Learn all about the causes of sudden death and how to prevent its occurrence in your life and that of loved ones.
You have the floor sir yeah good morning everybody my name is uh we I’m a cardiologist working for Arad multip Specialist Hospital in Lagos here and I’ll be taking us through causes of um sing death and this is this is the beginning so everybody should pay attention okay so here we
Go just a second just a second okay here we go can you hear me please hello yes Dr we can hear you okay good morning everybody so we will talk about the caes of s death you can see in this photo about somebody who is been resuscitated I mean probably trying
They’re trying to prevent sudden death from happening in this patients so briefly uh marad hospital is a we here are very scientific we practical protective and futuristic and we’re also involved in medical training we use the latest techniques to treat our patients and honestly we are we’re sort of
Experiencing um white patronage from people who have traveled out of the country and who are also trying to continue their their treatment here because of um the outcomes the positive out we had we’ve had almost like 99.8% success rate of care of high impact cardiovascular diseases because
We are consultant here so you have a high chance of surviving in Arad more than anywhere else in the world so what is sudden death it’s um we can Define it as uh an unexpected demise within 1 hour of onset of symptoms or when death OCC course unnoticed within 2
Okay so I guess we adjusted that okay so sudden death itself has been reported to occur in an increasing fashion in Nigeria and it stems from various diseases we should try not to kind of ascribe certain death to Mystical forces or witches or or religious things I mean
The the causes of certain death as we go along we see that it cuts across every gender every race and uh Every Nation I mean that’s geographical medicine it’s it cuts across certain kind of tribes and certain kind of uh existence in life so when it occurs when it’s about to
Occur when there is a medical condition you have to seek the best medical care and awareness is critical in any disease prevention treatment I told so we have to go a little bit back to the history of what it means to die suddenly and it goes back to almost the 16th century
Almost 4,000 years ago when somebody is called the cast Gast de he had a contact with icy water and died suddenly because he felt tightest in his chest and he said I’m a dead man oh God have mercy on me well um medicine was that is almost non-existent then
Scientific approach to Medicine was non-existent there but hypocrates had described something related to it so then in Rome you had people like herin who first described Ang pectoris and V bzel who also talked about Cardiac Arrest when it comes to occlusion of of vessels so we can appreciate how the
Western world has been documenting their findings over something they could not really understand but they filed it was claiming lives and they just could not just described what they saw and wrote it down so you talk about now we’re in the 20th century or 21st century and uh
History has uh progressed I mean medine has progressed to now that people have an organized way of looking at things and you talk about research which is organized curiosity so you talk about a group of inherited diseases called cheles I know my audience is really wide
And cuts across all ages and strats of society and things that so I’ll try to make things really simple and also giving the content that would really um um um benefit the people who are highly up there so you talk about channelopathy that is things that affect the cells
That conditions that affect the cells without any organic cost that can lead to people dying suddenly so but try not to ascribe it to mystical forces or somebody doesn’t like you and kills you mysteriously no it’s really something that’s that is there that you cannot see
In the person and you can see this slide is telling us about it’s showing us about a a physical activity taking place and this young man collapsing and uh cardiopulmonary resuscitation and uh probably advanced cardiac life supports taking place this patient is likely going to survive because he in an
Advanced setting and you can many people can think about or remember the Danish footballer Ericson that fell down during the World Cup and his heart stopped and they had to restart it right now he’s still playing competitive football though he had to move move on for those
Who like football he had to move on from interland to Europe to no to UK and he still playing Top Flight soer so sudden death will always want to occur but we can prevent it but at the same time let’s go to some epidemiology let’s see
How because you ask how common is it that just die Suddenly It’s only happening in my hometown and in the US found that the incident of sudden CC death is almost like the size of a whole town people just die like that and even with the Advan uh treatment and
Management and everything there people to go down in Europe is even worse 50 to 200 per 100,000 people in Africa here if you try to look for cost of sudden death what comes up is sudden cardiac death but at the same time it’s also Rising the privilege the incidence of sudden
Death is rising but it’s mainly sudden cardiac death because 90% or the greater percentage of CA of s death is really through the heart and you can see this pie chart here you could talk about it’s talking about caes of sing cardiac death in athletes less than 40 years old and
It’s saying that in less than 40 years old you have a large proportion of people who have hypertrophic cardiomyopathy at 36% and other likely causes of St them that has spread over the the the the the assessment you can see congenital anomalies they mightly increase cardiac Mass talk about rupture the talk about
Tunel Led that’s left an descending 5% of people and others di cardiopathy arenic ventricular contraction right vular contraction all kinds of anomalies that we don’t see with our eyes and this all can lead to S death in people less than 40 so it subop s Africa sudden death has been
Increasing and it comes with chest pain that chest pain you have that you ignore that you apply Rob or abon you just say I’m trying to grow older I’m stronger or I went to the gym that s that that chest Pate that you that you experience don’t
Ignore it come to the hospital come to Arad let us evaluate you and you’ll be out of it you’ll be able to prevent anything um catastrophic happening to one so now we want to bring this s kardiac death we want to bring it to our bed our living rooms and in our
Population to want to show you people who have really gone from sudden death all this information is on the internet and uh so copyright is not really an issue it’s everywhere so but you need to see that it cuts across all stru of society and one has got to have a
Scientific approach to it people can die anytime but you have to find what is going on so you see now the Deputy Governor Bon then long time ago died in sleep of arrest then one of the Commissioners in Ono State died in his sleep at 54 54 is still young you know
Then one of our presidential candidates also died died in PH when was about to be released and everybody knows him the young ground president of Nigeria and one of our renowned people said oh he’s he was surprised over the sudden death that happened in him people have all kinds of all kinds of
Explanations for his death but we in the scientific and Orthodox medicine think about the information that um science gives us about the condition of a person and when you look at the autopsy results of President mko Abola his heart was so diseased and his autopsy was done by
