Sudden cardiac death

Sudden death in a young person is a devastating event for any family. Unfortunately, in many cases this can be the first presentation of an underlying heart condition in an otherwise healthy person. A range of inherited heart conditions can cause sudden death and therefore it is important to investigate family members following such an event. There are two main types of inherited heart conditions, i.e. those causing electrical or structural problems in the heart. Electrical problems include long QT and Brugada syndromes, while structural problems include hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy.

When a person dies suddenly, a post-mortem (also known as an autopsy) is often performed to determine why the individual died. Some heart conditions are more easily diagnosed at post-mortem than others. In particular, structural causes of sudden death can be determined at post-mortem since the heart may be thickened, enlarged or structures within the heart, such as blood vessels and valves, may be abnormal. The heart often appears “normal” in those who died because of electrical problems of the heart, such as in long QT syndrome. The abnormalities in the heart are often at the cellular level and cannot be seen at post-mortem. These post-mortems, where no abnormality is found in the heart, or other structures in the body, are often called “unascertained” or “undetermined”, meaning no direct cause of death was identified.

Grief

Grief is a normal reaction to the death of a loved one. Although it is associated with a period of intense suffering, for most people it does not require the help of professional counsellors. For a minority however, grief reactions can be significant and prolonged and interfere with day-to-day functioning. The sudden and unexpected nature of the death can impact on the grief response leading to what is known as a complicated grief reaction. If you have experienced a sudden unexpected death you may benefit from talking to a counsellor.

Grief is often perceived as something to “get over” in a fixed period of time. In fact grief is not a straight, linear process; it is circular and cyclical and can be described as occurring in phases. There is much overlap, and passing back and forth through these phases. The general view these days is that bereaved individuals do not “get over” their loss and get back to normal, but rather adapt and adjust to the changed situation.

Grief reactions can be described as emotional, behavioural, physical and psychological. Some common reactions are listed below;

• Emotional grief reactions - depression, despair, anxiety, guilt, anger, hostility and loneliness.
• Behavioural grief reactions - agitation, fatigue, crying and social withdrawal.
• Physical grief reactions - loss of appetite, sleep disturbances, energy loss and exhaustion.
• Psychological grief reactions – preoccupation with thoughts of the deceased, lowered self esteem, helplessness and hopelessness, a sense of unreality and memory and concentration difficulties.

A range of support services is available to assist bereaved persons through their grief process. Below are some websites of support groups, alternatively speak to your GP or local community health centre for more information.

Support Groups
SADS www.sads.org.au
NALAG Centre for Loss and Grief (Australia) www.nalag.org.au
Lifeline Australia www.lifeline.org.au Lifeline New Zealand www.lifeline.co.nz
Skylight www.skylight.org.nz

Thanks to Ms Colleen Fitzpatrick, Senior Counsellor, Department of Forensic Medicine, Glebe, Sydney Australia for help with the section on grief.

Registry contacts Registry Coordinator: Ms Jodie Ingles
QLD - Jodie Ingles, Royal Brisbane & Women’s Hospital 07 3636 3244
NSW - Laura Yeates, Centenary Institute & RPA Hospital 02 9565 6187
VIC - Vanessa Connell, Royal Children’s Hospital 03 9345 5724
VIC - Tina Thompson, Royal Melbourne Hospital 03 9342 7151
VIC - Ivan Macciocca, Genetic Health Services Vic, 03 8341 6201