Hi ,

How are you doing today?

We've all heard this tragic story: "How could he just collapse and die like that? He seemed so healthy! He went to the gym every day, ate well, and wasn't overweight."

While most people recognize chest pain as a common symptom of heart disease, sudden cardiac death (SCD) is often the very first manifestation of underlying heart disease that develops silently over the years.

Heart disease can develop even in regular exercisers and those who "seem" otherwise healthy.

Understanding Sudden Cardiac Arrest (SCA)

Sudden cardiac arrest (SCA) occurs when the heart suddenly stops beating effectively, cutting off blood flow to vital organs. This can cause a chaotic heart rhythm or a complete stoppage of the heart. The person loses consciousness within seconds and dies within minutes without immediate intervention.

Coronary artery disease (CAD) accounts for 80% of sudden cardiac arrest cases and proves fatal in 90% of cases.

(Additional causes of SCA are heart rhythm problems, valvular heart disease, cocaine, amphetamine use, and blunt chest trauma, among others.)

Coronary Artery Disease is a condition characterized by an insufficient blood supply to the heart, resulting from blockages caused by inflammation and immune dysfunction in the blood vessels that supply the heart.

The Hope: Prevention is Possible

Recent research in the Canadian Journal of Cardiology analyzed over 500,000 participants over 14 years, revealing that 40-63% of sudden cardiac arrest cases could be prevented through modifiable lifestyle factors.

Key Risk Factors Are

Physical Activity and Weight: A sedentary lifestyle, higher body fat percentage, and increased waist circumference.

Sleep: Getting fewer than seven hours of sleep every night.

Smoking can substantially increase risk.

Low intake of vegetables and fruit.

Mental Health: Depression, low mood, and social isolation.

Environment: Exposure to air pollution.

The Challenge of Prevention

Knowing something is preventable doesn't automatically translate to prevention. Several factors explain this paradox:

Long-term Thinking: Lifestyle changes require sustained effort over the years, while benefits aren't immediately visible. Our brains are wired for immediate gratification.

Socioeconomic Barriers: Access to healthy foods, safe exercise environments, and quality healthcare varies dramatically. What appears "simple" clinically may be practically impossible given someone's circumstances.

Behaviour Complexity: Sustainable change requires comprehensive support systems and often addressing underlying mental health challenges that both increase SCA risk and make protective behaviours harder to implement.

What can you do?

Beyond lifestyle modifications, certain tools can identify at-risk patients before tragedy strikes:

Risk Assessment: Utilize cardiovascular risk calculators that incorporate family history, lipid profiles, blood pressure trends, hours of continuous sitting, and inflammatory markers, such as hs-CRP, among others.

Testing for Lipoprotein(a) reveals genetic risk affecting 20% of the population.

Testing for ApoB100 measures harmful lipid particles, providing a more accurate assessment of cardiovascular risk than standard cholesterol panels.

CT Coronary Angiography: This is one of the most powerful tools for detecting coronary heart disease before symptoms, such as chest pain, appear. It can identify dangerous plaque buildup that causes blockages in the heart's blood vessels years before symptoms become apparent. (I will explain this in another email)

The key is transitioning from reactive to proactive care and in identifying and addressing coronary disease before it becomes fatal.

What small step would you like to take today to lower your risk for sudden cardiac death?

Best regards,

Shabnam

Dr. Shabnam Das Kar, MD

Functional Medicine Doctor

Tiny Habits Coach

Email: info@drkarmd.com

Reference:

Luo, Huihuan, et al. "Modifiable Risk Factors and Attributable Burden of Cardiac Arrest: An Exposome-wide and Mendelian Randomization Analysis." Canadian Journal of Cardiology (2025).