Renowned people apparently you can trust them and um though there’s a margin of herot they found that there was a pinpoint narrowing of the arteries of and Mark thickening and enlightment of the heart and that leads us to think of vulnerable myocardium vulnerable means something that is likely to go to some
Kind of go to some kind of um event vulnerable being at at risk for something so his heart was already at risk The myocardium is is the heart muszle itself that is his heart muscle was already diseased and anything will happen any time so you see another person
Also died of St cardiac death this was during ‘s um regime inos was playing soer and he just died suddenly like that he was certified feet La play socer Then another person came from Dubai and that was it he died suddenly too and so in these situations we have to make
Sure sorry about that so in this situation we have to make sure that we try to find out what is really causing people to Die Young so we know about um a lot of young people may not know him but he was a very Patriotic Man he was
Actually my star in football that he was playing in Europe and he was called home to play football and he suddenly collapsing G and you can see all the people around him we’re not sure whether all these people around him trying to say was someity he collapsed on the
Field while playing for his country a very strong midfielder talented and all those around him we are not sure whether they have the basic life support or Advanced C life support training but you see if you superimpose this in what happened in Europe I mean the patient
That the player that went through this kind of experiences alive today and that’s Ericson still playing soer so this topic is so important that it was brought by by popular demand and AR hospital is the place where most of the Specialists here have this basic life support and advanced ciac life support
Training and we can make a difference in somebody dying or not so another case that happened in Nigeria is the case of some referees who went for their fitness test testing program they were removed from the list probably because they failed the test but somehow Nigerian Factor they found their names back on
The list again as the referees who qualify but they they passed away due to sudden cardiac death so one of our renowned professors in Nigeria she’s also a cardiologist professor so MIM also documented that there are the most common common cause of sudden sudden death in Nigeria was hypertensive heart disease accounted for
6.7% of cardiovascular diseases and he said he also mentioned Le vular hypertrophy occurring in most of the patients so most people will have left vular hypertrophy and they won’t know that paper was published she published that paper in 2013 thank you very much so we don’t look at it we don’t Focus
Critically on sing them this slide shows us about Advanced cardiac life support we teaching this um young people how to really apply the advanced cardiac life support in hospital in in young babies or babies who were going to who could go who could die any time we were trying to
Rescate them which is part of the training of advanced cardiac life support to prevent sudden death so in the first decade of Life sudden death is where because of increased regout and other kind of qualities that a baby has they have um a kind of um stable
Autonomic nervous system but as we grow older though at that time sudden cardiac death can still occur in babies you have certain infant death syndrome but that may not be the topic the main focus of this presentation but in young people when they are playing spots you find
That they can have like I mentioned hypertrophic myopathy and all of that kind of that I mentioned before chel parties these are conditions you don’t see with your eyes so it’s very easy to ascribe certain kind of De to your neighbor killing you somebody you owe
Money do something to you or that kind of thing but it’s things that caes you don’t see they’re right there inside the person so we’ll tell you where arul comes in because we have Specialists who can recognize the likelihood of somebody going to sudden cardiac death and reverse it before happening so this
Graph is very important because because it shows us the the association of increased risk with age increased risk of sudden cardiac death with age you can see that right here when you are young 20 30 years of age in adolesence and young adults is mainly the likely causes
Of sudden cardiac death are things that you still don’t see once you hit the age of 40 40 and above you see the graph goes off a sharp increase in the risk of people dying suddenly so over the hill the Americans will say you’re over the hill and once the general population
Once they above 35 you find that you have advanced heart disease as high risk ischemic heart disease conditions that you really don’t know about but when you come to the hospital you can be able to identify those those risk factors and uh I like being a hospital where you we try
To look at this C RIS factors we can do a lot in reversing this possibility of you being high risk you can reduce your risk level from being high risk to low risk so you see the five common causes of sudden death are um M cardiac and if
You look at this table also or look at this graph also oh something has disappeared you see that when people are playing sports the kind of sports they can play that leads to the likely this to sudden death is the first one is really basketball here some how the the
The editors have chopped off the top of this C but I being the originator of the slid can tell you that the first the highest one the son K A traumatic that is the number that is highest here the sport that predisposes to S Kia B is basketball is basketball so we are
Soccer Nation so we can say we can avoid uh a large number of people dying from basketball but over SE as well in America you have a lot of people playing basketball and they’re more predisposed to S cardia true basketball so it’s it goes to the s De goes to fatal Arias the
Heart will just beat irregularly and found thatti was just breathless and you found that it just go down AC infection and then the intracranial hemorrhage a infection means heart attack Hemorrhage bleeding in the brain the or a clo may call sometimes the vessels in the body the big vessels a
Will just rupture tear like that and you will not know and the person will just bleed to death this information was got from very reliable sources the Bible of Cardiology Brown world and the book mentioned 128 causes and contributing factors to to S cardiac 128 likely causes so I’m sure there will
Be more now because a lot of stories is still going on so I’m not saying everybody will have one but I mean 120 like of s all right so what really causes s c death what is the pathopysiology what is the thing there that causes to that there something called vulnerable myocum
That is a myocum is the thickness the heart muscle the major heart muscle itself vulnerable means that any trigger can make it beat uh or work abnormally and the person will just go down become breathless complain or chest pain become weak and if you do not intervene within
Seconds you just find that the person would actually go down and go down and down and down and down till they die so even excitement somebody who has had a weak heart vulnerable myocardium myocardium is that thick heart muscle the heart main heart muscle that pumps blood out on the heart is already
Vulnerable it’s already weakened and then you not have excitement some people have all these problems that they inherited and we don’t know so if you’re so excited it can trigger arthas on a vulnerable myum and this slide is very very important in the sense that it’s um
