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Even though 50% of men and 63% of women fall victim to SCA without any prior symptoms of heart disease, the American Heart Association cites several conditions or situations that may lead to SCA.
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Heart Disease
Underlying heart disease - either known or unknown - is nearly always found in victims of SCA. Typically in adults this takes the form of atherosclerosis. In 90% of adult victims of SCA, two or more major coronary arteries are narrowed by atherosclerosis; scarring from a prior heart attack is found in two-thirds of the victims. Therefore, the risk factors for SCA include similar risk factors for atherosclerosis, such as smoking and high blood pressure.
A heart that's scarred or enlarged from any cause is prone to develop life-threatening ventricular arrhythmias. The first six months after a heart attack is a particularly high-risk period for SCA in patients with atherosclerotic heart disease. A thickened heart muscle from any cause (typically high blood pressure or valvular heart disease) - especially when there's congestive heart failure too - is an important predisposing factor for SCA.
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Heart Medications
Under certain conditions, various heart medications can set the stage for arrhythmias that cause SCA. In particular, so-called "antiarrhythmic" drugs, even at normally prescribed doses, sometimes may produce lethal ventricular arrhythmias ("proarrhythmic" effect). Regardless of whether there's organic heart disease, significant changes in blood levels of potassium and magnesium (from using diuretics, for example) also can cause life-threatening arrhythmias and cardiac arrest.
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Recreational Drug Abuse
In people without organic heart disease, recreational drug abuse is an important cause of SCA.
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Other Causes
Less often, inborn blood vessel abnormalities, particularly in the coronary arteries and aorta, may be present in young sudden death victims. Adrenaline released during intense physical or athletic activity often acts as a trigger for SCA when these predisposing conditions are present.
Other factors such as respiratory arrest, electrocution, auto accident, drowning, choking, or trauma can cause SCA. With children, it can also occur from SIDS, overdose, poisoning, and illness. A hard blow to the chest can bring on cardiac arrest, as seen in children struck by a baseball or playing lacrosse.
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