What is sudden cardiac arrest?
Sudden cardiac arrest (SCA) is a condition in which the heartbeat stops abruptly and unexpectedly. This usually is caused by ventricular fibrillation (VF), an abnormality in the heart's electrical system. The ventricles (the two muscular chambers of the heart that pump blood) may flutter or quiver erratically (ventricular fibrillation). Consequently blood flow to the body and, most importantly, to the brain stops. The person suffering from sudden cardiac arrest will lose consciousness and die In fact, the victim is often clinically dead within 30 seconds of this event. Although their heart will continue to "flutter" and their eyes will remain open and even look like they have life in them for several minutes and even hours in some cases, they are brain dead within minutes.
Is SCA the same as a heart attack?
No. A heart attack is a condition in which a blood clot suddenly blocks a coronary artery, resulting in the death of the heart muscle supplied by that artery (unless the clot is opened within a few hours). Heart attack victims usually experience symptoms such as chest discomfort or pain and remain conscious. Most people who have a heart attack survive the event. Some will develop an SCA. Other people have an SCA independently from a heart attack and without warning signs. SCA results in death, is generally untreatable, and is confirmed upon autopsy.
Who is at risk for SCA?
Most commonly people who die from SCA have an underlying cardiac condition. They have heart disease, like congestive heart failure, previous heart attacks and are older with a myriad of health problems. These are the kind of people who often die from SCA.
However, SCA does occur in active people who are healthy and have no known medical conditions occasionally. In these patients, the cause of SCA may not ever be determined, even with an autopsy. This was true for Justin as well, a full autopsy was completed.
Now let's talk about Justin. Did he have a heart condition? No, his heart was healthy on autopsy. There were no signs of congenital diseases, like Hypertrophic Obstructive Cardiomyopathy (the condition that kills young healthy athletes). There were no signs of stenosis, dilatation, obstruction, plaques, or ischemia. In other words Justin's heart was a healthy heart. The official diagnosis will be Sudden Cardiac Arrest (SCA) of unknown etiology. All of us have irregular heartbeats from time to time. Some call them palpitations, some call them skipped beats. Patients come into the Emergency Room all the time with palpitation and skipped beats. Thankfully most of the time our hearts recognize these abnormal beats and correct for them. We might not even realize it has occurred. Unfortunately, in some individuals their heart does not recognize this abnormal beat and does not correct it, which causes the heart to go into ventricular fibrillation (VF), leading to a quick, painless brain death followed by full body death. When SCA occurs, often the person has underlying heart disease or a heart condition and this is the cause of the SCA. When SCA occurs in a healthy individual like Justin without a heart condition we are often left without any answers as to why the heart did not recognize the abnormal beat and fix it or "re-start" the regular rhythm.
Justin died long before Stephanie heard his "snoring" and tried to awake him. The "snoring" sound was most likely agonal breathing or "death rattle" indicating Justin had been brain dead for several minutes, if not longer. There was no saving Justin. He was truly taken from this earth and went peacefully in his sleep without any knowledge of what was happening. He kissed Stephanie goodnight and that was his last memory.
I was able to speak with the coroner before, during, and after the autopsy, and, thanks to Staci, we have many of the medical records including the paramedic and ER run sheets, and spoke briefly with the doctors who treated Justin. I have tried to write this explanation is in a straight forward manner but as you can imagine there is nothing straight forward about losing my healthy 35 year old brother and best friend.
Please feel free to post comments or ask questions. I am happy to answer any questions or better explain for those who feel they want a better understanding.
Sincerely,
Jared Marcucci
