8 ms·

Dubious about the "heart attack" diagnosis, at least as the phrase is usually understood. More likely "Sudden Cardiac Arrest"[1]: "In over half of the cases, ho

by fernly 7y ago

Dubious about the "heart attack" diagnosis, at least as the phrase is usually understood. More likely "Sudden Cardiac Arrest"[1]: "In over half of the cases, however, sudden cardiac arrest occurs without prior symptoms." Like, the pump just stops. You'd feel faint and then be unconscious. [1] https://www.webmd.com/heart-disease/guide/sudden-cardiac-death#1-3 https://www.webmd.com/heart-disease/guide/sudden-cardiac-dea...

echelon 7y ago
Does this happen in young, healthy individuals? I was reading the Wikipedia article linked in another thread [1], and several of the "sudden" deaths were people in their 40s that appear to have been healthy. Do you feel symptoms, eg. during exercise, that you should listen to so as to inform you to stop whatever activity you're doing? Feeling light-headed, short of breath, blurry vision, etc.? I run and also perform in theater, so I'm a little anxious about this. (Not to be a hypochondriac.) FWIW, I'm going to do some research on my own, but I'm always impressed with the well-informed audience on HN that spans many disciplines. [1] https://en.wikipedia.org/wiki/List_of_entertainers_who_died_during_a_performance#21st_century https://en.wikipedia.org/wiki/List_of_entertainers_who_died_...
- Gibbon1 7y ago
  I think some people are born with heart defects that can result in sudden cardiac death as a young adult. Also strokes. In half a century I doesn't know of any friends or friends that had that happen. But then again I know of three people that died when the car they were working on fell off the jack.
  - WalterBright 7y ago
    > But then again I know of three people that died when the car they were working on fell off the jack. Yikes. I had my car fall off once when I was standing next to it getting ready to go under. Now I put two sets of jackstands under it, and give the car a hard shake first.
    - tonyedgecombe 7y ago
      I've had it happen twice, once with a trolley jack and once with the car jack. In both cases the ground was a softer than I realised. There is no way I would crawl under without axle stands.
      - TheHypnotist 7y ago
        Good idea. Never assume the jack is enough.
- chispamed 7y ago
  Last year med student here, sudden cardiac arrest commonly occur in young people. Apart from infectious myocarditis which you might notice as fatigue and reduced performance after you’ve suffered a respiratory infection, hypertrophic myocardiopathy and especially hypertrophic obstructive cardiomyopathy is often hereditary and can be mortal without showing prior symptoms. That’s why after a patient’s death you usually examine their broader family if HOCM was the cause as it can be detected via ultrasound and treated pharmacologically or interventionally (injecting alcohol in the obstructive parts or implanting a defibrillator).
  - FeepingCreature 7y ago
    I'm adopted. Can I find out if I'm at risk from a DNA mapping service like 23andme?
    - alpaca128 7y ago
      > it can be detected via ultrasound and treated pharmacologically or interventionally To me that sounds like a more reliable way to find out.
    - chispamed 7y ago
      Prevalence is 200 per 100k so you’re almost certainly not affected. If you want to be sure a routine ECG and a trans thoracic ultrasound usually is sufficient to diagnose / exclude cardiac myopathy. 23andme doesn’t even look at the whole genome, they just look for common disease associated polymorphisms. No way of telling if you have a mutation that’s not in their database and even if you have a mutation it could be deactivated epigenetically or other factors could lead to you not suffering the disease.
  - JshWright 7y ago
    > Last year med student here, sudden cardiac arrest commonly occur in young people. I think you mean that in the population of people who experience Sudden Cardiac Arrest/Death, many of them are young people. SCD is definitely not "common".
- IfOnlyYouKnew 7y ago
  Had it happen to a classmate in school. I seem to remember it's either second or third most common cause of death in young people (in rich countries), usually behind traffic accidents. But that has to be considered together with the fact that, generally speaking, young people just don't die. Oh, and to fuel your paranoia: had a friend die in Moscow from a stroke. Death could have easily been prevented, if they had called paramedics and not the police, who thought he had taken drugs and just locked him in a cell where he died 8 hours later.
  - raxxorrax 7y ago
