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  • Do not like this article!!!! Echo not necessary??

    Possible Causes of Sudden Cardiac Death Found

    Thu May 20, 7:04 PM ET Add Health - HealthDay to My Yahoo!


    By Steven Reinberg
    HealthDay Reporter

    THURSDAY, May 20 (HealthDayNews) -- Researchers say they may know why a young American man or woman unexpectedly goes into cardiac arrest and dies.


    A study of more than 6 million U.S. military recruits, including over 100 cases of sudden cardiac death, has found that the primary causes were cardiac arrhythmia and a structural problem in the coronary arteries.


    Sudden cardiac death is a leading cause of death in the United States, taking more than 400,000 lives each year.


    "This finding is revolutionary," said lead researcher Dr. Robert E. Eckart, a cardiologist from Brooke Army Medical Center in San Antonio, Texas. "Previously, it was thought the leading cause of sudden cardiac death in younger people was abnormal muscle thickening of the heart."


    Eckart said the cause of sudden cardiac death varies by country. In Italy, for example, the main cause is a unique type of heart muscle problem. "We thought it would be important to look at a population that would be more representative of the U.S. as a whole," he said.


    In their study, Eckart and his team collected data on 6.3 million military recruits spanning 25 years, from 1977 to 2002. During this period, there were 127 sudden cardiac deaths, according to the data presented Thursday at the Heart Rhythm 2004 meeting in San Francisco.


    "We found that the leading cause of sudden cardiac death was a coronary artery problem," Eckart said. "This anomaly is when one of the coronary arteries takes off from the aorta in an abnormal fashion."


    The second leading cause of sudden cardiac death in people with seemingly healthy hearts was the development of a deadly heart rhythm, known as an arrhythmia. Eckart believes this problem is genetic.


    Given these findings, Eckart said he has changed his approach to treating young people who complain of chest pain. Before, he screened these patients with an echocardiogram, which is an ultrasound of the heart, to look for abnormal heart muscle.


    But now he does an electrocardiogram (EKG) to look for abnormal electrical activity in the heart. Eckart also looks at the condition of the coronary arteries to see if there is any abnormality.


    "By doing those two simple things, we are going to make a larger impact on sudden cardiac death in this young population," Eckart said. More research is needed to identify people with a genetic susceptibility to deadly heart rhythms, he added.


    Eckart strongly recommends that young patients with a family history of premature sudden cardiac death have an EKG to look for the problems that can cause these deadly heart rhythms.


    Dr. Ramon Brugada is a cardiologist and director of molecular genetics at the Masonic Medical Research Laboratory in Utica, N.Y. He said, "This study points out the importance of screening young people with EKGs."


    However, many of these conditions can appear normal on an EKG, he cautioned. "You have to catch it at the right time," he said.


    "If you have a family history of sudden death, if someone in the family died at 20 or 25 with no previous medical problems, that should raise a red flag that there is some inherited disease. Other family members should have an EKG screening," Brugada advised.

  • #2
    Re: Do not like this article!!!! Echo not necessary??

    Dr. Eckart appears to be an idiot.
    This study does not seem to be a good sampling. It is limited to military recruits and only uses 127 deaths.
    The young people who unfortunately die on the athletic field is more numerous.
    Lisa quoted some studies a few months ago that showed that almost 40% of those deaths are HCM related. And of course, EKGs are not too useful with HCM.
    Fx

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    • #3
      Re: Do not like this article!!!! Echo not necessary??

      I was thinking along the same line as I read the article. If he only looked at military recruits he alrready has a flawed study since there can not be any possible corrolation to the general public.

      Unless drafted, and not properly screened medically during the draft exam, those with certain medical problems (known or unknown) are not going to join the military if they see the physcial requirements as something that would be too hard for them.

      Before accepting the results of any study the first question that has to be asked is who funded the study. Many times that speaks mountains as to the initial "unwritten" purpose or goal of the study.

      Be interesting to see who paid for this study?

      Lynn

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      • #4
        Re: Do not like this article!!!! Echo not necessary??

        I am still learning about HMC, and I do not doubt any of the research that has been done in this area.

        Yet I do find this study to be interesting at least. You pointed out that the number of young athletes who die on the field is very high and that HCM is a suspected factor.

        But I am not sure if this sample is tainted, so to speak. Of course there are some people who did not volunteer to join the army due to known medical issues. Yet there are also many who must have joined the army without knowing they had anything wrong with them. So I guess my point is that maybe the two factors wash one another out?

        I wonder what % of the army deaths also had hearts with muscles thickening? Now that might shed some more light.

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        • #5
          Re: Do not like this article!!!! Echo not necessary??

          From the viewpoint of someone whose husband already had 16+ years of military service when he was diagnosed with HCM, and someone who has spent countless hours here learning, I can say that most with HCM wouldn't have passed the initial basic training. If they did get past that phase, they probably wouldn't get past the physical training that they have to do to keep their bodies in tip top shape. That's not mentioning the physical exam (pushups, running, etc) they have to do annually. It's not unheard of for HCM'ers to make it into service, but it IS unusual for them to persist for any length of time. Just my opinion.

