DEATH WITHOUT NOTICE - CARDIAC ARREST By Dr Olayiwola Ajileye MD & Dr Bisi Abiola PhD
Death is an inevitable and non-negotiable end to every mortal, but the arrival of death need not be sudden and unexplainable. The incidence of mortality can be controlled and managed to the barest minimum by individual and population methods.
The world has just woken up to the sad news about the demise of the legendary Music and entertainment Icon, Michael Jackson. He died sadly of Cardiac Arrest ( an example of a Sudden Death Syndrome ). While the world is trying to come to terms with this surreal and unfortunate development, it is imperative to give a thought to how these kinds of incidents can be medically and preventatively managed. Also, in recent times, the spate of sudden death amongst many people of African descent , particularly notable public figures and celebrities has called for a collective attention on this matter with a view to advising Africans about the imperative of regular, periodic health screening or health MOT to certify individual life worthiness.
Sudden death by definition is usually non-traumatic, non-violent, unexpected occurrences in individuals previously witnessed to be enjoying apparent normal health status. It is often difficult to consider that someone who is apparently young, agile, productive and fit may be at risk. It is not uncommon for many Africans to apply superstitious attributions to these tragic events.
The agenda here is not to make sundry diagnosis of the causes of death of these individuals but to raise due awareness to the suddenness of these losses, and advocate for the need to put our health first and foremost.
What are the most common debilitating diseases that could lead to sudden death?
From orthodox medical perspectives, commonest causes of sudden deaths are existing, undiagnosed or misdiagnosed heart problems. It could be degenerative, inherited or congenital.
It could be as a result of problems arising from the heart functions. For example, irregularities of the electrical impulses that upset the natural rhythm of the heart anatomy or blood supply. In clinical terms, I am talking about ischeamic heart disease or coronary heart disease (CHD) (Cardiac Arrest), arrthymias, and cardiomyopathies - an inherited form of heart muscle disorder.
If this is undiagnosed, a number of predisposing illnesses such as High blood pressure (Hypertension), prolonged or acute stress, high blood level of cholesterol and high blood sugar may precipitate a sudden death syndrome.
It is also important to mention that abuse of unlicensed medications, abuse of therapeutic agents without recourse to medical or pharmacist advice can potentially lead to dangerous drug interactions with lethal consequences. Particularly in people who are unaware of any pre-existing medical problems.
Thrombo-embolic episodes (blockade of blood vessels) in the heart, lungs and certain critical parts of the brain can precipitate a sudden death scenario. Generally, people talk about heart attacks, severe sudden chest pain, and stroke occurring in the respiratory and cardiac centres in the brain tissue.
Blood vessels disease in very critical areas of the body can lead to sudden death e.g. intracranial aneurysm or disease of the large blood vessel with sudden rupture.
Inherited metabolic problems may lead to sudden death but these are common amongst younger age groups.
What are the symptoms of these diseases?
Mostly, these diseases are symptomless or the warning symptoms are often ignored. For example, headaches, chest discomfort and pain, breathing problems, fainting attacks, dizziness, tiredness, fatigue, blurring of vision and convulsion. Sometimes, in many unfortunate cases like Michael Jackson, there might not be enough time to register a symptomatic complaints and the implication is that patient sudden develop severe chest pain and eventually coma within a very short period of time, usually at a time when prompt medical intervention is very remote and response time is painfully prolonged.
The fact that majority of this diseases are asymptomatic, but detectable by periodic comprehensive health screening, makes them preventable. Somebody with an inherited heart problem may lead an apparently active, normal and symptom free life, until such time that sudden death occurs. Early diagnosis of these diseases is very important as prompt treatment increases the likelihood of full recovery and certainly prevents worsening of health.
What are some of the predisposing factors?
There are many predisposing factors to these diseases. Smoking, high blood pressure, high fat food, diabetes mellitus, lack of physical active exercises, obesity, particularly abdominal obesity, stress and exhaustion can precipitate episode of sudden death in a vulnerable person. Michael Jackson in recent times has been under immense pressure and stress from his social and professional life. He cannot be said to be different from most individuals in every society with high networth career and image and professional or vocational responsibilities. Often anticipation of an event leading to high alert and hyperaroused state causing release of performance enhancing chemicals in our body i.e. adrenaline push and other neuro-endocrine chemicals can set up a state of cardiac hyperactivity which can potentially lead to sudden death or cardiac arrest in a predisposed individual. The question is then, are you predisposed? do you know your predisposition status? How can you prevent such occurrence or modify the effect of such predisposing and precipitating factors in order to prevent sudden death?