    That is pretty horrible. Of course the police would suspect drugs. Maybe they should mandate medical personal being available in every police station. One of our teachers went jogging and just dropped dead from an aneurysm in the brain. His wife told us that he wasn't feeling too well that day, but good enough for a little bit of exercise. He was 33 when he passed and was the youngest teacher we had. His condition was only detected after his death. I don't know if it could have been prevented and if this form of atery damage could have been repaired.
    - IfOnlyYouKnew 7y ago
      I'd say nobody should even end up in a jail cell if all that happened is that person complaining of nausea, pain, and blurred vision. Or really any medical symptoms. I'd go as far as saying even someone yelling "I have taken drugs", or having needles stuck in every visible vain should get medical treatment first. In most countries, taking drugs (as opposed to possession and/or sale) just aren't crimes, anyway.
- HeadsUpHigh 7y ago
  Yes it mostly happens in young-er individuals because the reasons behind it are most likely genetic/hereditary and thus these people often don't live long enough to die from them later on. Some reasons include hypertrophic conditions( I'm not 100% sure on the english terms and I'm still an undergrad). Other reasons have to do with problems on ion channels which cause issues with electrical signals traveling through the heart resulting in ventricular fibrilation( e.g. Brugada, but you might have had episodes of passing out in the past). Some of this stuff is detectable but it's hard and there's no effective screening of the population. You might want to get checked by a specialist if you have a family history of early sudden deaths. Environmental factors include things like steroid abuse( often in conjunction with amphetamin usage, see Rich Piana suspicions).
- iicc 7y ago
  Famously footballer Fabrice Muamba had a cardiac arrest while playing. https://en.wikipedia.org/wiki/Fabrice_Muamba#Cardiac_arrest_and_retirement https://en.wikipedia.org/wiki/Fabrice_Muamba#Cardiac_arrest_...
- clSTophEjUdRanu 7y ago
  I'm not a doctor but for some reason I get anxious about this as well. You said you run? My logic is that if I had a heart defect it would have showed itself playing sports growing up or during my time in the service. A friend of mine knew someone who dropped dead on a hump to the range at Twentynine Palms.
- mikestew 7y ago
  In my particular case, Wolf-Parkinson’s has been known to kill young people (a college basketball player about 20 years ago comes to mind). My case was fixed with ablation. I asked the cardiologist, “isn’t that what killed that ball player a few years back?” “Yup. And if it hasn’t killed you by now (in my 40s), it probably isn’t going to.” Didn’t make the tachycardia (rapid pulse) anymore fun when an incident occurred, but at least it wasn’t probably going to be fatal. And as additional anecdata, I’ve seen a Cat 1 bicycle racer in his mid-30s drop dead mid-race from a heart-related thing. Just kind of quit riding and fell over; from my non-professional observation, it was a literal case of “dead before he hit the ground”.
qwerty456127 7y ago
> "Sudden Cardiac Arrest": "In over half of the cases, however, sudden cardiac arrest occurs without prior symptoms." Like, the pump just stops. You'd feel faint and then be unconscious. What a wonderful way to die. No sickness, no disability, no pain. Just turn off when the time comes. I wish everybody could die this way. Not too early preferably.
- rusk 7y ago
  Speaking as somebody who lost a loved one this way ... it's very hard on the family. I often wonder about my father's last moments ... did he know what was happening? Did he have any regrets, or any last things he wanted to say to people? For us as a family it was like a bomb going off, and we spent many many years cleaning up the debris, and in some ways nearly two decades later we still are. There are plenty worse ways to go, but it's not something I'd like to inflict on my family if I had the choice.
  - qwerty456127 7y ago
    I'm sincerely sad for you having lost a loved one whatever a way yet I still can't imagine a way which would be less sad. And that's not because all the ways are equally sad but because all the other seem worse. So I certainly wish me and everybody else in my family are going to die this way when the time comes as long as we can't just live forever healthily and happily. Of course it would be better if we could know exactly when this is going to happen, some people do, but that's so unusual it's hard to hope.
  - fyfy18 7y ago
    The death of any loved one is hard on any family, but IMO a quick, relatively painless, death is definately easier. My mother-in-law died from cancer a few years ago, and after many months of pain and constantly in and out of hospitals, when she was finally lying on her deathbed unconcious as her body began to give up, my wife was tasked with making the decision of whether doctors would administer a lethal morphine dose to end her suffering.
    - 7y ago

