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INSIDECOSTARICA.COM | COSTA RICA  NEWS |        Friday 02 September 2011

Sudden Cardiac Death Leading Cause Of Death in Costa Rica

The cases of sudden cardiac death (muerte subita) increases in Costa Rica, where in 2010 alone 5.422 people died from cardiovascular disease, making it the leading cause of death in the country.

Sudden cardiac death is natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms. Other forms of sudden death may be non-cardiac in origin. Examples of this include respiratory arrest (such as due to airway obstruction, which may be seen in cases of choking or asphyxiation), toxicity or poisoning, anaphylaxis, or trauma.

Sudden cardiac death does not forgive age, sex or physical condition, experts day.

It is important to make a distinction between this term and the related term cardiac arrest, which refers to cessation of cardiac pump function which may be reversible.

Medical experts in Costa Rica say that a person can survive sudden cardiac death, one is by way of a defibrillator implant. At the Hospital Mexico in San Josť, 82 patients have had defibrillator implants over the last three years.

The phrase sudden cardiac death is a public health concept incorporating the features of natural, rapid, and unexpected. It does not specifically refer to the mechanism or cause of death.

The most common cause of sudden cardiac death in adults over the age of 30 is coronary artery atheroma. The mechanism of death in a the majority of patients dying of sudden cardiac death is ventricular fibrillation and as a consequence there may be no prodromal symptoms associated with the death. These patients may be going about their daily business and suddenly collapse without the typical features of myocardial infarction such as chest pain and shortness of breath.

There are a number of cases in which patients feel the effect of myocardial ischaemia. Myocardial ischaemia is associated with referred pain, classically to the front of the chest, the left arm and the jaw. Patients may feel generally unwell, with nausea, dizziness and vomiting. These symptoms may precede the death for any length of time between a few minutes and several hours.

Although the most frequent cause of sudden cardiac death is coronary artery disease, other causes include:
- Non-atherosclerotic coronary artery abnormalities
- Hypertrophy of ventricular myocardium
- Myocardial diseases and heart failure, including
- Arrhythmogenic right ventricular cardiomyopathy
- Hypertrophic cardiomyopathy
- Dilated cardiomyopathy
- Myocardial infarction
- Noncompaction cardiomyopathy
- Inflammatory, infiltrative, neoplastic, and degenerative processes
- Diseases of the cardiac valves
- Congenital heart disease
- Primary electrophysiological abnormalities, such as
- Long QT syndrome, both congenital and acquired
- Sick sinus syndrome
- Brugada syndrome
- Catecholaminergic polymorphic ventricular tachycardia
- Magnesium deficiency
- Rhythm instability related to neurohumoral and central nervous system influences
- Cystic tumour of the atrioventricular nodal region
- Commotio cordis
- Mechanical interference with venous return
- Aortic dissection
- Toxic/metabolic disturbances



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