cardiovascular evaluation with a competent cardiologist in an appropriate facility as such evaluation requires more than sounding the chest. The same recommendation applies to people with personal history or family history suggesting an increased risk of sudden death. Early identification of risk can help in mitigating those risks and saving lives.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107