2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | Circulation

Sudden Cardiac Arrest: The Hidden Threat To Healthy Young Lives

Sudden cardiac arrest (SCA) occurs when the heart abruptly stops functioning, leading to haemodynamic collapse and sudden death. It can manifest within an hour of symptom onset in witnessed cases or within 24 hours in unwitnessed cases. In autopsy findings, it is described as a natural, unexpected death due to cardiac or unknown causes.

SCA is responsible for nearly 50% of all cardiovascular deaths, with up to half of these being the first sign of an underlying cardiac issue. The causes of SCA vary with age. In younger individuals, primary electrical diseases, cardiomyopathies, myocarditis, and coronary anomalies are more prevalent. In contrast, older populations typically experience SCA due to chronic structural heart diseases, often associated with coronary artery disease, acute coronary events, or valvular heart conditions.

Genetic cardiac conditions are linked to 25–49% of SCA cases in the young, potentially affecting family members as well. Reversible factors, such as electrolyte imbalances (e.G., hypokalaemia and hypomagnesaemia), ischaemia, coronary spasms, drug-induced arrhythmias, or even lifestyle factors like dehydration and unsupervised use of supplements, contribute to some cases. While reversible causes may account for up to half of SCA instances, identifying them remains challenging.

Athletes, despite appearing fit, may develop cardiac issues from dehydration, inadequate diets, or misuse of supplements or hormones aimed at muscle growth. Additionally, inherited conditions affecting the heart's structure or electrical function can lead to fatal arrhythmias. When SCA strikes, the heart ceases to pump blood, halting oxygen delivery to vital organs. Without immediate intervention—ideally within three minutes—death or irreversible brain damage may occur.

Some warning signs, such as dizziness, fainting during exercise, chest pain, palpitations, and unexplained seizures, may precede SCA. Recognising and addressing these signs can save lives.

Preventing sudden cardiac arrest: key measures

• Regular cardiovascular health check-ups

• Screening for diabetes, hypertension, and obesity, alongside regular moderate exercise

• Avoiding unsupervised use of supplements, chemicals, or hormones

• Adopting a balanced diet and avoiding smoking or tobacco use

• Managing blood pressure, cholesterol, and blood sugar levels

• Genetic testing for families with a history of early cardiac arrest

• Proactive steps like these, combined with awareness of the risks, can help mitigate the threat of SCA among young, seemingly healthy individuals.

The writer is a Consultant at the Cardicare Heart and General Hospital.Email: [email protected]

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Frida Maanum: 'No Obvious Cardiac Causes' For Arsenal Midfielder's Collapse

Arsenal say Frida Maanum has undergone tests which found "no obvious cardiac causes" for her collapse in the Continental Cup final.

The midfielder went down off the ball in second-half injury time during the final at Molineux, in which the Gunners beat Chelsea 1-0 after extra time.

Arsenal say Maanum, 24, has been fitted with a device to monitor her heart.

The Norwegian has not joined up with her country for their Euro 2025 qualifiers, which begin on Friday.

In a statement released on Thursday, Arsenal said Maanum has undergone "extensive testing" which has been reviewed by "two leading cardiologists".

"There are no obvious cardiac causes found from these thorough investigations so far," added the Women's Super League club.

"Frida has subsequently had a monitoring device fitted to record her heart function and will now undergo a progressive return to train protocol.

"Once she has been monitored for a full one-week period, her normal training will be closely reviewed and monitored, before a decision will be made on her returning to play."

Arsenal had previously said Maanum was "stable and doing well" after the Continental Cup final was stopped for seven minutes as she was treated by medics after collapsing on the pitch in Wolverhampton, before being taken off on a stretcher.

She did not need to go to hospital and travelled home with her Arsenal team-mates.

Norway are set to begin their European Championships qualification campaign on Friday against Finland before travelling to the Netherlands on 9 April.

Maanum has made 77 appearances for her country, scoring 14 goals.

Arsenal are currently third in the WSL and host Bristol City next on 14 April.

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