Common causes of sudden death: Recognise the signs

Imagine enjoying a day of cycling with your family. The sun is shining, the view is beautiful, and things could not be better. Then, one of your family members collapses and does not get up. 

It sounds like a nightmare scenario, but it happens on a regular basis. Some of the causes of sudden, unexpected death are rare, but others are quite common. Here is an overview of some of the causes of sudden, unexpected death and how to recognise the signs.

Heart diseases

Dr Sanon Mitala, a pathologist, says the leading causes of sudden death include myocardial infarction (heart attack), and abnormal rhythms of the heart (arrhythmias). 

“Most people who die suddenly between the ages of 35 and 60 years have one of these conditions. These are preventable causes of sudden death since they have known risk factors including smoking, hypertension, diabetes, too much bad cholesterol in the blood and family history of cardiac/heart disease,” he says. Though common among adults, sudden cardiac deaths, according to mayoclinic.org also plagues young athletes. 

Dr Barbara Kakande, a cardiologist, says cardiac arrest is the cessation of pumping of the heart in a person who may or may not have been diagnosed previously with heart disease. This, she says, causes the loss of blood flow throughout the body. It may occur suddenly or gradually. 

Heart attacks

These happen when blood vessels called the coronary arteries, which supply blood to the heart tissue get blocked, causing the tissue to get damaged or die. 

“This blockage of blood flow may sometimes be minor thus a slight function compromise or major making the heart fail to pump. When blood flow to other body parts is compromised, death is eminent. Approximately half of all deaths from heart attacks occur suddenly and unexpectedly,” Dr Kakande says.

Arrhythmias

These are conditions where the heart’s electrical system is disturbed by irregularities where the charge meant to make the heart work becomes abnormal. As such, the heartbeat becomes too slow, too fast or too irregular. 

“The patients may feel their heart beat, which is referred to as palpitations. Some of these conditions, such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy may be diagnosable using imaging tests,” she says. 

However, others do not have any obvious detectable abnormality since most are due to inherited abnormalities of channels in the heart, and may be identified or suspected from a resting electrocardiogram (ECG) or exercise test, or from having a family member dying suddenly. 

Congestive heart failure

Here, one may die from the heart pumping function completely failing after progressively weakening or from the occurrence of a fatal heart rhythm abnormality. According to Dr Kakande, failure on the left side gradually or abruptly causes fluid accumulation in the lungs which leads to shortness of breath, more so when lying down and oedema of the feet. If the heart gets overwhelmed, it will fail to supply blood to the heart easily.

Stroke

Seeing that the heart supplies blood to the body, when negatively affected, the other body parts are also affected. For instance, an irregular heart beat could lead to a clot, which will travel to the brain, causing a stroke. 

“The risk of getting a stroke is heightened when one has underlying chronic diseases such as high blood pressure. When the brain stem is affected, then functionalities such as muscle control, consciousness and eye opening are compromised. Seeing that strokes mainly happen at night, death cannot be ruled out,” Dr Kakande says. 

It is important to note that the risk of sudden death from heart disease is highest between 6am and noon, and lowest from midnight to 6am.

Pulmonary disease

Lungs work hand-in-hand with the heart. When the heart has problems, the lungs are affected thus diseases such as pulmonary disease. In its chronic state, death will occur although the impacts is in slow succession. The condition, Dr Mitala says, causes oxygen levels to fall while carbon dioxide levels increase thus a change in the acid-base balance. 

Suffocation (asphyxia) 

This commonly causes sudden death during sleep and can be caused by a number of things. For instance, cooking in a small room with closed doors and windows causes a build-up of carbon monoxide, which can lead to death. 

“Carbon monoxide weakens you, causing you to slowly fall asleep and eventually die in your sleep,” Dr Mitala says, adding that drugs such as pain medications, if taken in overdose, can reduce the effort of breathing and cause suffocation. Additionally, aspiration of stomach contents following vomiting, especially among the drunkards can also cause suffocation and death. Other causes of suffocation include chocking, pneumonia, asthma, and clots in the blood vessels of the lungs,” Dr Mitala adds.

Dr Franklin Wasswa, a general practitioner, says to avoid death, if there is someone available when the suffocation happens, they should put the person in a recovery position. This makes it impossible for one to drown in their own vomit or for it to get into the lungs. Maintain this position until they regain consciousness. 

Suffocation also happens among babies, hence the need to keep heavy clothing away from their beds and hanging the mosquito net well above their head and out of the reach of their hands. 

Sleep disorders

One of these is obstructive sleep apnea where breathing stops and starts during sleep. The patients/sufferers tend to snore loudly and wake up very tired even after a full night’s sleep. Sudden death will occur since during sleep, muscles in the neck relax and collapse on the airway causing blockage. 

Regardless of the cause of sleep apnea, Dr Wasswa says, it can be managed. For instance, if it is because of obesity, you have to lose weight. If it is from the brain (central sleep apnea), you need to get a continuous positive airway pressure (CPAP) machine to pump air into your lungs. As such, the sufferer will wear a mask and sleep as the machine pumps into the lungs,” he shares.

Hypoglycaemia

People taking diabetic medication may sometimes not take it incorrectly, leading to low blood sugars. This, he says, will cause the body to shut down the brain followed by the heart. 

Dr Wasswa says there is also a rare familial syndrome of people who die during sleep and it happens when all the body muscles relax. It happens during the rapid eye movement (REM) stage of sleep and at that point, one cannot breath. However, this is a rare syndrome,” he shares. 

Dr Mitala says the other medical conditions that cause sudden death include epilepsy though this happens when one is sleeping. Most of these conditions are preventable and treatable by trained health workers if detected early enough, he clarifies. 

The common causes of sudden death occur in the major vital organ systems of the body. If you or those you care about have risk factors, attention to prevention or treatment of these factors may prevent their sudden death. Always remember to call emergency services if you see someone collapse, or you cannot wake up your baby.

According to age

The number one most common cause of death among people, young and old, will vary depending on their specific age group. The following are the most common causes of death according to age group:

Teens

The most common cause of death for teens is accidents. These unintentional injuries most often occur because of automobile accidents and could actually be preventable. According to the Centres for Disease Control and Prevention, six teens are killed every day from injuries due to a car accident.

Young adults under 35

The most common cause of death for men and women under the age of 35 is accidents/unintentional injuries which are (again) mostly attributed to automobile accidents.

Middle-aged men and women under 65

The most common cause of death for both middle-aged men and women is heart disease with cancer closing the gap and coming in at a close second.

Seniors

The most common cause of death for seniors is heart disease, which includes heart attack, heart failure, and heart arrhythmia. This is typically associated with other ongoing health issues such as diabetes, high blood pressure, and smoking history.