Variety of Medical Cases Connected with SDS and the Place of Sudden - Essay Example

Introduction Amid the pressing and widely discussed social problems generated by such notorious diseases as cancer, AIDS, new epidemics like SARS or avian influenza, many of less visible health problems that endanger lives of people may remain largely unnoticed by the public. However, some of such potentially deadly conditions are still far from being fully understood, and therefore, considering the possibility which we will discuss that in reality much more people are susceptible to them than currently thought, beg for their further investigation, and for making the general public aware of them. Among such conditions is what is generally termed as the sudden death syndrome (SDS). This notion pertains to a bunch of different medical cases that may be associated with various causes. What is important, though, is that to SDS are susceptible young people who have previously manifested no visible disturbing symptoms that would suggest that such incidents might happen. In this regard, it is perhaps the most important task for the medical establishment to target the younger part of the general public in order to inform it about the risks associated with SDS. More specifically, drinking, as one of the most prevalent types of harmful behavior in young adults that may be linked with SDS, should be specifically addressed with the hope to decrease the teenage abuse of alcohol. Let us take a look at what forms SDS may take, and try to see why the investigation of the linkage between SDS and teenage drinking is important to researchers. Variety of medical cases connected with SDS and the place of Sudden Arrhythmia Death Syndrome in them As we have mentioned, SDS is the term that may be used to cover a wide range of incidents of unexpected non-traumatic and non-violent deaths due to natural causes. In fact, cases of SDS affect people with such diverse illnesses as epilepsy (such epilepsy related deaths are termed Sudden Unexpected and Unexplained Death in Epilepsy (SUDEP) (Lathers and Schraeder, 1990) and Fatty Liver Syndrome (FLS) of both alcoholic and non-alcoholic origin (Randall, 1980). As shown by research, even young athletes have something to fear, as some of them, mostly males according to statistics, fall victim of sudden deaths due to hard to detect heart diseases (Testa, 2006), and while different types of cardiovascular disease may be uncovered postmortem, any such death is quite disturbing. But perhaps the most perplexing, due to the apparent lack of underlying pathologies, type of heart-related sudden deaths is associated with Sudden Arrhythmia Death Syndrome (SADS), which is a disorder of the hearts electrical system capable of killing seemingly healthy individuals without warning. SADS is also known as Long QT Syndrome. This syndrome interferes with the length of time between the onset of the Q wave and the end of the T wave in the electrical cycle of the heart called QT interval, which is needed for the recharge of the hearts electrical system after a heartbeat. People with a prolonged QT interval are more likely to develop an abnormally fast hearth rhythm called arrhythmia. When this happens, blood cannot flow from the heart, and the person can lose consciousness and may suddenly die as the result of the brain deprivation of blood. It is currently known that this dysfunction has its roots in an abnormality of protein structures of cells in the heart referred to as ion channels. These cells indeed serve as the channels that control the flow of such ions as sodium, calcium, and potassium. It is the pattern of the inflow and outflow of these ions that generates the hearts electrical activity. It is also known that dysfunctions of these channels may be acquired, for example due to the effect of some medicines, or inborn, when a mutation in one of the genes responsible for the formation of channels occurs. In this respect, it is unknown exactly which inherited defects lay ground for different types of arrhythmias. For instance, it is thought by some researches that cases of SUDEP also work by inducing heart arrhythmia. In any case, it is clear that abnormalities related to SADS lead to the slow electrical recovery of the heart. What is also not known, though, is how widespread this condition is in reality. It was once thought that the rate of occurrence of SADS was quite low, but today there is the reason to suspect that in many instances this abnormality lurks undetected in many more people, and that SADS may be among the most common causes of unexpected and sudden deaths (Aliot et al., 2000). Therefore, the thorough investigation of all manifestations of SDS is very important to researches because what is known today may turn out to be just a tip of the iceberg. The connection between teenage drinking and SDS Now, it is not a coincidence that we have established a link between SDS and teenage drinking. In fact, today it already will hardly surprise many people that millions of teenagers in the Western countries have access to alcohol and consume it quite vigorously. It has been statistically confirmed that almost two-thirds of high school senior students consume alcohol at least once per week (University of Iowa Health Care, 1999), and some more often, so alcohol is the most popular drug among teenagers and young adults. It is also a self-evident fact for many that alcohol has some risks peculiar to young adults. Some of the most often cited ones are that alcohol may serve as the so-called 'gateway drug' that may instigate teenagers to try other drugs as well, and that in a young age it is especially easy to get hooked to alcohol and become alcoholic in the