An Initiative to Educate General Population on Sudden Cardiac Death- A Short Discussion

Rupa Potti

Department of Nursing, Chicago State University, IL, United States of America

*Correspondence to: Dr. Rupa Potti, Department of Nursing, Chicago State University, IL, United States of America.

Copyright © 2022 Dr. Rupa Potti. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abbreviations
Sudden Cardiac Death (SCD), Ischemic Heart Disease (IHD), Left Ventricular Ejection Fraction (LVEF), Implantable Cardioverter- Defibrillator (ICD), Hypertrophic Cardiomyopathy (HCM), Arrhythmogenic Cardiomyopathy (ACM)

Introduction
Since evidence shows that most of the SCD occur without any warning signs, it is imperative that the general population are aware of cardiac health. This awareness will help them to be proactive in managing and maintaining cardiac health. Further, it helps to prevent SCD by recognizing and managing preventable risk factors. It has been studied that SCD can be caused by conditions affecting heart, respiratory system, metabolic conditions and infections. Though most of the SCD are caused due to arteries supplying to heart muscle, the reason for about 40% of the SCDs is not explained. Though the exact risk factors of SCD other than Ischemic Heart Disease (IHD) and stroke are not known, factors such as obesity, hypertension, coronary heart disease, male gender, high resting heart rate, diabetes mellitus including modifiable risk factors like smoking may contribute to the fatality. Further, cardiomyopathy and inherited arrhythmias are also known to contribute for SCD [3]. Other causes of SCD are known to be low left ventricular ejection fraction (LVEF) [4], caffeine induced hypokalemia affecting the functioning of heart [5], hypertrophic cardiomyopathy (HCM) [6] and structural abnormalities of heart [7].

Background
United States of America alone records approximately 350,000 SCD each year [1]. It has been studied that about 45%- 90% of the natural deaths are due to cardiac conditions solely or in conjunction with any other illnesses or conditions causing exertion of the heart. Out of all the SCDs about 8.3% deaths have no known cause. About 75% of the SCDs in non-atheromatous conditions were known to have caused from myocardial ischemia during severe physical exertion. This could be due to tachycardia, shorter diastolic time and severe compression during systole [2]. Since evidence shows relation between SCD and genetics, cardiac conditions, non- erythematous conditions, caffeine, physical exertion and structural abnormalities, it is important to study these aspects to prevent SCD.

Discussion
Since SCD occur is general population who do not have any cardiac conditions, it is important that the population-based strategies should be taken up to maintain cardiac health to prevent SCD. It has been studied that physical activity decreases the SDC risk by 50% though more study is needed about the exact physical activity and intensity [1]. Though physical activity lessens the risk of SCD, evidence supports that, sudden physical exertion will cause SCD due to physiological changes that occurs in functioning of the heart [2]. This makes it imperative that the general population are aware of the risk of SCD with severe physical exertion to be able to prevent them.

Correlation between SCD with inherited arrythmias and cardiomyopathy, recognizes that genetic testing may be beneficial in recognizing the risk factors. SCD can be prevented in these clients with genetic cardiac conditions by avoiding medical management with high risk medications [3]. Genetic studies will be helpful in determining the medical management of any cardiac conditions if necessary. It is also helpful in determining the need for implantable cardioverter- defibrillator (ICD) in clients who are at risk of developing ventricular arrythmias before the ventricles go into severe dysfunction [3]. Due to the risk of SCD in HCM, the SCD risk assessment is recommended for evaluating the use of ICD as prophylaxis to prevent SCD [6]. Congenital or acquired structural abnormalities of the heart such Arrhythmogenic Cardiomyopathy (ACM) and Hypertrophic Cardiomyopathy (HCM) are known to cause arrythmias which are sometimes fatal, causing SCD. Due to the fatality caused due to structural and functional abnormalities, it is proposed that further studies are recommended in use of 2D Echogram in detection and management to prevent SCD [7]. So far it is observed that, though there is evidence that the 2D Echocardiogram detects cardiac abnormalities which can cause SCD in asymptomatic clients, it is not a protocol to screen the general population for risk through this method [4]. Further studies are needed in this area of early screenings to detect risk factors for SCD. Apart from all the screenings, it is important that the general population are educated on the effects of moderate intake of caffeine on SCD. This is important primary prevention initiative as moderate amount of caffeine is known to cause severe hypokalemia. Caffeine causes potassium to redistribute into cells and increases the renal excretion of potassium. It can also deplete potassium through both the above mechanisms [5]. Though the cardiac screenings are important, primary prevention strategies pertaining to diet, exercise and stress management also should be stressed so general population are aware of the causes and prevention of SCD.

Conclusion
To conclude, the importance of the educating general population is enormous due to the staggering numbers of SCD. The sudden fatalities caused due to structural, functional, infections and other conditions of heart necessitate initiatives to educate the population about the importance of lifestyle, periodic health screenings and follow-up care to prevent SCD.

Acknowledgements
The paper is the sole production of the author. The author acknowledges her mother-in law, Mrs. Jyothsna Devi who passed away at an early age of 69 with sudden cardiac death. The author intends to educate nonhealthcare population about the risks and prevention of sudden cardiac death. The paper is a short discussion of the condition and should not be taken for generalizing any information presented.

Funding
No funds were received from any party or agency in sending this article for publication. No other authors other than the primary author RP were involved in this commentary.

Conflicts of Interests
There is no conflicting interest in terms of personnel, resources, or any other bias which could have interfered in this work.

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