The it talks about the triggers the triggers of sudden death triggers of sudden death I’ll try and quickly run through it you see here you have ischemic disease you have failure you have channelopathies you have a unusual thickness of the of the wall of the heart then you have W paron white
Syndrome that is are all diseases that in Lay man stand there inherit inherent abnormalities of heart rth itself so we now have all this in the person and you have triggers and modulators and it keeps on progressing towards a final stage final arthia going through arith ventricular fibrillation that’s usually
Fibrillation means the heart just beaten erratically where you already have a weaken heart because of something you inherited or something that you acquired so that leads to S kiac death you can see the most common one which is the acute mol infraction the heart attack is shown in this slide as partial blocking
These are all the shamas the hamburgers all the oily food that stock to the vessels D reducing blood flow to part of the heart and making it die and this is the heart attack it’s leads to s c death so again this shows the same thing then several stories have have mentioned
About that pinpoint stenosis that is a kind of stenos that is a blockage of areas of the vessels of the heart which which can lead to death and that’s is what happened that’s what they found in the autopsy of the the late man that died that died from autops so again a your
Heart beats so fast every every day goes about 100,000 times a day the heart is a strong organ but when it’s diseased it gives it some time before it starts showing possibility that he’s going to die suddenly so that’s that’s ventricular fibrillation you have the normal heartbeat you know normal
Synchronous heartbeats starting from the upper part of the heart and going to to the lower part of the chambers of the heart is the m the thickness of the heart is making sure that the uh the heart pumps out blood regularly to the other parts of the body will feel good
But when it start fibrillating you see the ventes will Quaver and beat so fast irregularly and we find that it gives this pattern on this and person cannot get blood out so easily and sudden cardiac death can OCC if there’s no intervention so that’s just pain patient
Will present how will they even present how will somebody who may have sudden kind present fting spells like you see this slide palpitations palpitation doesn’t mean oh you see this large amount of money your heart start beating or you’re in love with someone your heart start beating or you are worried
About something you heart start beating it has to be persistent beating of that heart of palpitations and then that could be the sign of sudden death so that’s it there so here in Arad if you present early without chest that fatigue that’s painting and we know that and you come
Here early you know time is of the essence of the of survival time of presentation the quickness of response and we can assure in this hospital that our operations are lightening fast the medical officer nursing and consultant assessment happens very very fast we’ll assess you place oxygen make sure you’re
Breathing get an IV access get your blood and analyze it with the state ofth art point of care everything is done within seconds here give you a very very strong chance of surviving in Arad Hospital our point of care testing is very Advanced and so we do all test
Rapidly and synchronously and so we that’s why we have very positive outcomes of 99.8% survival rate of the major adverse cardiac events preventing them AR L here so so most of the time we do a t xray Echo then C C we have collaborations with places we can do
Card immedately we have a city on site that is a c Tom graphy on site MRI to designated centers though one is coming up on street so most of us here have the basic life support and the advanced cardiac life support training so we respond to patients with chest pain who
Could die suddenly in an advanced fashion and we do it according to the standard of care based on world standards in our so these measures can help to achieve the Public Health by benefits so like I said we stabilize you we go ahead and we do the definitive
Care so this is the c that most of us have the BLS basic life support and advanced cardiac life support this was done in United States and so if V fibrillation occurs what do we do we have to resuscitate him and if it’s happening outside the hospital you have
To call for help you have to call for help one one way or the other and you start your cardiac compression start your cardiac compression you check the pulse and make sure the patient is breathing you shock and here in the hospital here in hospital resuscitation or person who has fibrillation we have
Uh our defibrillators in almost all the hallways here we keep on checking them for functionality we have in emergency room of WS and so this is a photo of uh people applying trying to apply the a automated uh defibrillator so like I said this is how heart attack course the heart muscles is
Damaged so it’s a medical emergency when when someone is having chest pain and having symptoms you have to come to the hospital and so we make our diagnosis there the ECG typical ECG but there are some non-typical ECGs too and we some sort of experienced some here it was the
Wellen syndrome and when we had the well syndrome we had a catastrophic outcome but at the same time the patient presented very late but basically this is the ECG that shows you about what is going on in the heart of patient and we have ECG machines all that everywhere
So this is just a follow of a train carrying your cholesterol into your heart and TR hello can you hear me there okay so we want to avoid some foods that are high in cholesterol which are organ meats and sausage and vacon saturated vegetable oils and poultry skin and most of this
Information you know red meats once in a while and the dietary approach to fat fat cholesterol is a form of fat and it’s better you a person goes for unsaturated fats more than saturated fats those kind of oils that are just thick that are solid room temperature
Most of them are containing trans fat and you need to avoid that you need to take on more of the um oils that’s are sort of liquid at room temperature avoid most of those package cookies and big Goods that have shortening butter popcorn reduce all those that and all
Those potato chips and package cookies so like I said trans fat increases your your your bad cholesterol and is strongly linked to coronary heart disease several studies published in the Journal of American Medical Association of Cardiology reveal that an additional 6.2% decrease of heart attack and Stoke in some New York counties where
Transport were were burned so there’s a direct think association between transpant cholesterol and the prevalence or incidence of heart attack so this is more information about relationship of cholesterol to es schic heart disease it’s not done in Nigeria here it’s done in other places but what applies there can apply here to what
Happens there can apply here so this epidemia abnormal cholesterol you talk about lipoprotein a known to be prootic all this we can access here we can analyze your blood and get out the lipoprotein and find out whether you have a predisposition to Major adverse cardiovascular events which can lead to
Sudden cardiac death and there are some studies that also talk about the RR interval analysis program as a predictor of intervention when it comes to implantable cardiov Def defibrillator they call it the ICD this from was from the National Institute of Cardiology in from war Poland which was presented in