future (Claypool, 1997). The mentioning of such risks constitutes an important part of most educational programs about alcohol abuse addressed to teenagers. However, in one way or another all of the manifestations of SDS that we have mentioned earlier are also linked with alcohol and therefore should equally be not omitted from educational programs. For example, those suffering from SUDEP are advised to avoid alcohol in order to minimize risks, even though remote, of deadly outcomes, and occurrences of FLS related sudden deaths are outright associated in most cases with alcoholism. In its turn, SADS, when viewed in the context of its possible connection with alcohol consumption, is particularly relevant for teenagers. This is so because the percentage of SADS related deaths may be especially high in children and young adults as in most cases the first manifestations of this heart dysfunction take place in teenagers or pre-teens. Actually, symptoms usually emerge much earlier in males, around eight years old, than in females, who on average have first symptoms around fourteen years old. At the same time, as was shown by a major theoretical work based on a rigorous research that was initiated early in the 1970s by Dr. G. Michael Vincent and his associates and which lasted well into the 1990s, there are many young people with undiagnosed and untreated Long QT Syndrome who therefore have a high risk of dying from SADS. Moreover, it turned out that published medical findings were mostly ignored by many physicians (SADS Foundation, 2006). Thus, those teenagers who yet have to learn that they have abnormal and potentially dangerous heart rhythms may aggravate their condition by abuse of alcohol. And there is something to be worried about as SADS occurs in one in approximately 7000 people, and in the United States alone between 3000 and 4000 children and young adults perish each year due to SADS (Macnair, 2005). Now, returning back to the issue of teenage drinking it must be admitted that the exact nature of the influence of alcohol on the probability of SADS occurrence is not yet clear and demands the further research. But it is nevertheless well known that the muscle of the heart is very sensitive to poisonings by alcohol so that alcohol overconsumption may even lead to damage and failure of the heart (the condition known as alcoholic cardiomyopathy). Therefore, the risk of SADS should also be added to the already long list of negative influences of alcohol on teenagers and young adults. The logic behind the inclusion of the mentioning of the risk of developing SDS is quite clear - in contrast to somewhat vague and already customary premonitions about the prospects of becoming an alcoholic or a drug addict, teenagers might be more impressed by the persuasive evidence that sudden death may be in store for those who abuse alcohol. Remaining research questions and possible hypothesis In many points we had to admit that many physiological and statistical aspects of various forms of SDS are not yet known. In this regard, we may formulate some research questions that flow logically from our review of the problem. The first such question is what is the exact correlation between underlying physiological roots of different forms of SDS that may have similar mechanisms (like SUDEP and SADS) and the ability of alcohol to precipitate the onset of SDS The second general research question may be attributed to the heart related cases of SDS and pertains to the need to investigate exact genetic mechanisms that are responsible for Long QT Syndrome. One of the benefits of this branch of research may be that those teenagers and young adults who have genetic inclination to Long QT Syndrome may become aware of the heightened danger associated with drinking. Building on the knowledge that may be obtained from the research on the previous points, the third research question should be what is the real number of people susceptible to SDS, and what degree of emphasis on SDS in educational programs for teenagers would work best to minimize the number of actual cases of sudden deaths. Finally, we may formulate a hypothesis that the further research will uncover a complex and interdependent picture of the mechanisms of various forms of SDS, and hopefully will offer clues for their effective preventive treatment. However, before this happens, one of the early positive results of such research may be the ability for people susceptible to Long QT Syndrome to consciously form a lifestyle that would exclude risky activities. For sure, for teenagers and young adults this would most probably mean a very careful rethinking of their drinking behavior. Sources Aliot, E, (Ed.), Clementy, J., (Ed.), and Prystowsky, E. N., (Ed.). (2000). Fighting Sudden Cardiac Death: A Worldwide Challenge. Futura Publishing Company. Claypool, J. (1997). Alcohol and You. Franklin Watts. Lathers, C. M., (Ed.), and Schraeder, P. L., (Ed.). (1990). Epilepsy and Sudden Death (Neurological Disease and Therapy). Dekker. Macnair, T. (2005). Long QT Syndrome. Retrieved June 20, 2006, from http://www.bbc.co. uk/health/conditions/longqt1.shtml Randall, B. (1980). "Fatty Liver and Sudden Death. A Review." Human Pathology Journal, 11(2): 147-53. Sudden Arrhythmia Death Syndromes Foundation, (2006). History of the SADS Foundation. Retrieved June 22, 2006, from http://www.sads.org/about.html#History Testa, M. (2006). Exercise concern: Sudden death syndrome. Retrieved June 21, 2006, from http://www.active.com/story.cfmstory_id=12804&sidebar=575&category=keep_fit University of Iowa Health Care, (1999). Teenage drinking. Retrieved June 22, 2006, from http://www.uihealthcare.com/topics/alcoholproblems/alco4138.html Read More