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Medica Superspecialty Hospital

A ‘Heart’-felt Message for Her

She stole a million hearts with her dynamic on-screen persona. A controversial life…and now an equally controversial after life. The legend of Sridevi lives on, as the debate about her last few hours on earth rages on. We take this opportunity to stop-awhile and give a thought to certain facts related to sudden cardiac arrest in women

Sudden cardiac death (SCD) in women :

A 38-year follow-up from the Framingham Heart study evaluated the incidence of sudden cardiac death in women compared with men

1. Women had a lower SCD rate than men at all ages

2. The risk of sudden death among women with coronary heart disease is one-half that of men with the same condition

3. A higher fraction of sudden deaths are seen in women with no prior indication of heart disease (63 versus 44 percent in men)

4. However, among patients with heart failure the absolute risk in women is only one-third that of men

5. Phobic anxiety is associated with an increased risk of SCD in women. Some of this risk can be ascribed to conditions like diabetes, hypertension, and elevated serum cholesterol.

Heart attack: women vs men

It is more difficult to establish the diagnosis of heart disease in women

  • Women generally show signs of heart disease about 10 years later than men
  • The risk-factor burden is greater in women
  • Women are less likely than men to have typical angina
  • Women coming to the emergency room with new onset of chest pain are usually diagnosed less aggressively than men
  • Women coming in to emergency with chest pain are more likely to have angina than heart attack, but in case of a heart attack, it is more fatal
  • Many cases of heart attack in women go unrecognized, particularly at younger ages or in patients with diabetes.
  • Treadmill exercise testing has a higher false positive rate in women
  • The prevalence of significant heart disease found at the time of angiography (in case of chest pain) is lower in women than men
  • Most women with chest pain and no evidence of blockages on coronary angiography have cardiac syndrome X or microvascular disease, or far more rarely, takotsubo cardiomyopathy or coronary dissection.

Look out for heart disease

1. Six minutes walk test: if you can walk more than 500 meters in six minutes you do not have significant blockages or if you can walk 2 km or climb two flight of stairs you do not have significant blockages

2. Never ignore unexplained weakness, tiredness, chest burning or breathlessness after the age of 40

3. If any member of your family had heart disease (male before 55 or female before 65), it amounts to strong family history – For future generations in Sridevi’s family, it will now be counted as strong family history if her SCD is linked to blockages in the heart

Facts about SCA & SDA

1. Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) refer to the sudden stopping of organized cardiac electrical activity. In case of SCA, an immediate intervention (eg, CPR, defibrillation, cardioversion, antiarrhythmic drug) can restore circulation, thus saving the person’s life.

2. The exact mechanism of collapse is often impossible to establish since, for the vast majority of patients who die suddenly, cardiac electrical activity is not being monitored at the time of their collapse.

3. However, in rare cases where it was possible to monitor cardiac electrical activity at the time of the arrest, ventricular tachycardia (VT) or ventricular fibrillation (VF) – very fast heart beat – accounted for the majority of episodes, with bradycardia or systole (no heart beat) accounting for nearly all of the rest. Studies have shown that sustained arrhythmia (abnormally rapid heartbeat) is usually preceded by ventricular ectopy (irregular rhythm)

4. There are many cardiac and non-cardiac causes for a sustained arrhythmia that can result in SCD. Majority are related to heart disease, with non-cardiac causes accounting for only about15 to 25 percent of the deaths.

What to do in sudden cardiac arrest

Start CPR and continue till medical help arrives along with external electric shock machine.

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