An abstract recently in Brazil and they talked about the predicted marker of sudden cardiac death in patients who have the icds that once they see runs of premature ventricular complexes you can almost say that this patient is supposed to having s cardiac D from even though the patient is wearing an IC
So the developed a basic computer program called the pcrr and applied it for R interval analysis this a b Advanced for non cardiologist but at the same time want to predict we just want to prevent um sudden C death from happening so again if you think generally and worldwide we talk about
Things we should avoid things we should avoid things we should enjoy yes we can have a little taste of everything but when we make the wrong Foods continously in our lives it can actually build up to a risk factor for certain cardiac death so if you look at this edible oils which
Oil is really really good which one should we even take which oil which oil is is good that we can take the most supreme or Superior kind of oil that we can take is the olive oil it’s very common out of the country but here we
Use it for prayers which is okay but I’ve seen people who have actually drank a whole bottle of olive oil before developed a lot of diara you don’t need to drink a whole bottle of olive oil to provent cardiac death but it’s at least it’s very almost low very low in
Cholesterol almost non-existent in it so the most healthy oil you can use to cook to prevent s CC death is the only one so talk about eggs again can we eat eggs or not does egg can egg lead to certain character say Don’t eat eggs I’ve eaten eggs and I’m still alive and
I love eggs but it’s the quantity you eat one egg per day is okay it’s not associated with mortality from cardiovascular death or cancer that was found out by the Spanish European prospective study epic Spain and uh precautions about eggs it doesn’t apply to children or adolesent because it
Contains a lot of nutrients they young people need those nutrients to grow and um several studies have revealed that it just it’s just about a quarter of their stud population that had this eggs that was actually susceptible to increase in cholesterol of from diet just about a
Quarter and we have to be careful when you analyze the effect diet cessor have on the amount ofone we have that can lead to atherosclerosis and certain kind there we have to take into consideration that the current stories available now that is stula in the scientific Community are small randomized control
Trials they are small so we cannot really extrapolate those stories to the general population but it can give us an idea that it’s not every body that that their cholesterol will increase if they eat eggs so the summary is that you can eat one or two eggs and uh there’s the
Egg politics too several stories have revealed that is those people who are really really trying to sell their eggs are supp SOL research for people to scientist to say that eggs are not bad but eggs contain cholesterol and so just that genetic susceptibility to developing hyper cholesterolemia it’s very individual and
Is about the qu of the population based on current studies so the risk factors for heart disease heart attack that can lead to sudden CCT that you can see from this slide it’s quite clear then intracerebral hemorage stroke high blood pressure stroke narrowing of the blood vessels and again bringing it home this
Was a singer many of you would know if you are older in middle age generation or younger this was a person person who went to United States came back died suddenly sudden sudden death this wasn’t the sudden but an autopsy was done and sudden K sometimes the only time you can
Find out the cost is by lemia in the brain so again management is fast you have to do something when somebody complains that oh part of my face doesn’t feel right part of my leg is was weak I have trouble seeing it one eye I have trouble seeing in the other
Eye I can’t walk very well I feel dizzy get that person to the hospital quickly enough I have trouble speaking or we just notice that a sister’s voice is not as clear or slau that could be a stroke that is about to happen and can lead to
S cardiac death so we have to act so again pysiology of stroke have explained that there just blood clots blocking vessels going to part of the brain and leading to sto and that leads us to embolism also and this blockage of the respiratory system and one person that
People will know who was prominent who was a Minister in Nigeria also died ofar embolism probably they did help or not we really don’t know but you have to know that these diseases are no respector of persons once you feel the signs and symptoms you have to take
Action quickly and the way these hospital is built now the founder and the chief medical director has a very conducive environment for patients to survive the likelihood of survival of a patient that may go to sudden death is very high here the the likelihood that they will survive is very high in Arad
Here so the risk factors for most of this diseases like um embolism you have uh DVT D trombosis age gr70 obesity malignancy autoimmune diseases air travel then the qu opies we’ve seen patients here that young people who their blood will just clot and they’ll be breathless they faint it resuscitate
Them you don’t find any reason risk factors for their blood clotting and if there’s absence of obvious reasons for their blood plotting it’s something that could be genetic or her D you have the factor five lighing you have poy po s anti tropin deficiency so many lupos anticoagulant in women so
Many of those kind of conditions that it’s better searched for and not assume that it’s not there on the advanced level you need to search for all these risk factors and make sure you can tackle them before it causes the patient to die suddenly or the relative patient to die suddenly
So the clinical features of cloting in the lungs you have disa tpia chest pain pric pain and copy so like I said sudden death itself can cannot be totally understood without autopsy it may be too late for the patient for the disease but for the relatives who have a kind of
Connection to the disease it can allow the Der relatives to go for early checks patients who have died suddenly below the age of 40 the can go for it can prompt them when based on the findings from the patient in autopsy can prompt those relatives to come to places like arand for some
Cardiac risk factor modification or genetic testing and it’s stand them at a better chance of survival and not dying how their relative died and everything is scientific so like I said channelopathies Lut syndrome buug syndrome all these are very rare but they’re not so rare they’re rare because
We’ve not just found them we’ve not tried to look for the reason why somebody died suddenly and our condition here in Africa is not held by our religion and our culture some people Buri their dead within 24 hours of death they don’t bother to Patient di there’s
Still a lot of mystery about deaths here but when we have the mind of searching trying to help ourselves understand ourselves better and preventing sudden cardiac death from happening to us then we have to go that step further the step further is to actually do those genetic testing and pursue the reason why
Somebody died prematurely and most of them will go to the this s c will go through malignant arthas the heart will just start beating erratically and before you know the best of collapses and so you have the bug syndrome po death syndrome sodi tathy it present like with syned person be
