Around 5 million americans experience heart failure and 250k die of it annually. Incidence and prevalence are arising given the increasing average age of the population and the life style deterioration. Despite improvements in the therapies, prognosis for heart failure remains poor with a probability of 20% of death after 1 year from the diagnosis and >80% after 8 years. Of them up to 50% are unexpected, an event called "sudden cardiac death" (SCD). SCD is produced by a lethal cardiac arrhythmia, most often ventricular tachycardia or fibrillation with bradyarrhythmias and pulseless electrical activity occurring less frequently and generally in hearts with more advanced structural disease. Mechanical or vascular catastrophes like a pulmonary embolus or cardiac or vascular ruptures are also possible causes.
She's just standing in the living room of her new home after another long and stressful day at work. She used to be quite athletic practicing cyclism at a competitive level but thing changed and now even a flight of stairs seems too much. She has now a completely sedentary life style passing the whole day at the office. Relying on fat/sugar rich comfort food is typical in these cases as it is to binge drink during dinner. With some individual predisposition all the risk factors are present and now her heart has become too weak. If you could look through her chest you'd see that her myocardium (muscular wall of the heart) has become too thin like it would have been for any neglected muscle. Fat buildups in her coronary arteries realized small, localized and silent infarctions making her heart even weaker. It would be enough to put an ear on her chest and just listen to her beats to realize there's something wrong with it but who ever goes to the doctor in time?
Her heart stumbles, skips and takes pauses continuously... each beat can be last one.
Suddenly her heart throughs a PVC but this time the classical pause after it lasts for too long turning into asystole, her heart gives up and stops beating.
I remember I once saw an autopsy of a woman died of this condition. Her heart literally looked like and had the same consistency of a plastic baloon filled with water.
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