by fernly 7y ago

echelon 7y ago

Does this happen in young, healthy individuals? I was reading the Wikipedia article linked in another thread [1], and several of the "sudden" deaths were people in their 40s that appear to have been healthy. Do you feel symptoms, eg. during exercise, that you should listen to so as to inform you to stop whatever activity you're doing? Feeling light-headed, short of breath, blurry vision, etc.? I run and also perform in theater, so I'm a little anxious about this. (Not to be a hypochondriac.) FWIW, I'm going to do some research on my own, but I'm always impressed with the well-informed audience on HN that spans many disciplines. [1] https://en.wikipedia.org/wiki/List_of_entertainers_who_died_during_a_performance#21st_century https://en.wikipedia.org/wiki/List_of_entertainers_who_died_...

Gibbon1 7y ago
I think some people are born with heart defects that can result in sudden cardiac death as a young adult. Also strokes. In half a century I doesn't know of any friends or friends that had that happen. But then again I know of three people that died when the car they were working on fell off the jack.
- WalterBright 7y ago
  > But then again I know of three people that died when the car they were working on fell off the jack. Yikes. I had my car fall off once when I was standing next to it getting ready to go under. Now I put two sets of jackstands under it, and give the car a hard shake first.
  - tonyedgecombe 7y ago
    I've had it happen twice, once with a trolley jack and once with the car jack. In both cases the ground was a softer than I realised. There is no way I would crawl under without axle stands.
    - TheHypnotist 7y ago
      Good idea. Never assume the jack is enough.
chispamed 7y ago
Last year med student here, sudden cardiac arrest commonly occur in young people. Apart from infectious myocarditis which you might notice as fatigue and reduced performance after you’ve suffered a respiratory infection, hypertrophic myocardiopathy and especially hypertrophic obstructive cardiomyopathy is often hereditary and can be mortal without showing prior symptoms. That’s why after a patient’s death you usually examine their broader family if HOCM was the cause as it can be detected via ultrasound and treated pharmacologically or interventionally (injecting alcohol in the obstructive parts or implanting a defibrillator).
- FeepingCreature 7y ago
  I'm adopted. Can I find out if I'm at risk from a DNA mapping service like 23andme?
  - alpaca128 7y ago
    > it can be detected via ultrasound and treated pharmacologically or interventionally To me that sounds like a more reliable way to find out.
  - chispamed 7y ago
    Prevalence is 200 per 100k so you’re almost certainly not affected. If you want to be sure a routine ECG and a trans thoracic ultrasound usually is sufficient to diagnose / exclude cardiac myopathy. 23andme doesn’t even look at the whole genome, they just look for common disease associated polymorphisms. No way of telling if you have a mutation that’s not in their database and even if you have a mutation it could be deactivated epigenetically or other factors could lead to you not suffering the disease.
- JshWright 7y ago
  > Last year med student here, sudden cardiac arrest commonly occur in young people. I think you mean that in the population of people who experience Sudden Cardiac Arrest/Death, many of them are young people. SCD is definitely not "common".
IfOnlyYouKnew 7y ago
Had it happen to a classmate in school. I seem to remember it's either second or third most common cause of death in young people (in rich countries), usually behind traffic accidents. But that has to be considered together with the fact that, generally speaking, young people just don't die. Oh, and to fuel your paranoia: had a friend die in Moscow from a stroke. Death could have easily been prevented, if they had called paramedics and not the police, who thought he had taken drugs and just locked him in a cell where he died 8 hours later.
- raxxorrax 7y ago
  That is pretty horrible. Of course the police would suspect drugs. Maybe they should mandate medical personal being available in every police station. One of our teachers went jogging and just dropped dead from an aneurysm in the brain. His wife told us that he wasn't feeling too well that day, but good enough for a little bit of exercise. He was 33 when he passed and was the youngest teacher we had. His condition was only detected after his death. I don't know if it could have been prevented and if this form of atery damage could have been repaired.
  - IfOnlyYouKnew 7y ago
    I'd say nobody should even end up in a jail cell if all that happened is that person complaining of nausea, pain, and blurred vision. Or really any medical symptoms. I'd go as far as saying even someone yelling "I have taken drugs", or having needles stuck in every visible vain should get medical treatment first. In most countries, taking drugs (as opposed to possession and/or sale) just aren't crimes, anyway.
HeadsUpHigh 7y ago
Yes it mostly happens in young-er individuals because the reasons behind it are most likely genetic/hereditary and thus these people often don't live long enough to die from them later on. Some reasons include hypertrophic conditions( I'm not 100% sure on the english terms and I'm still an undergrad). Other reasons have to do with problems on ion channels which cause issues with electrical signals traveling through the heart resulting in ventricular fibrilation( e.g. Brugada, but you might have had episodes of passing out in the past). Some of this stuff is detectable but it's hard and there's no effective screening of the population. You might want to get checked by a specialist if you have a family history of early sudden deaths. Environmental factors include things like steroid abuse( often in conjunction with amphetamin usage, see Rich Piana suspicions).
iicc 7y ago
Famously footballer Fabrice Muamba had a cardiac arrest while playing. https://en.wikipedia.org/wiki/Fabrice_Muamba#Cardiac_arrest_and_retirement https://en.wikipedia.org/wiki/Fabrice_Muamba#Cardiac_arrest_...
clSTophEjUdRanu 7y ago
I'm not a doctor but for some reason I get anxious about this as well. You said you run? My logic is that if I had a heart defect it would have showed itself playing sports growing up or during my time in the service. A friend of mine knew someone who dropped dead on a hump to the range at Twentynine Palms.
mikestew 7y ago
In my particular case, Wolf-Parkinson’s has been known to kill young people (a college basketball player about 20 years ago comes to mind). My case was fixed with ablation. I asked the cardiologist, “isn’t that what killed that ball player a few years back?” “Yup. And if it hasn’t killed you by now (in my 40s), it probably isn’t going to.” Didn’t make the tachycardia (rapid pulse) anymore fun when an incident occurred, but at least it wasn’t probably going to be fatal. And as additional anecdata, I’ve seen a Cat 1 bicycle racer in his mid-30s drop dead mid-race from a heart-related thing. Just kind of quit riding and fell over; from my non-professional observation, it was a literal case of “dead before he hit the ground”.

