A five-year-old girl, Kamini, from Uttar Pradesh’s Amroha district, had a sudden cardiac arrest while watching cartoons on her mobile phone on 21 January 2024. Kamini was lying on the bed next to her mother holding the phone when she suddenly fell unconscious. Her family immediately rushed her to the hospital where she was declared brought dead.
In another recent case, Prince Kumar a 16-year-old, fainted while playing cricket in the same district on 31 December 2023, and was rushed to the hospital where he was declared dead. Similarly, Sangeeta, a school kid from Bangalore, suffered a sudden cardiac arrest while playing a kabaddi match at her school in February 2023.
These incidents came as a shocker as they made headlines about sudden cardiac deaths in children. According to a study published in The Lancet, in August 2023, sudden cardiac arrest is a global public health problem with a mortality rate of more than 90%.
What is sudden cardiac arrest?
Sudden cardiac deaths are unforeseen events that can happen with or without pre-existing cardiac conditions. It can occur within an hour the symptoms begin to show up. Hence, it is important not to ignore the vital signs, say experts.
People often get confused between a heart attack and cardiac arrest, says Dr Vijayalakshmi Balekundri, former professor of pediatric cardiology at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore. “Heart attack or myocardial infarction is where a person’s heart muscles don’t get enough oxygen due to a sudden stop in blood flow. While in cardiac arrest, the heart stops functioning due to electrical disturbance,” she explained. When the heart and lungs stop working, cardiopulmonary arrest is the final stage leading to death.
Children and cardiac health
In most cases in children, sudden cardiac deaths are caused due to arrhythmias, abnormal heart rhythms, and undetected heart diseases from childbirth, says Dr Mohan Murali Jangamsetty, interventional cardiologist, Apollo Spectra Hospital, Bangalore.
“Fast heart rates are often caused due to ventricular tachycardia, a common condition in children where the body doesn’t receive enough oxygenated blood due to fast heartbeats,” he added. Knowing the family history of parents, and grandparents who have died due to cardiac issues helps in understanding the condition.
According to Dr Jangamsetty, in very few cases, sudden cardiac arrest resulting in death could be the first and only symptom but most of the time, people would have experienced some of the signs such as loss of consciousness and blackouts.
Why is there an increase in sudden cardiac deaths?
It’s the lifestyle choices that we make that affect our heart, says Dr Abhishek Singh, consultant cardiology, Manipal Hospital, Ghaziabad, Uttar Pradesh. “Stressful life and increased intake of processed food make them prone to develop cholesterol plaques in their blood vessels resulting in blockages and narrowing of arteries. This increases the chances of obesity, hypertension, and diabetes. This could lead to massive heart attacks and sudden cardiac deaths in young adults,” he said.
Dr Singh added that in many recent cardiac deaths in young adults, they would have had a lifestyle that includes drinking alcohol, smoking tobacco, or vaping which are not cardiac healthy.
The reason behind sudden cardiac arrest
Most congenital diseases may go unnoticed as there would be no symptoms at birth, says Dr Balekundri. Experts list five common reasons behind sudden cardiac deaths in children and young adults:
- Aortic stenosis – One of the common valve diseases in children, especially in newborns. The condition results in the narrowing of the aortic valve opening. The valvular obstruction leads to sudden cardiac arrest.
- Long Q-T syndrome – In people with long QT syndrome, a heart signaling disorder, loud sound or noise startles them, affecting their heart function and resulting in sudden cardiac arrest.
- Hypertrophic cardiomyopathy – A genetically transmitted condition that thickens the heart muscle, making it difficult for the heart to pump oxygen and nutrient-rich blood to the body. They are at high risk of cardiac arrest during sports or intense physical activities.
- Hypercholesterolemia – It is a condition that runs in the family, where they have high levels of cholesterol as their body fails to eliminate bad cholesterol from the blood. When left untreated, they are at high risk of stroke and sudden cardiac arrest.
- Viral infections – Infections caused by viruses can lead to myocarditis where the heart muscles are irritable and produce arrhythmias leading to cardiac arrest. Dehydration itself can also cause sudden cardiac death due to the thickening of blood flow.
According to Dr Balekundri, the usage of artificial protein supplements, steroids, or injections to maintain a good body or to avoid getting tired while working out, increases the risk of sudden cardiac arrest.
Dr Balekundri says, if a postmortem is carried out in such cases, the exact reason behind a sudden cardiac death can be pinpointed.
“It is not easy to convince the grieving family to agree to postmortem. However, we can make them aware of how it would help them know the cause or identify congenital diseases and how it could be prevented in the family,” said Dr Singh.
How to prevent it?
“A simple screening of ECG or echocardiogram would pick up any underlying cardiac conditions. If detected early, the necessary precautions and medication can be given to minimize the risk of cardiac arrest,” said Dr Singh.
Dr Singh adds that choosing a good lifestyle, ensuring 30-40 mins of physical activity for at least five days a week, including more vegetables in one’s diet, and choosing lean protein helps in keeping the heart healthy.
Takeaways
Reports of sudden cardiac deaths in healthy children and young adults have increased over the years. Undetected congenital diseases, physical inactivity, and complications from post-viral infections are some of the common causes of sudden cardiac arrest. Early screening and lifestyle changes help to reduce the risk.