What are the lifestyles and habits that could aid these diseases?
Lax attitude to one's own health matters, lack of proper self-vigilance and unresponsive attitude to subtle warning signs can be detrimental. Majority of Africans and black folks are highly driven people, as a result paying poor attention to need for periodic health screening, medical check ups can proof very fatal.
Our diet is by nature loaded with high carbohydrates and unhealthy fat, conscious dietary vigilance, can go a long way. Poor eating habit, eating very heavy meals late at night reduces the body metabolic rate and promotes accumulation of food in fatty form. On the other hand, extreme weight management lifestyle, extreme dieting regime, calorie counting and obsessional exercise regime and weight loss programme can be sometimes counter productive. Excessive weight loss within a short period of time resulting from poor self image and body dysmorphic disorder, anorexia nervosa and eating disorder can lead to atrophy (shrinkage) of the heart muscle and this can easily lead to cardiac malfunction and arrest. Michael Jackson was well known to be someone with professionally driven weight consciousness and given the coming events lined up for him ("This is It"), this could have driven him more into weight control regime which could potentially have lead to a situation of cardiac arrest. However, the world awaits the outcome of his autopsy. It will be very informative and will educate a lot of us globally.
Smoking certainly predispose to high blood pressure and blood vessels disease, particularly in-predisposed individual. Strong family history of certain health problems or sudden death should not be dismissed or ignored: People should try to know their family predisposition to certain health problem and seek to investigate cause of sudden death in any family member.
These may go a long way in pointing an individual to whether they need to undergo preventative measures or treatment.
How can these diseases be prevented?
The world has just lost an irreplaceable legend at age 50, with tributes pouring in from across the globe, t his underlies the importance and implication of his death. The loss is colossal not only to the world of entertainment, but to his immediate family and friends, who did not even have the opportunity to share his last moment with him and say goodbye. Therefore, prevention, they say, is better than cure; sudden death is a total loss to any family and it certainly has reverberating psychological and social implications within a family system. The best prevention is periodic health screening and health awareness. Health screening provides an excellent opportunity to detect disease and health issues in the early stages.
By recognising specific risk factors and helping to make informed decisions about your own health, it is possible to improve the quality of your life and reduce the risk of developing disease in the future.
Lifestyle changes can be advised following a health screening exercise and measures to prevent tragic occurrences can be advised. Certainly, if any problem is identified, the risk can be quantified and treatment advised.
Periodic and regular health screening, locally and internationally is one means by which the incidence of sudden mortality can be reduced. Basically, health screening is looking after ones own future and it is indicative of one's sense of responsibility to your family, nation and the world at large.
Many black people and particularly Nigerians possess tremendous ability to accumulate so much wealth and resources but they remain very poor in the consciousness and attention they give to their own health.
It is a vogue and common trend amongst our people to attend regular financial reviews, portfolio review meetings, and investment seminars and of course we take our cars, generators for regular servicing for optimum performance, but such attitude is not extended to personal health matters unless there is an emergency or obvious morbidity.
Given what we know now about sudden death, the need for health screening to maintain good health is very paramount.
Benefits of Health Screening
Health Screening provides an excellent opportunity to detect disease and health issues in the early stages. By recognising specific risk factors and helping you to make informed decisions about your own health, it is possible to improve the quality of your life and reduce the risk of developing disease in the future. Indulge Nigeria Ltd and Valor Health Options (UK) Ltd can facilitate this bespoke comprehensive health screening exercises for you, locally and internationally with minimum hassles to you but maximum peace of mind and dignity.
You will also be advised about small changes to your lifestyle that may help reduce the risks associated with certain disease with emphasis on prevention rather than cure.
Dr Olayiwola Ajileye (MD) is the director of Valor Health Options Ltd, a Birmingham, UK-based organisation that can help you organise bespoke periodic health screening engagements with Private and Independent Health Facilities in the United Kingdom. [email protected]
Dr Bisi Abiola (PhD), CEO Indulge Nigeria Ltd, Nigeria based organisation that help promotes healthy living and education on lifestyle management and publisher of INDULGE Health & Fitness Magazine. [email protected]