          Reenie
          Reenie

          ****************
          Husband has HCM.
          3 kids - ages 23, 21, & 19. All presently clear of HCM.

          Comment


          • #6
            Re: Do not like this article!!!! Echo not necessary??

            Oh boy,
            I have some problems with this.

            First of all, he’s using the bases of six million three hundred thousand recruits, who had previously passed their induction physicals, - over a twenty-five year span of time from 1977 through 2002. How many of these soldiers has this researcher really examined? If he is just going on the old records of other doctors, who knows how comprehensive they were?

            Of the recruits complaining of chest pains, how many were given EKG’s and how many were given echo’s, how many were given both and how many received neither? How many of the soldiers from his bases were examined and showed abnormalities and subsequently suffered sudden cardiac death? It would seem to me that if a soldier was diagnosed with a heart problem he would have been given a medical discharge and would no longer be a part of the sample.

            This leads me to believe the preponderance of those suffering sudden cardiac death are those who; A) never complained of chest pains, B) complained of chest pains but were never properly evaluated, C) complained of chest pains but were found to be ‘fit’ (not eligible for a medical discharge and/or not restricted to limited duties with a cardiac condition.) We are talking of medical diagnostic failures here.

            Next, how many of the soldiers were severely stressed prior to their death? (This could be hours prior.) Are there any records to give even a hint of this situation?

            Finally we come to his sample (with many unanswered questions.) He claims 127 sudden cardiac deaths in six million three hundred thousand population (excluding those given medical discharges if or when a serious cardiac condition was uncovered.) That works out to 1 in 49,606+ soldiers. - - - Do you think his ‘work’ or his conclusions have any significance?

            For a definition of Sudden Cardiac Death in the Young (under 35) and a list of conditions which fall under this umbrella term, see;
            http://www.c-r-y.org.uk/Sudden_Cardiac_Death.htm

            And to think this presentation was probably made in Lisa’s presence,
            Burt

            Comment


            • #7
              Re: Do not like this article!!!! Echo not necessary??

              "Finding is revolutionary" whoa what a load! We've known that arrythmias are the #1 killer of athletes for a long time.

              As a young person trying to get into the military myself I was always behind on running in my ROTC unit. It didn't matter how much I trained I never qualafied. They were going to waive that part becuase my aptitude scores were awesome.

              As far as EKGs go the only time mine runs an abnormalaty is when I'm having an attack. Sometime's I really do believe "military intelligence" is an oxymoran!

              With this information it will make physical exams for recruits in highschool even less a possibility. I was lucky I didn't fall out dead in all my 4 years in that position. Physically they give no one a break if I couldn't run fast enough I got another lap. I never got faster just more bitter.

              Mary s.

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              • #8
                Re: Do not like this article!!!! Echo not necessary??

                Here’s a couple more that I find ‘interesting’;

                Sudden cardiac death is a leading cause of death in the United States, taking more than 400,000 lives each year.
                Does that sound a tad high to you? Sudden cardiac death? That’s 1,095+ per day. They must be piling up in the streets. - - - That's ten million in 25 years - His researchers found 127 in that time.

                "We thought it would be important to look at a population that would be more representative of the U.S. as a whole," he said.
                Just how is it representative? His ‘group’ all started with an induction physical, followed by Basic Training. Do most citizens do that? Also, most US citizens (or their parents) came from all over the world.

                Eckart said the cause of sudden cardiac death varies by country. In Italy, for example, the main cause is a unique type of heart muscle problem.
                Holy cow, keep away from Italy. - - If somebody moves from Italy to Spain or the US say, - what does his unique heart muscle problem become then?

                I should spread some of this in my garden.
                Burt

                Comment


                • #9
                  Re: Do not like this article!!!! Echo not necessary??

                  I've been complaining of chest pain since I was 12. They did plenty of EKGs on me which never showed anything. Ditto for stress tests. Echocardiograms are simple, non-invasive, inexpensive procedures, so why would any qualified MD decide they shouldn't be part of screening young people with a family history of sudden death?

                  I guess the laughing boys in their white coats are still at it! Here I thought MD's had gotten somewhat smarter about these things! These organization certainly has a lot of work to do!

                  Comment


                  • #10
                    Re: Do not like this article!!!! Echo not necessary??

                    “Ahem. Based on the failure of my fellow doctors in the US Army to discover heart problems in soldiers over the past 25 years, leading to 127 documented sudden cardiac deaths, I have deemed it unnecessary to perform echo’s on men complaining of chest pains.”

                    “My next study will prove that parachutes are extraneous equipment for troops jumping out of airplanes. So far we have one documented record of a pilot bailing out in Alaska, falling into a large snow bank and suffering only two broken legs. Instead of parachutes they should be equipped with splints.”

                    Shakespeare had it right – “What fools we mortals be.”
                    Burt

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