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Sudden Cardiac Death in the Young

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Jacob Stanley

on 18 February 2017

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Transcript of Sudden Cardiac Death in the Young

Thank You!
By Jake Stanley
Sudden Cardiac Death in the Young
Before we start...
Upsetting and potentially distressing content

Support is available : )



Causes of Sudden Cardiac Death
Can be divided into the following:

Arrythmogenic Right Ventricular Cardiomyopathy

Ion Channelopathies
Long QT Syndrome
Brugada Syndrome

Wolf Parkinson White Syndrome

Commotio Cordis
Four Types:

Arrythmogenic Right Ventricular Cardiomyopathy

A Myocardial disorder in which the cardiac muscle is structurally and functionally abnormal (thickened, stiffened, or enlarged)

Complications include heart failure, arrythmias, and sudden cardiac death.

Cardiomyopathy can occur at
any age
Epidemiology, Clinical Presentation and Examination Findings
High genetic influence in all cardiomyopathies

All are more common in men

Estimated to account for between 40-60% of all SCD (<40yrs)

Symptoms range from dyspnoea, palpitations, syncope.

Concealed vs Overt stage and Paroxysmal nature

More commonly found incidentally or on

Electrocardiograph (ECG) findings
Ion Channelopathies

Long QT Syndrome
Brugada Syndrome
Long QT Syndrome
Long QT Syndrome
Long QT Syndrome
Brugada Syndrome
Brugada Syndrome
Wolfparkinson White Syndrome
Commotio Cordis
QT Interval
70,000 people in UK
More prevelant in females
Congenital or Acquired
Multiple congenital causes due to genetic defects
Can effect different ion channels and therefore can have varying exacerbating factors

Shaving, Alarm Clocks, Swimming and Children?
Clinical presentation:

ECG Findings

Prolonged QT (QTc) Interval
450 ms in Males (11 small squares)
460 ms in Females (11.5 small squares)
460 ms in under 16's (12 small squares)
Alteration in the transmembrane ion current that normally constitute the action potential

Causes changes to the sodium channel during upstroke and early repolarisation

Second leading cause of death of males under 40

Affecting between 70,000-140,00 in UK

More common in SE Asia

"Sleeping Death Syndrome"

Clinical features and findings:


ECG changes:

ST elevation in right precordial leads
Appearance of RBBB
T Wave abnormalities
Movement of V3 and V4 to second intercostal space
Accessory Atrioventicular Pathway

105,000 people with WPW in UK

15-30% of those with WPW will develop AF

Delta Wave (V1)
V1 reveals all
Shortened PR interval

Sudden Cardiac Death due to projectile striking the chest wall
More common in sports such as lacrosse, hockey and martial arts
So What?
Conditions leading to SCD are not being picked up early enough
Young people are dying as a result
Conditions leading to SCD are often found incidentally

Symptoms such as Syncope, Palpitations, Seizures, Dyspnoea and TLOC should not be dismissed.

Young does not neccesarily = healthy

ECG is an excellent investigative tool, and a language between health care professionals. Become fluent!
Full transcript