“natural death from cardiac causes heralded by abrupt loss of consciousness”

Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to the rest of your body. Sudden cardiac arrest is different from a heart attack, which occurs when blood flow to a portion of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest. Sudden cardiac arrest is a medical emergency. If not treated immediately, it causes sudden cardiac death. With fast, appropriate medical care, survival is possible. Administering cardiopulmonary resuscitation (CPR) — or even just compressions to the chest — can improve the chances of survival until emergency personnel arrive.

Risk factors(HT, LDL, DM, etc))

AtherosclerosisLVH

CAD

Myocardialischaemia

Coronary thrombosis

Myocardial infarction

Arrhythmia &Loss of muscle

Remodelling

Ventriculardilatation

Endstageheart disease

Heart failure

Sudden death

The cardiovascular continuum

CONGENITAL ACQUIRED Electrical Heart muscle Valvar arterial

Atheromatous coronary disease

Hypertension Post viral Rheumatic heart disease

Rare < 15 years of age 15-35 years:- congenital electrical atheromatous >35 years atheromatous hypertension

Myths of excercise

For those identified to be high risk for SCD

A 28 % Reduction in LDL-C significantly reduces cardiovascular events

Major corronary

events

Coronary

deaths

Cardiovascular deaths

All-cause deaths

Per

cen

t p

rop

ort

ion

al ri

sk r

ed

ucti

on

Meta-analysis illustrating the beneficial effects of statin therapy

-31 %-29 %

-27 %

-21 %

•-35

•-30

•-25

•-20

•-15

•-10

•-5

•0

LaRosa et al, JAMA 1999; 282: 2340-2346

Intravascular ultrasound (IVUS)