Fainting be in a meeting with the person just switch off or the person is swimming the person just switch off the person is singing the person will just switch off or the Pres is doing some um matrimonial responsibility the person will switch off and you wonder and wake up again you
Wonder what’s happening it’s something is a condition that is not apparent that kind of person will need an implantable cardoval defibrillator God forbid if that person switches off I mean faints while driving you know what can happen so we have all those PCG Advan Short QT syndrome Roman syndrome there’s
So many like that that can kill a person so you have the long Q syndrome diagnosis in male the criteria is different in female the criteria is different so this is also talking about the different types of long C syndrome that is you just have a part instead of
Heart relaxing heart heart heart cycle cardiac cycle relaxing you have a prolongation once there prolongation that person has a tenden to go to fibrillation or this point fibrillation and be exercising just F swimming like I mentioned sex female fale sex or even why person is sleeping remember that
That 7% of patients actually it can they can actually not wake up and that would be the reason why they died in their sleep so latest infos is genetic testing is important and you will see that these are all cardiologists in Nigeria many cardiologists my teachers and my um
Mentors who went to France on conferences we have to exchange ideas that is a Dr professor professor a lot of them and and several others and we exchange ideas and scientific information with the world so this information is what we try to um use an
AR light here to make sure that we give our patients the best so the latest information about studing cardiac death is also that some modifiable risk factors have been identified and divided into metabolic factors behavioral factors psychosocial factors and also environmental factors the environmental factors is quite important is something
We ignore that is pollution pollution comes from particulate matter and um you talk about particulate matters and also pollution coming from traffic it’s very common in labors and people don’t realize that once the air is dirty and you breathe it in it goes into your lungs and your heart it can actually
Accelerate artherosclerosis in you and that’s the basis for the for the Mesa Air study that was published in the in 2016 where a group of researchers actually came together and measured the air quality and related it to the likelihood of developing therosis and sudden cardiac death and the fin that
There was a significant Association so air pollution itself is a risk factor it’s an environmental factor that that can cause you to die suddenly over time and this is usually that’s why sometimes it’s good to just live in the Ral Legos we live in Lagos Lagos is terrible when
It comes some areas have very bad air pollution and talk about China too on a worldwide level and some areas of United States that’s why people want to move to suburbs and rural areas where the air is cleaner and when we have trees and we have nature they act as the carbon sink
We act as polutan sink so we should favor more green green areas in our cities and avoid air pollution coming from factories and and vehicles because they are cardiac rors so unfortunately we’re doing ourselves a disservice if we don’t acknowledge ailments that are like high blood pressure people have high blood pressure
And they would not take their medications please take them when there’s high blood pressure you have a congenital her weakness in iotic your large vessels in the body and you don’t know and you have that high blood pressure you don’t know you have weakness your blood vessel don’t know
Atic deception can occur and it will just tear the blood vessel will tear then if before the person knows it he ends up dying suddenly that’s atic dsection and this slid shows about the risk factors hypertension Maan syndrome existing arism these are all conditions that we diagnose in the hospital but
Generally make sure that you check your blood pressure so that’s atic dissection in vessels is normal there and you have dissection that is breakage in the wall so different types deaking stf management when you do the citic surgery stand there so is often fatal 30,000
Deaths in US every year so we talk about the futuristic prevention of sudden cardiac death which is that in AR light here we felt let us move forward into the future how do we make sure that we respond to a patient who could die suddenly in Arad and hell and make that
Difference we want that rapid detection of situation that can lead to kind death we have the automated electronic and automatic deflators everywhere at the same time we want to make sure that by want to create an app that can tell us where the defibrillators are in the hospital so
That if anybody Falls or there is a sudden need for a defibrillator you can look at your phone quickly and say yes this defibrillator is in this place and we can grab it straight away and shorten the response time to be able to to help the patient survive so that’s what we’re
Doing now so sudden death itself is an interplay of lifestyle choices and environment it comes together with genetic kind of predisposition heritable acquired age interplay of several things environments that interplay when it comes together it can lead to sudden death so that’s where I’m going to end
The talk and give you some time for questions thank you very much thank you Dr we it was a very informative um session so in the chat we have three questions um the first one he says please can the doctor suggest relevant test to be conducted to identify if
There are major risks or signs of certain death one need to one needs to wash out watch out home yes thank you for the question um the kind of test we can carry out to prevent Sor C death are what we do in the ambulatory Clinic here we make sure
That based on the age of the person most of our patients have are above 40 at that time you have mostly acquired causes or likely causes of heart disease or likely causes of POS or risk factors for sudden cardiac death it starts from your blood pressure we help you manage
Your blood pressure efficiently and give you scheduled appointments we make sure that you are not diabetic if you’re diabetic we control it we control your blood sugar we also look at your serum uric acid which is also a risk factor for heart disease and which has been recognized by the European Society of
Cardiology recently as one of the Baseline investigations we do that here so we make sure that if that uric acid is high we try to bring it down to normal and then again one of the tests we also do here is to make sure that if you experiencing chest pain we don’t
Take it that oh it’s peptic caler disease or or any other or IND digestion we think about the worst that can happen to you and we go to the algorithm of chest pain you get an ECG straight away and a tropon using a stateof thee earthart handheld analyzer which tells
Us the level of a hormone our Nam are coming from your heart we can tell us whether you’re going to die or not and that’s the troponin I and trolin C so we do all those test once you’re normal you can say that your risk of sing cardiac
Death is reduced to the beest minimum okay thank you sir um Mr samel asks that can a diagnosed first degree heart block be reversed since it is asymtomatic will it progress or remain the same under proper lifestyle management yeah a first degree yes hard block itself you have um
Type one type two and type three type two A and B is there movies one and two so type one is benign I mean like he said is asymptomatic but once you see type one just observe depression and see what’s happens type one can be associated with so many disease diseases