qwerty456127 7y ago

> "Sudden Cardiac Arrest": "In over half of the cases, however, sudden cardiac arrest occurs without prior symptoms." Like, the pump just stops. You'd feel faint and then be unconscious. What a wonderful way to die. No sickness, no disability, no pain. Just turn off when the time comes. I wish everybody could die this way. Not too early preferably.

rusk 7y ago
Speaking as somebody who lost a loved one this way ... it's very hard on the family. I often wonder about my father's last moments ... did he know what was happening? Did he have any regrets, or any last things he wanted to say to people? For us as a family it was like a bomb going off, and we spent many many years cleaning up the debris, and in some ways nearly two decades later we still are. There are plenty worse ways to go, but it's not something I'd like to inflict on my family if I had the choice.
- qwerty456127 7y ago
  I'm sincerely sad for you having lost a loved one whatever a way yet I still can't imagine a way which would be less sad. And that's not because all the ways are equally sad but because all the other seem worse. So I certainly wish me and everybody else in my family are going to die this way when the time comes as long as we can't just live forever healthily and happily. Of course it would be better if we could know exactly when this is going to happen, some people do, but that's so unusual it's hard to hope.
- fyfy18 7y ago
  The death of any loved one is hard on any family, but IMO a quick, relatively painless, death is definately easier. My mother-in-law died from cancer a few years ago, and after many months of pain and constantly in and out of hospitals, when she was finally lying on her deathbed unconcious as her body began to give up, my wife was tasked with making the decision of whether doctors would administer a lethal morphine dose to end her suffering.
  - 7y ago