We are all familiar with people we see as healthy
dropping dead suddenly. In the 80s Samuel Okwaraji, a brilliant Nigerian
midfielder, dropped dead in the field of play in a match against Angola. A sitting
Governor in Nigeria’s second Republic was said to have collapsed upon undertaking
some exercise. Others have slept without waking up. Many cases are happening
across the world, not least in Nigeria. What could be responsible? Consider as
examples the following hypothetical cases:
Case 1: It is Sunday morning.
Pastor Ayo woke up hale and hearty and was getting ready for church. But while
dressing he fell. The wife who was in the next room rushed in and saw the
husband gasping for breath. Her shout for help attracted neighbours who
assisted and got the man to hospital. There the nurse on shift recorded BID
(brought in dead) and sent for the doctor who confirmed him dead.
Case 2: Mr Musa was in his 50s. He
loved taking meat. From suya to nwonwo to fried chicken to the next ‘take away’
in Mr Fans, the man enjoyed himself. At times he would wash them down with some
beer. He was billed for a holiday abroad in a week’s time. However, just two
days to his leaving, Musa died in his sleep.
Case 3: Chief Okonkwo heard through
the media that exercise was good for the body, and could help prevent some
illnesses. He has not been doing it. He remembered this when he felt unwell and
so decided to jog. To ‘shake off the illness’ he tried two kilometers at a
stretch. He could not complete it, for, he collapsed. There was no immediate
help on the lonely road, and so he passed out.
What is Sudden
Death? It
is an unexpected immediate cessation of life in an otherwise healthy person.
Cause of
Sudden Death (SD): SD occurs when there is an overwhelming disease of or damage to the
heart. The disease or damage could be structural (having to do with parts of
the heart) or organic (relating to chemical processes in the body that affect
the heart). Their effect usually ‘accumulates’ over many years, only to ‘burst’
suddenly one day. The person is then said to have ‘heart attack’. Usually the
person drops and lies lifeless. They have no pulse because the heart has
stopped contracting. During the years of ‘accumulation’ the person may occasionally
feel somehow (warning signs) which they may ignore or attribute to some other
trivial causes. At times too, there may not be any signs at all. Kanu Nwankwo
had a structural heart disease that would have prematurely claimed his life,
but thank God the defect was picked early upon routine medical examination at
Inter Milan Football Club.
Some of the diseases or damage that may occur to the
heart are:
1.
Deadness of a segment of the heart muscle (Myocardial Infarction, MI)
2.
Cessation of the pumping action of the heart (Asystole)
3.
Disorderly and ineffective pumping action of the heart (Arrhythmias)
4.
Formation and deposit of fatty substances in the wall of arteries
supplying blood to the heart (Atheroma formation in Coronary arteries)
5.
Formation of blood clot (Thrombosis) inside a coronary artery
6.
Narrowing and eventual or sudden blocking of the lumen of an affected
coronary artery by either an atheroma or a thrombus
7.
Transport in the systemic blood circulation of atheroma or thrombus
formed elsewhere in the body (embolus) to a coronary artery or cavity of the
heart (coronary artery or ventricular embolism) where it could occlude the
coronary artery affected or impair the contraction of the ventricle where it
lodged.
Who is at risk
of experiencing SD?
Anybody and everybody, but the following predispose
to higher risk:
1.
Carelessness: Those who do not have time to check their health status
are taking a big risk.
2.
Smoking. Nicotine stimulates the heart and raises the Blood Pressure.
3.
Hypertension. This causes the heart to work extra time, and anything
that overworks may soon break down.
4.
Diabetes. Diabetes mellitus is a syndrome that stresses many systems in
the body, and the heart is not spared.
5.
Obesity. This adds load to the heart.
6.
High consumption of certain animal protein and saturated fat.
7.
Physical inactivity or sedentary lifestyle.
8.
Excess alcohol consumption.
All these factors are controllable. Those which
cannot be controlled are:
9.
Age and Sex. Events leading to SD are commoner in males 50 years and
over, and less in women before menopause.
10.
Family history. Heart diseases leading to SD run in families due to
shared genetic, environmental and lifestyle factors.
Warning Signs
that one may have heart attack:
1.
There may be no signs at all.
2.
Chest pain. This is usually central, ‘heavy’, ‘gripping’, or tightness
in the chest. It occasionally extends to the shoulder, arm, back or upper
abdomen. It may last for a short time and pass away. It is usually more
pronounced on doing a little work.
3.
Awareness of one’s heartbeat. This may be accompanied by tiredness
and/or sweating. Again, it passes away after a short time.
4.
Easily tired on mild exertion
5.
Undue breathlessness.
6.
Fainting tendencies.
Warning signs do not mean that one may have an attack immediately. However, we should take steps to visit the hospital once we begin to feel them.
Preventive
Measures: What to do whether or not you have the warning signs:
1.
Health Checks: Check your body regularly. The regularity depends on
what is to be checked. For example, Blood Pressure (BP) should be checked every
3 to 6 months if stable, and more frequently if high. Check your Fasting Blood
Sugar (FBS). Check your weight. Strive to stay within standard range. Check
your Body Mass Index (BMI). Keep it within 19 – 25 kg/m2. These and
other tests are the secret to good health. Visit a health facility and see a
qualified medical doctor for comprehensive check and management.
2.
Check your Lipid Profile (LP) yearly. LP includes Cholesterol and
Triglycerides values. This is the most important test as far as SD is
concerned. That is why we have separated it from other routine tests. It is
actually the secret to avoiding SD. To neglect it is to court disaster. See a
qualified medical doctor to properly assess you. Where an abnormality is
detected, you would be placed on appropriate treatment.
3.
Do commensurate exercise. Do not overload your heart. A brisk walk,
short distance jog, mock skipping can be done as your heart can tolerate about
thrice a week.
4.
Rest. Avoid undue stress – from Board meeting to Caucus meeting, to Association
meeting, etc. Rest re-invigorates you. It relaxes your brain and reduces its
high demand for oxygen and nutrients compared to when it is actively working.
That high demand would have to be met by the heart.
5.
Regulate your diet. Do not eat and drink everything because others are
taking them. Know what is good for your system and use it.
i) Generally, use more water, fruits,
vegetables, plant proteins e.g. beans, soy, nuts; sea foods e.g. crabs, fresh
fish, fish oils, periwinkles; light carbohydrates, groundnut oil, soya
beans oil. Preferably boil your foods, including meats and plantain.
ii) Use minimally, foods like palm oil,
egg yolk, meat (If over 50, best to avoid red meat and
egg yolk altogether, or use them very sparingly), heavy carbohydrates like
cassava products
and yam.
iii)
Possibly avoid fried foods, skin of poultry, refined foods especially
refined sugar.
6.
Vasoprin. This is a brand of Aspirin tablets formulated for the blood
vessels. Aspirin prevents platelets aggregation and so prevents blood clotting
and thrombus formation. The strength of conventional Aspirin is 300mg per
tablet while that of Vasoprin is only 75mg per tablet. So it is low dose
Aspirin. It is recommended in a dose of one tablet a day for people at risk of
developing SD on a continuous basis. It is taken with a full glass of water. It
is not recommended for children and youths less than 20 years of age.
What to do if someone falls
unconscious around you:
1.
DO NOT try to sit the person up. Allow them to lie.
2.
If you know to do cardiac massage, go ahead, otherwise, call for help
immediately and get the person to the hospital as fast you can.
3.
Even when you can do cardiac massage and perhaps other resuscitative
measures, still do not delay in getting the person to the hospital. This is
where they will get comprehensive attention.
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