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Shocking Heart Deaths: Why They Happen

Sudden cardiac arrest isn't the same as a heart attack.
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WebMD Feature

Someone in the prime of their life -- a professional sports star, teen athlete, marathon runner, or other seemingly healthy person -- isn't supposed to collapse and die from heart disease. But it occasionally happens, making sudden cardiac arrest front-page news.

The rare nature of sudden cardiac arrest among the young is precisely what makes it so attention-grabbing. According to the Cleveland Clinic, sudden cardiac death kills 1 in 100,000 to 1 in 300,000 athletes under age 35, more often males.

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Among the most publicized cases: U.S. Olympic volleyball player Flo Hyman in 1986; college basketball player Hank Gathers in 1990; and professional basketball players Pete Maravich in 1988 and Reggie Lewis in 1993.

People wonder if anything could have been done to prevent such an event. They wonder who's at risk, and whether anyone can survive sudden cardiac arrest.

Fortunately, the answer is yes, says Christine E. Lawless, MD, MBA, a cardiologist and sports medicine doctor in Chicago. She is the co-chair of the American College of Cardiology's sports and exercise council, and a consulting cardiologist for Major League Soccer.

"We're trying to get folks to recognize that the person can come back from [cardiac] arrest if you get there within a minute," Lawless says. With immediate use of an automated external defibrillator, people have a chance to live.

What Is Sudden Cardiac Arrest?

When you hear about a young person dropping dead, you may think "heart attack." But sudden cardiac arrest (also referred to as sudden cardiac death) is different.

A heart attack stems from a circulation, or "plumbing," problem of the heart, according to the Sudden Cardiac Arrest Association. It happens when a sudden blockage in a coronary artery severely reduces or cuts off blood flow to the heart, damaging heart muscle.

In contrast, a sudden cardiac arrest is due to an "electrical" problem in the heart. It happens when electrical signals that control the heart's pumping ability essentially short-circuit. Suddenly, the heart may beat dangerously fast, causing the heart's ventricles -- its main pumping chambers -- to quiver or flutter instead of pumping blood in a coordinated fashion. This rhythm disturbance, called ventricular fibrillation, "occurs in response to an underlying heart condition that may or may not have been detected," Lawless says.

Ventricular fibrillation disrupts the heart's pumping action, stopping blood flow to the rest of the body. A person in sudden cardiac arrest will collapse suddenly and lose consciousness, with no pulse or breathing.

Without immediate CPR or a shock from an automated defibrillator, the person usually dies within minutes -- that's why it's called "sudden cardiac death."

There is a connection between heart attack and sudden cardiac death, however. A heart attack can trigger an electrical malfunction that can lead to sudden cardiac arrest.

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