Type one heart block can be associated with hypertension diabetes can be associated with structural heart disease structural heart disease as at the same time you may just be something that you find as an incidental finding in a normal person so the kind of management is You observe repeat ECGs and see
Whether there’s a progression from type one to type two or to type three most of the time patients with type one heart block has nothing to worry about but at the same time in the arite here we try to follow them up with scheduled appointments hello are you there yes yes the next
Question can a hypertensive patient participate in fasting patient patient participate in fasting yes yes yes a hypertensive patient can participate in fasting it’s based on your religious commitment but from the Cardiology point of view you need to control your blood pressure and taking your medications with a little
Quantity of water is not should not be something that should affect your commitment to your God or to your fasting or to the tenants of your religion taking your medications should not be it’s not a form of food so taking your medications is more or less a
Wisdom thing that yes I need to take my I recogn recognize that I I have hypertension and I need to take my medications yes you can take your medications while you’re fasting and the fourth question is it possible for B passy stroke related to have a normal face after years um
Patient the question is is it normal for somebody who has a facial deformity in stroke to be normal after a year right yes okay um this question will be better answered by a neurologist I’m not a neurologist but at the same time um from patients we’ve seen the recovery of neurological
Deficits in patient is very diverse and it’s very very much um individual some patients will have or and also based on the type of stroke the person has that led to that facial deformity it’s been documented that patients with hemorrhagic stroke that is bleeding in the brain have very serious
Neurological deficit which is dense at the onset so the facial deviation will be very very significant at the beginning at said for patients with bleeding in the brain but once the bleeding stops and over time they recover and that facial deformity can recover within probably 6 months but if
It’s schic stroke that is the kind of stroke that happens because there’s a blockage partial blockage of blood vessel of of the blood vessel and blood supply to the brain is schem to can can be mild at onset as the facial deformity can be mild initially then it takes a
Longer time to recover so it depends on the type of stroke and the same individual variations are there but um it’s better you refer this question to a neurologist rather than a cardiologist hello okay the next question should someone on a hypertensive drug still bother about a one of chest pain and mind
Skipping you know in your talk you mentioned um that part of the signs is the chest pain not should that shouldn’t be ignored and they should come in to check at the hospital so is this something that after a oneof pain they should ignore or still coming okay the question is um that
Somebody who is hypertensive and now has chest pain on one location should ignore whether they should ignore it or not or come into the hospital my answer is please come into the hospital come into Arad and we’ll do a cardiovascular screening for you and we’ll be able to say whether that chest
Pain should be ignored or not because it will be a precursor of something more catastropic or it may not be anything but you need to come to the hospital for specialist to specialist management and review next the next question please what do you recommend for Primary Care GPS to do to do
Suspected sou cardiac emergencies what do you the question is what you GPS GPS what do you what do you suggest for a what sorry please sorry I didn’t get the question please what do you recommend for Primary Care GPS to do suspected sudden cardiac I think that question itself is not clear
Mr yeah I can hear you now what do you I suggest for I think we should just go to the next we’ll come back to it the question is not quite clear okay a patient was diagnosed with h high high BP and placed on hyperintensive drugs I
Have done ECG and all Eternal tests and shown all to be normal but with the drugs taken and rest I am getting home I’m getting some fast heart rates could this be side effects of the drugs like Jan amodine and in this Cotin okay by my understanding from your question he said this patient has been taking medications and you can go ahead hello are you there yes we can hear you okay um the answer to that question about or the person is taking their their medications for hypertension they
Get home and they have a fast heartbeat the answer to that is that if you have a fast heartbeat when you got home and you feel uncomfortable with it you cannot breathe well or you feel like fainting or you have a chest pain with it please come back to the hospital
You need a better review maybe some drugs well it’s very rare for anti-hypertensive medications to cause a fast heartbeat because many of the antihypertensives that we use actually reduce the heart rate so if that happens that you have a fast heartbeat when you get home on anti-hypertensives please come back to
The hospital for an evaluation and we’ll be able to help you right thank you Doctor the next question at what stage should one consider surgery to correct structural heart disease the question is at what age should at what stage stage stage at what stage yes should one consider surgery
To you one consider surgery to correct structural heart disease heart disease yes yes the stage is the stage at which you correct structural heart diseas is when you find out that you you cannot cope with activities of daily living once there is exhaustion or you reach the terminal end of medical management
If with medical management one cannot carry out activities of daily living one needs to correct it and then again in young people in babies it’s much better to correct any structural heart disease at that young age than to wait for for the person to grow older this question is better
Answered by a Pediatric Cardiologist in that section but adults who have structure heart disease once they cannot carry out their activities of daily living without symptoms they should go for correction hello did you get doctor yes I you’re welcome got it the next one Are there specific exercises that is recommended to
Prevent um some of this conditions that can lead to sudden deaths yes the question is um are there exercises that one can do to prevent sing kardiac death yes there are exercises one can do the first one is that you one has got to accept exercise as a lifestyle change as a lifestyle
Thing not necessarily exercising and stopping enjoy exercise just like you enjoy going out watching movies and so like that and um one wants to do what call resistance training and also um cardiovascular training that is you want to make sure that you do cardio by running at least 30 minutes most days of
The week 30 minutes for most days of the week running or walking based on your body mechanics walking fast 30 minutes most days of a week for cardiovascular endurance that gets the heart stronger once the heart is stronger it functions at it better and efficient more efficient level and then weight training
Weight training also helps the body to function better and strengthens the hearts to helps the hearts to pump blood oxygenated blood to all parts of the body and the person can actually feel better and the outcome is us better and this can prevent certain CC death so as
