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Sudden arrhythmic death syndrome

Causes and Diagnosis of Sudden Arrhythmic Death Syndrome (SADS): – Heart diseases such as cardiomyopathy, congenital heart disease, and myocarditis. – Conduction diseases like WPW […]

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Causes and Diagnosis of Sudden Arrhythmic Death Syndrome (SADS):
– Heart diseases such as cardiomyopathy, congenital heart disease, and myocarditis.
– Conduction diseases like WPW syndrome.
– Rare diseases including long QT syndrome, Brugada syndrome, and CPVT.
– Unexplained deaths in young people with type 1 diabetes.
– Factors considered during diagnosis by medical examiners include nutrition, toxicology, and genetics.
– Post-mortem diagnosis is common after ruling out other potential causes.
– No definitive pre-mortem diagnostic tests are available.

Prevention and Epidemiology of Sudden Arrhythmic Death Syndrome (SADS):
– Focus on evaluating primary arrhythmia in individuals under 35.
– Emphasis on atherosclerotic coronary disease in older individuals.
– Implantable cardioverter-defibrillator is proven to prevent sudden death.
– Oral beta-blockers like propranolol are ineffective in preventing SADS.
– Over half of SADS deaths are attributed to inherited heart diseases.
– SADS deaths are predominantly reported in young males, especially in England.
– Families with genetic cardiac diseases are at higher risk of SADS.
– Specialized cardiological evaluation is recommended for affected families.

Impact of SADS in Asia:
– Southeast Asian immigrants, particularly Laotian Hmong, are most affected.
– Primarily affects young Hmong men from Laos and Northeastern Thailand.
– Other affected Asian populations include Filipinos, Chinese Filipinos, Japanese, and natives of Guam.
– Median age of affected immigrants is around 33 years.
– Syndrome is more prevalent in areas with Southeast Asian populations.

Historical Context and Cultural Beliefs Surrounding SADS:
– Laotian Hmong were chosen for study due to high sudden death rates in the US.
– Study conducted in Ban Vinai, Loei Province, Thailand in 1982-1983.
– Local religious practices in Ban Vinai prevented autopsies, leading to challenges in understanding the phenomenon.
– Outbreak linked to inability to worship properly during Laotian Civil War.
– Belief that improper worship leads to attacks by evil spirits during sleep.
– Nightmare visitations and sleep paralysis are common among victims.

Syndrome and Disorders Related to Sudden Arrhythmic Death Syndrome (SADS):
– Brugada Syndrome and its association with sudden unexpected nocturnal deaths among Southeast Asian refugees.
– Sudden unexplained death syndrome in Southeast Asian refugees and Thai construction workers.
– Various names for the phenomenon such as Digeuton in Indonesia, Bèi guǐ yā in China, Nachtmerrie in Dutch, and Bangungot in the Philippines.
– Cultural beliefs associated with SADS, including its link to sleep paralysis and belief in malign spirits.
– Medical studies and publications related to SADS, including familial evaluations and sudden deaths in specific populations.

Sudden arrhythmic death syndrome (Wikipedia)

Sudden arrhythmic death syndrome (SADS) is a sudden unexpected death of adolescents and adults caused by, as the name implies, a cardiac arrest. However, the exact cause of the cardiac arrest, and thus the exact cause of death, may not be found. These deaths occur mainly during sleep or at rest. One type of conduction defect known as Brugada syndrome can be responsible.

Sudden arrhythmic death syndrome
Other namesSudden adult death syndrome (SADS), bed death, sudden unexpected/unexplained death syndrome (SUDS), sudden unexpected/unexplained nocturnal death syndrome (SUNDS), Sudden Death Syndrome, Sudden Death, Delayed Death
A type of a deadly ventricular arrhythmia - Ventricular fibrillation pattern seen on an ECG
SpecialtyCardiology Edit this on Wikidata
Causes
  • Ion channelopathies:
    Long QT syndrome (LQTS),
    Brugada syndrome,
    CPVT (catecholaminergic polymorphic ventricular tachycardia),
    PCCD (progressive cardiac conduction defect),
    Early repolarization syndrome,
    Mixed sodium channel disease,
    Short QT syndrome, Idiopathic ventricular fibrillation (IVF)
  • Structural heart disease:
    Arrhythmogenic right ventricular cardiomyopathy (ARVC),
    Dilated cardiomyopathy (DCM),
    Hypertrophic cardiomyopathy (HCM),
    Wolff-Parkinson-White Syndrome (WPW),
    Mitral valve prolapse (MVP)
Risk factorsFamily history of heart disease, Asian ancestry, Primary arrhythmia, atherosclerosis, type 1 diabetes
Frequency14.9 per 100,000 people in Japan
110.8 per 100,000 people in United States

The syndrome is rare in most areas around the world but occurs in populations that are culturally and genetically distinct. It was first noted in 1977 among southeast Asian Hmong refugees in the United States and Canada. The syndrome was again noted in Singapore when a retrospective review of records showed that 230 otherwise healthy Thai foreign workers living in Singapore died suddenly of unexplained causes between 1982 and 1990.

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