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By Melissa Tennen, HealthAtoZ writer
Women, listen up. Do you know your risk for sudden cardiac death (SCD)? If you don't, that could be a prescription for disaster.
"SCD is a leading cause of death in this country," says Anne B. Curtis, M.D., president-elect of the Heart Rhythm Society and director of clinical electrophysiology at the University of Florida in Gainesville. "We tend to think of this as a man's problem. But it's clearly a problem in women."
SCD is not a heart attack. A heart attack is when an artery becomes clogged or blocked, interfering with oxygen-rich blood flow to the heart. The heart can still pump but part of the heart muscle doesn't get the oxygen it needs and dies.
SCD usually happens when the heart rhythm suddenly becomes fast and irregular. When this occurs, the heart does not pump blood the way it's supposed to. Think of SCD as an electrical short that causes the heart to stop. Once that happens, the brain is starved of oxygen. Death can happen within five minutes.
The death rate from SCD is extremely high. Only 5 percent of people who develop these abnormal heart rhythms survive. The most common heart rhythm disorder causing SCD is ventricular fibrillation (VF), which occurs when the lower chamber of the heart quivers instead of pumping rhythmically and the heart cannot pump blood.
SCD causes more than 400,000 deaths a year.
Avoiding risks
In a study published in The Journal of the American Medical Association, nearly 70 percent of women who died of SCD did not have a history of heart disease before their deaths. However, most women who died of SCD had at least one risk factor.
Risk factors include:
- A heart attack.
- Enlargement of the heart.
- High blood pressure.
- High cholesterol.
- Smoking.
- Obesity.
- Diabetes.
- Family history of SCD or cardiovascular disease.
Smoking was the strongest risk factor, particularly among women who smoked 25 or more cigarettes a day. Their risk of death was four times higher than that of nonsmokers.
"In men, the majority of the time, they have a known history of coronary heart disease. In women, identifying who is at risk becomes a real challenge because many of them don't have a prior history of heart disease," Curtis says.
Another part of the problem is that generally, doctors aren't looking for heart problems in women. They aren't necessarily asking about risk factors or symptoms such as shortness of breath and fatigue, a common symptom in arrhythmias, or abnormal heartbeats. A gender bias still exists, Curtis says. While awareness of SCD among patients and doctors is improving, it's still a problem.
One of the best ways to prevent SCD if you have an arrhythmia is to get an implantable defibrillator device, which can detect abnormal heart rhythms and shock the heart to correct the problem. But you are better off preventing arrhythmia in the first place.
"One of the reasons why there is so much interest in prevention is that there is such a high death rate," Curtis says. "The key is to try to identify high risk patients."
Prevention through lifestyle
The good news is that you can prevent VF and SCD if you:
- Eat a healthy diet, low in fat and sodium. Follow the DASH eating plan (Dietary Approaches to Hypertension), which was designed by the National Heart, Lung, and Blood Institute to lower sodium and blood pressure. The diet includes:
- Six servings of grains.
- Three or four servings of vegetables.
- Four servings of fruit.
- Two or three servings of low-fat dairy products.
- One or two servings of meats, poultry or fish.
- Nuts, seeds and dry beans three times a week.
- Two servings of fats and oils.
- Sweets sparingly.
- Exercise at least 30 minutes most days of the week.
- Get your blood pressure, blood sugar and cholesterol checked regularly. Know your numbers.
- Take your medications as your doctor directs you.
This article was reviewed and updated June 2007.
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