How does a healthy 27-year-old go into cardiac arrest?

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UPDATE: Another healthy Australian has died suddenly of heart complications while competing in a sporting event, just weeks after a 27-year-old man suffered cardiac arrest during the City to Surf.

The 39-year-old Ironman competitor died yesterday during the swim stage of the Ironman 70.3 event on Queensland’s Sunshine Coast. Fellow competitors and rescue personnel brought the man back to shore after noticing he had swam slightly off course.

“[Our] medical team worked on the gentleman for over half an hour. The team did an amazing job but were not able to revive him,” Ironman Asia Pacific CEO Geoff Meyer told the ABC.

“The thoughts from the medical team is that it was a heart attack.”

The Glow previously reported: One of Australia’s most iconic annual events ended in tragedy yesterday.

Chris Head, a 27-year-old Fox Sports employee from Coogee, collapsed as he reached the finish line of the City to Surf run in Sydney. He was rushed to St Vincent’s Hospital just after 11am, but passed away shortly after arriving. According to the NSW Ambulance Service, Mr Head had gone into cardiac arrest.

“This means the heart went into such a fast electrical rhythm that the body can’t cope and it goes into arrest, or it doesn’t function any more and it needs CPR and a shock to the heart,” explains Professor Chris Semsarian, a cardiologist from Sydney’s Royal Prince Alfred Hospital.

According to reports, Mr Head was a fitness lover who was involved in a CrossFit group and had recently returned from a trip to Kakadu. It’s hard to believe someone so young and healthy could suddenly die from a heart complication, but Professor Semsarian sees this in his clinic more often than you’d expect. Here, he answers some of our questions about cardiac arrest in young adults:

Is cardiac arrest common among young people?

“It’s hard to get the precise figures, but we believe that up to five young people under the age of 35 pass away each week in Australia from this type of sudden cardiac death – it happens a few times a week in otherwise healthy, fit young people,” says Professor Semsarian. “I see, in my clinic, one or two every fortnight – a family where they’ve lost a young person.”

Why does it happen?

“Over the age of 35, coronary artery disease – or blocked arteries – is the most common cause of sudden death, and that’s due to blood pressure, smoking, all that kind of stuff,” Professor Semsarian explains. However, for people under 35, the main cause of sudden death is inherited or genetic heart conditions. Generally, these conditions either affect the muscles of the heart, or its electrical system.

Are there always warning signs before a sudden death?

The majority of people with genetic heart conditions don’t die suddenly, and sudden death is considered a rare complication. However, it can happen with no warning symptoms.

“For about 50% of young people who die suddenly, that’s their first presentation of [heart] disease, which is really scary,” Professor Semsarian explains. “They don’t have any warning symptoms, and so that makes it very, very difficult to detect who’s at risk in the community.” In the remaining 50% of cases, symptoms have presented.

The first preventative step is ensuring people with a family history of heart diseases – particularly among young family members – are properly checked. This usually involves an ECG (electrocardiogram), which is an electrical test of the heart, and an ultrasound of the heart. Professor Semsarian says cardiologists have come to understand more about the genetic causes of heart conditions in recent years, meaning they can identify at-risk people and initiate prevention strategies more easily.

What are some of the warning signs of a heart problem?

Although chest pain is a well-known symptom of heart problems for the older population, Professor Semsarian says the signs can be quite different in young people. “It can be anything – blackouts, unusual chest pains, heart palpitations – they’re watching TV or reading a book and their heart races, those sorts of symptoms,” he says. “There can also be no symptoms. The majority of people who get those symptoms have no heart problems, but you have to be on the lookout for these sorts of things.” Generally, symptoms of genetic heart conditions won’t present until the teenage years.

During exercise, dizziness or a noticeably high heart rate following recovery can indicate a heart problem, although not necessarily. Professor Semsarian stresses that blackouts are a particularly concerning sign.

If I notice odd symptoms during exercise, what should I do?

“[You] should immediately stop. Nine times out of ten it’ll be nothing, but in the one time you want to make sure you let the heart come down to a normal rhythm, and if it’s a symptom that is unusual for you, you should at least go to a GP and get a simple ECG to see if there are any electrical changes in the heart,” Professor Semsarian says. However, he reiterates that physical exercise has huge benefits for the heart, as well as other health conditions.

If I have a heart condition, should I avoid exercise?

Professor Semsarian  recommends: “Low and moderate-level exercise is good for the whole population. High-level exercise – competitive sports, things like that – are fine, but if you have one of these underlying heart conditions you should avoid those high-level activities. No one should be discouraged from exercise, but if there’s a family history of heart problems or you’re getting funny symptoms from high level exercise, it’s probably worthwhile getting it checked out to make sure everything’s okay.”

How can I keep my heart healthy?

Keeping your heart healthy under the age of 40 is quite straightforward – it’s all about eating a healthy diet and regular exercise. “The exercise recommendation is 30 minutes a day, five days a week, at the miminum – that’s 150mins a week,” Professor Semsarian says. For people over 40, issues like cholesterol, smoking and blood pressure also need to be monitored.

Professor Semsarian adds that energy drinks have been reported to trigger heart complications among some young people, especially teenagers. “There’s no doubt energy drinks do trigger fast rhythms of the heart – in a normal person that’s probably not a problem, but a person who might be susceptible to a heart problem, like someone with a genetic condition, it can actually trigger serious rhythm problems that can lead to sudden death,” he explains.

You can follow Professor Chris Semsarian on Twitter here.