The heart is growing stronger the likelihood that you have high blood pressure is much much much lower and your glucose control which is also much important the glucose control become better with exercise so like I would recommend 30 minutes of walking fast in a safe neighborhood at least most days
Of the week at least minimum three times a week and lifting weights also if there’s a gym around your house join a gym lift weights go through that let the gym instructor guide you as to the use of weights and continue daily make make it a routine don’t make it a start and
Stop thing I know most people are pressed for time but start it’s better to start and not to start so those exercises but before you start any exercise you need to see your cardiologist first do the general and basic basic investigations and letting be able to clear you for
Exercise next pleas thank you Doctor um the next question is regular heart Bor a symptom of cardiac related issue is regular heart block a what heart bur a symptom of cardiac related issue yes is the question is is heart block a symptom of cardiac related issues yes heart block is associated
With several cardiac conditions heart block is associated with hypertension sorry heart bone heart bone oh heart bone okay yes okay heartb burn yes heartb burn is well heartb burn is important is I’m glad this is about the best question that you’ve asked heartborne belchin if you Belin if you
Heartb come to the hospital for screening because anatomically the the your esophagus and your stomach is very close to your heart heart attack Sol kardiac death can be like heart bone heart can mimic the pain of a heart attack about to happen so if you say it’s just heartb it may just be
Something as it may actually be chest pain of sudden cardiac death that is starting come let us tell you that this is heartborne and this is not hard Bor don’t say this is hard Bor and you sit down at home when you are especially when you above 40 and you are much more
Prone to esic hard disease a lot of people eat a lot and they have hard born when they want to sleep mountains of food if you see some people eating you will know that there’s there’s really no no no starvation in Nigeria they develop hard bone but at
The same time when you develop This Heart bone it can be a sign of heart disease because the thoracic plexus the nerves that suppli the esophagus also supplies part of your heart so they are Clos related structures you if you having repeated heartb you can take your
Anter seed yes but coming to to the hospital let us tell you that this is heartb this is not heart disease ComEd you understand yes understood okay um one of our um one of the participants what has a question about an hypertensive um patient who was consistent with his medication and
Followups consultation with the cardiologist also with adherance to the advice or he ended up dying of pulmonary embolism two months afterwards so the person would like to know what would have been the cause of this and how better can we avoid avoid the repetition in Future Okay um so the question is about
Someone who died of ponary embolism and was hypotensive and has always been taking the medications and going for clinic visits if this is the question yeah if this is the question well the answer is that PO embolism has to do with throwing of cloths from any source
Of the body but most likely the legs into the lungs that is pulmonary embolism that is blockage of the vessels and lungs and the person cannot breathe well the pathophysiology that is the way it happens is similar to a heart attack that is Harding like I mentioned in my
Presentation p bism is one of the causes of sudden cardiac death the person may have an acquired cause of that person has just gone to Canada flown flown to Canada on a on a continuous flight or Australia Long Hall flights or um just have a rare genetic condition whereby
The blood of this person clots has a tendency to clot to thicken more than the others I’ve seen that kind of patient here in the in the in AR where you have a young man of 35 suddenly faints and comes to the hospital you find out that
He has blood cloths everywhere and he’s not taking anything that is’s making his blood cloth and you find out that you have to ask for all those what they call rare genetic disorders that can lead to cloting they say rare because maybe some people don’t maybe it’s not well
Searched out for no once there is a cardiac condition and the person comes to the hospital regularly the high likelihood of certain cardiac death is reduced but when you talk about pulmonary embolism it will have been given some signs and symptoms before the person dies suddenly and if it happens
Suddenly it may be that the real cause has not been discovered so there are two diseases of different pathopysiology but also similar at the same time the conclusion is that embolism itself the risk factors are similar to heart disease but at the same time they separate so it for me that some other
Things led to that embolism very rare like that um question yes the I think this will be the last for today I want to thank everyone for participating fully the last question is what do you recommend Primary Care hcps GPS do in suspected certain C emergencies okay very good question once
A p a patient comes to you the age is very important the age is very important if somebody presents to you at an early age before the age of 40 in that graph I showed you if somebody presents with chest pain before the age of 40 the likelihood that the patient has ischemic
Heart disease or mocal infection is very low that likelihood is low before the age of 40 but if the patient still has chest pain you still need to rule out a cardiac problem so you go to the algorithm you admit the person you make sure that you place oxygen you make sure
The patient is breathing you get an IV access you draw blood you look for certain markers in the blood troponin is very important you do the Baseline Laboratory test full blood count total differential electrolytes and Ura urinalysis uric acid random blood sugar and the cholesterol do it for all your patients
That coming with chest pain don’t assume that ah it’s just ordinary chest pain maybe it’s m or something no young people take nowadays there’s drug abuse in Nigeria drug abuse can predispose to having heart attack at a very young age so you got to be very much aware of this
Order all those Baseline investigations for Young People Order the troponine also and will tell you whether this patient is having a time if the patient is above 40 that is even much more relevant if the patient is above 40 you want to make sure that you do that same
Thing too make sure the patient has the airway intact is breathing and get an IV access you draw the blood straight away for the full blood count total and differential electrolytes and Ura urinalysis uric acid random blood sugar and the blood glucose you do all that then the toonine
ECG ECG chest pain means ECG chest pain means ECG and if you know that you are not so comfortable with ECG snap that ECG and send to a Cardiologist you can send it to AR here we will analyze the ECG for you and give you a feedback and tell you
What to do a lot of hospitals do that with us as well myself I receive a lot of ECGs from peripheral hospitals and I interpret it for them and send it back to them those peripheral Hospital are our spokes because we here is our hope for AR but we have other spokes so
Spokes means other branches of AR multip Specialist Hospital in Lagos the doctors there we’ve trained them that if you have any patient with chest pain many of some of them are medical officers or general practitioners any chest pain you go through the algorithm make sure your patient is breathing make
