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By Radha Hackman , MD

Why would a healthy fit person collapse during exercise and die suddenly? In such a person there is usually an underlying heart condition. So, strenuous exercise would overburden the ailing heart, and they are more likely to suffer a heart attack or cardiac arrest. The two most common causes of sudden death during exercise are coronary artery disease and cardiomyopathy.

*Coronary Artery Disease (CAD)*

This is the commonest cause of sudden death during exercise in people over 40yrs. The coronary arteries whose job it is to supply blood to the heart get narrowed with cholesterol deposits (plaque). This means the heart may not receive enough blood during exercise. Complete blockage of a coronary artery will cause a heart attack.

People who die suddenly from CAD would often have had warning signs which they may have ignored. These are chest pain (angina), shortness of breath, fainting, shortness of breath, fatigue and exhaustion during exercise.

CAD can lead to a heart attack or cause the heart to beat abnormally (arrythmia) and thus cause the heart to suddenly stop beating (cardiac arrest). At this point, I must mention the left anterior descending (LAD) artery—often called the “widowmaker” artery because blockage here is almost always fatal. It can also happen without warning.

To prevent CAD:

Regular moderate- intensity exercise
Control conditions such as hypertension, diabetes and high cholesterol
Quit smoking
Reduce and manage stress
Maintain a healthy weight
Low salt low fat diet
Include whole grains, fish, vegetables and fruits in your diet.

*Hypertrophic Cardiomyopathy*

This is the most common cause of sudden death during exercise in younger persons. It is a disease in which the heart muscle
becomes thick. This can develop in childhood and there is often a family history of the disease. Cardiomyopathy is notorious for not giving any symptoms at all. World class athletes have died suddenly from this.
Although screening is not routinely recommended it is wise for anyone who plans to get involved in strenuous exercise to get clearance from a physician by history, physical exam and ECG.

*Less common causes of sudden death during exercise*
Artery in the lung gets blocked by a blood clot. ( Pulmonary embolism)
Electrolyte imbalance
Trauma to the chest during exercise

*How do you know If someone has had a cardiac arrest?*
Person suddenly faints or collapses and appears to be dead.
Stops breathing
Has no pulse
Muscles may twitch

*What should you do if someone has a cardiac arrest*

Call for help.

Ask someone to call 193 (Ambulance)

In the absence of a defibrillator start CPR (cardiopulmonary resuscitation) IMMEDIATELY.

Put the person on his or her back on the floor.

Kneeling next to the person place the heel of one hand in the middle of the chest.

Place your other hand on top of the first hand. Push HARD and FAST in the center of the chest at a rate of at least 100 compressions per minute. As a bystander don’t be afraid to do it. Even if you aren’t sure how, your attempt could save a life. CPR is life saving and can triple a person’s chance of survival. Keep doing cardiac compressions until you get medical help.

If there’s an automatic external defibrillator, follow the instructions & voice prompts, and use it!
( Dr Hackman is my class mate at the university of Ghana Medical School and is currently a private practitioner and owner of DUAH clinic in Accra .)

Copied from the wall of Dr Augustus Eduafo

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