Sudden Death Is An Important But Widely Under Recognised Consequence Of Stroke

Sudden death in people under age 35, often due to hidden heart defects or overlooked heart abnormalities, is rare. When these sudden deaths do occur, it's often during physical activity, such as a sporting event.

Millions of elementary, high school and college athletes compete every year without incident. Fortunately, if you or your child is at risk of sudden death, there are screening tests for heart defects, and precautions you can take.

Hypertrophic cardiomyopathy (HCM). This is a disease in which the heart muscle (myocardium) becomes abnormally thick, making it harder for the heart to pump blood. Hypertrophic cardiomyopathy, while usually not fatal in most people, is the most common cause of heart-related sudden death in people under 30. It's the most common cause of sudden death in athletes. HCM often goes undetected.

Coronary artery abnormalities. Sometimes people are born with heart arteries (coronary arteries) that are connected abnormally. The arteries can become compressed during exercise and not provide proper blood flow to the heart.

Long QT syndrome (LQTS). Long QT syndrome (LQTS) is an inherited heart rhythm disorder that can cause fast, chaotic heartbeats. The rapid heartbeats, caused by changes in the part of your heart that causes it to beat, may lead to fainting, which can be life-threatening. In some cases, your heart's rhythm may be so erratic that it can cause sudden death. Young people with long QT syndrome have an increased risk of sudden death.

There are other causes of sudden cardiac death in young people. These include structural abnormalities of the heart, including unrecognized congenital heart disease and heart muscle abnormalities. Other causes include inflammation of the heart muscle, which can be caused by viruses and other illnesses. In addition to long QT syndrome, there are other abnormalities of the heart's electrical system, such as Brugada syndrome, which can cause sudden death.

There's another rare cause of sudden cardiac death that can occur in anyone, though it's usually heard about in young people who play sports. It occurs as the result of a blunt blow to the chest — such as being hit by a baseball or hockey puck — at just the right time. Its medical name is commotio cordis. The blow to the chest can trigger ventricular fibrillation if the blow strikes at exactly the wrong time in the heart's electrical cycle.

Sudden death is an important but widely under-recognised consequence of stroke. Acute stroke can disturb central autonomic control, resulting in myocardial injury, electrocardiographic abnormalities, cardiac arrhythmias, and ultimately sudden death. Experimental and clinical evidence suggests that autonomic imbalance is more frequent after infarcts involving the insular cortex, a crucial region for the control of sympathetic and parasympathetic autonomic functions. Cardiovascular comorbidities increase the risk of cardiac morbidity and mortality after stroke. Thus, many sudden deaths and serious non-fatal cardiac events after stroke are probably due to an interaction between cardiovascular and neurological causes. The exact mechanisms leading to sudden death remain incompletely understood. Further research is needed to investigate the autonomic consequences of acute stroke and to identify patients at high risk of sudden death.

Allow yourself to grieve. Give vent to your intense emotions. This sudden death has allowed you no opportunity to prepare yourself; therefore, you will be going through all the stages of grieving after the death. It is better to express—rather than suppress—these feelings. Tears give release to sorrow.

Though you feel God has deserted you, the Bible assures us God has promised the Holy Spirit as your Comforter(Heb. 13:5; John 14:16). God is as saddened as you are right now.

Your body’s grief reaction is normal. You may experience disturbing physical symptoms.

Follow what feels right for you. Don’t let others dissuade you from doing what is meaningful for you.

Tell friends and relatives how you want to be treated. At times, say, “I want to be alone,” if that is your wish.

Share your troublesome thoughts and feelings with an understanding, nurturing friend. Giving vent to feelings with a friend who can listen with acceptance helps dispel their intensity.

Join a support group or grief recovery program. Call your local hospital or ask your pastor if such groups exist in your community. Seek counseling with a pastor or psychologist if you feel continually overwhelmed.

Keep busy, but not to the point you stop the grieving process. Take time to mourn and let go.