Sure that you have placed oxygen IV access draw the blood straight away pleas espe the topon do the ECG just X if you don’t understand ECG send it to the hub here which is where where I am here as a specialist cardiologist and I will interpret the ECG take a decision
Even though I may not be there or the patient is far away so for all GPS you need to have a cardiologist as a backup for your operations that makes you very safe doctor you don’t have to know everything in detail because you’re a generalist but for high impact diseases
Diseases that are major that can lead to Major adverse cardiac events like heart attack you must have the back off of the cardiologist and do an ECG stabilize the patient do an ECG send it to cardiologist get return and manage the patient accordingly have I answered a question yes thank you Doctor
Um and can you please unmute your mic Mr mu you are hello hello Mr can you hear me yes I can hear you than hello hello can we can you hear hello hello can you hello yes go ahead please yes go ahead please okay I’m sorry it’s like I can
Hear some Echo I’m calling from very far away I’m at the moment here in Australia I was one of your patient before I left Nigeria just last year I just want to ask um um does um heavy snoring have any bearing to heart disease please I hope you can hear
Me okay I can hear you you asked the question that does um snoring have any relationship with heart disease yes the answer is yes the answer is yes it does has snoring snoring has to do with um inhibition prevention of of um adequate air getting into the lungs due to obstruction of the
Flow in the Oro Farin yes once that happens you have period of hypoxide that is lack of oxygen in the to the heart and to the brain periodically when the person is snoring and when that happens initially it may be asymptomatic but over time it can lead to what you call call ponal
That is stress on the right side of the heart and once the right side of the heart develops disease it affects the left side of the heart so the heart itself can fail over a period of time if there’s um snoring it’s called um obstructive sleep up and it can be
Corrected most of the time it may be positional and you may need to adjust your position to prevent snor or it may be de rapid weight gain so you may need to um try and reduce some weight which is challenging but you can achieve it and um the other thing is if those
Preventive measures don’t occur don’t don’t kind of solve the problem one can go into a what you call sleep studies and go on to the CP use the CP continuous positive airway pressure that will will help increase the flow of oxygen to the lungs and to the heart and correct the
Snoring Sometimes some people Advocate Palatine surgery or surgery in the orar to widen the orings but most of the time snoring can be taken care of by preventive measures try to lose weight or you change your position and or you see a slep specialist who will determine
What is going on and be able to correct it but yes snoring over time can lead to pulmonary hypertension that is high blood pressure in the right side of heart heart right heart disease and left heart disease and a failure of the heart can also lead to arhythmia the heart will just bleeds
Erratically that’s over time so it’s good to correct smelling next have I answer a question yes you have thank you so much is unfortunate that we didn’t get to um um to examine this while I was still in Nigeria but hopefully I’ll be back sometime later this year then I’ll come
Back and um and see you thank you so much I think question thank you yeah next please okay um to answer Mr Valentine about our locations yes our drill locations you can come in for any of this test has mentioned by drya we have locations in is we have in
Ag we have a spoke at pen Cinema and a Spoke also at J M EA and also spoke in Bala and the uh Branch two in bada where we have the standard building and the plus building so yes you can come in for the test and we have specialist on ground
Like Dr ad we and yes you can call me um I think that will be all for now do we have any other questions okay the last question yes someone just asked is how registered with hmos yes you can use your hmos if registered with Al Hospital
Yes you can um the last question what is the major cost of blood cloth on the vein can the blood can the cloth lead to severe body pain and what is the solution to this clot from Mr Joseph okay did you get that the question is um there blood plots okay
What is the cause of blood clots where in the vein in the vein oh okay yes like I like I mentioned some conditions predisposed to blood clots in the veins some it can be hered Tre and it can be acquired heredity means that some people just have bad
Veins in their legs and that can predispose them to blood clotting in the in the veins and the legs and then they are throwing blood clots into the lungs and it cannot breathe well it can cause stroke that is heredity then some people can have some abnormal proteins in their
Blood that makes their blood just cloth like I mentioned they are hyper coagulable they just have this tendency to cloth because of some genetic random genetic variation or mutations so when that happens then you need genetic testing genetic testing to to discover the highly effective um um load of of
What is really going on those those genes that are abnormal you to really know that you may you may have to be on medication for life if the cost of that cloting is hereditary that’s the reason why genetic testing is important but if it’s an acquired cause of clots in the
In the in the body like you’ve traveled to Australia you are sitting down sedentary lifestyle you’re always sitting down you’ve traveled so far to C your back 13 hour flight you know or you sit down for a long time or you you have that um problem with um uh thickening of
The vessels like pollution also like I said pollution also can affect the thickening and narrowing of the vessels or roughening of the inside of the vessels that leads to the tendency to clot then if you remove those factors that are that are likely leading you to clot then the person will not likely
But when it happens and we know that in the hospital here there are medicines you can use they called anti-coagulant and we’ve managed several cases of patients like that here in arela patients will shle from Mainland to irand every day for 30 years at the
Same time when they now come to arel out here they said Doctor I have pain at the back of my legs you do a scan of of the legs that they have blood clots they always sitting down it go slow between mland and isand and that kind of thing
That kind of stasis that is the blood just standing there and they wear tight shoes and they just sit in the car like that we tell them you have to make sure you remove those tight shoes you try to be ambulant instead of sitting down all the time they don’t exercise they don’t
Do anything but we give them anticoagulants that is something to clean their blood and they do well we’ve had almost 100% success with here in managing people who have blood clots so I hope I’ve uh answered your question hello all right thank you so much Dr that will be all for
Today um we’ve all been informed it was a vast topic that everybody participated and gained one or two from thank you for all Jo and thank you Dr for delivering this so well um that’ll be all sh then for all asking about our locations we’re going to share um presentations link um the
PDF of our all location
1 Comment
Very Informative webinar. Thank you.