Understanding Sudden Fatal Heart Attacks: Causes and Preventive Measures – By Dr Harold Gunatillake

Overview:

Globally, cardiovascular disease continues to be a primary cause of mortality, accounting for 17.9 million fatalities in 2019, with approximately three-quarters of these deaths occurring in low- and middle-income nations, as reported by the World Health Organisation. Eighty-five per cent of these cardiovascular fatalities were due to heart attacks and strokes. Contributing risk factors encompass poor dietary habits, insufficient physical activity, tobacco use, alcohol consumption, and environmental pollution.

Sudden cardiac events have become increasingly prevalent in contemporary society, impacting individuals of diverse age demographics and lifestyles. Although advancements in healthcare have enhanced survival rates, comprehending the underlying causes and implementing preventive measures are essential in addressing this significant global health challenge. Sudden cardiac events and cardiac arrest occur when the heart ceases to function unexpectedly, often resulting in fatality. This discourse does not pertain to individuals who experience myocardial infarctions and survive through appropriate medical intervention; instead, it focuses on the reasons behind the sudden cessation of cardiac function, which can lead to death.

Individuals diagnosed with coronary heart disease possess a significantly elevated risk of experiencing a fatal heart attack, primarily attributed to the failure to adhere to an appropriate lifestyle. Nevertheless, despite maintaining strict discipline, it is not uncommon for individuals to encounter the reversal of such conditions.

Sudden fatal heart attacks may occur even in the absence of a prior history of heart disease, and the reasons for such occurrences remain unclear.

According to an article by Tim Newman on April 29, 2025, in Medical News Today, a new study has found 56 lifestyle factors that could help prevent most cases of sudden cardiac arrest, according to the author.

Globally, there are an estimated 2 million cases per year related to this heart event.

The common risk factors for heart arrest are preexisting cardiovascular issues, as mentioned and the following causes, too:

*When somebody drowns or chokes

How can diabetes affect your heart?

Diabetes can affect the heart due to sudden changes in electrolyte levels, which can impact the heart. Electrolyte imbalances, particularly in potassium (K+) levels, can significantly disrupt the heart’s electrical activity and potentially lead to cardiac arrest in diabetic patients. This is because electrolytes are crucial in maintaining the heart’s rhythm and conduction. Diabetic ketoacidosis (DKA) and other diabetic complications can exacerbate these imbalances, increasing the risk of cardiac arrest.

*Electrolyte abnormalities: The primary issue is a total body potassium deficit (see Hypokalemia). Initially, the potassium level may appear elevated due to the shift of potassium out of cells in diabetic ketoacidosis. However, once the acidosis improves, the potassium levels will swiftly drop, exacerbated by insulin therapy.

*Certain medications, including antibiotics and diuretics.

Diuretics can contribute to cardiac arrest by disrupting electrolyte balance, particularly regarding potassium and magnesium levels. This imbalance may result in life-threatening arrhythmias, such as torsades de pointes, which can subsequently progress to cardiac arrest. Furthermore, the administration of high-dose non- potassium-sparing diuretics, particularly in patients with left ventricular dysfunction, may elevate the risk of arrhythmic death.

Numerous risk factors associated with sudden cardiac death may include tobacco use, an unhealthy diet, and insufficient physical activity. The primary contributors to sudden cardiac fatalities include tobacco smoking,

excessive daytime napping, prolonged television viewing, inadequate consumption of fruits and vegetables, and difficulties in waking up.

There are also factors found

associated with a reduced risk of sudden cardiac arrest, and these include:

Regular vigorous physical activity drinking alcohol

drinking red wine

drinking white wine and champagne.

Scientific literature extensively supports the benefits of moderate alcohol consumption. In this context, the intake of red wine has been associated with a reduced risk of coronary heart disease (CHD).

Experimental studies and meta- analyses have primarily attributed this effect to a diverse array of polyphenolic compounds in red wine, including resveratrol, catechin, epicatechin, quercetin, and

anthocyanin. Resveratrol is regarded as the most effective compound in wine for preventing CHD due to its antioxidant properties.

Choice of Diet:

It is essential to reduce inflammation daily through a balanced diet.

Choosing to cut back on highly processed foods, such as processed meats and packaged snacks, can make room for more nourishing, anti-inflammatory options like delicious fruits, vibrant vegetables, wholesome legumes, crunchy nuts, satisfying seeds, flavorful oily fish, and hearty whole grains.

Stress and Lifestyle Factors

Chronic stress, along with our increasingly sedentary lifestyles, plays a significant role in heart attacks. When stressed, our bodies release hormones such as cortisol, which can lead to higher blood pressure and increased strain on the heart. Modern work routines, minimal physical activity, and unhealthy eating habits can increase the risk of cardiovascular disease.

Obesity and Poor Diet

The prevalence of obesity has skyrocketed due to diets rich in processed foods, sugars, and unhealthy fats. Excess body weight increases the strain on the heart and contributes to the development of hypertension, diabetes, and high cholesterol—all risk factors for heart attacks.

Genetic Predisposition

A family history of heart disease significantly raises the odds of experiencing a sudden heart attack. While genetic factors cannot be altered, awareness of this risk can guide lifestyle choices to mitigate its impact.

Sleep Disorders

Conditions such as sleep apnea have been associated with an increased risk of heart attacks. Sleep apnea interrupts normal respiration during sleep, resulting in oxygen deprivation that can place significant stress on the heart over time.

Infections or Inflammatory Conditions

Emerging research has highlighted the role of infections, such as COVID-19, and chronic inflammatory conditions in triggering heart attacks. These conditions can cause plaque rupture or arterial inflammation that destabilises cardiovascular health.

Regular Health Check-Ups

Routine medical examinations can help identify risk factors early, such as high blood pressure, cholesterol levels, or diabetes. Early intervention and lifestyle adjustments are essential to prevent heart attacks.

Medications and Supplements

For individuals identified as high-risk, medications such as statins or aspirin, prescribed by a physician, can help manage cholesterol levels and prevent blood clots. Additionally, supplements such as magnesium and omega-3 fatty acids may contribute to maintaining cardiovascular health.

Conclusion

Sudden heart attacks are a complex issue influenced by lifestyle, genetics, and our environment. While specific causes, such as genetic predisposition, may be beyond our control, there are numerous risk factors that we can actively work on to reduce.

Embracing a heart-healthy diet, engaging in regular exercise,

managing stress, and maintaining routine health check-ups can all play a vital role in prevention. Focusing on our cardiovascular health and making small, manageable changes can help reduce the risk of sudden heart attacks and lead to a healthier, more fulfilling life.

While there isn’t a single famous quote about the preventability of heart disease through a healthy lifestyle, the concept is widely supported by organisations such as the World Health Organisation and the Cleveland Clinic. Leading health bodies emphasise that a heart-healthy lifestyle, including a balanced diet, regular exercise, weight management, and not smoking, can significantly reduce the risk of cardiovascular disease. The effectiveness of these “lifestyle medicine” approaches is a key area of focus for preventing heart disease and improving overall quality of life.

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