Sudden death: getting to the heart of the matter

It might be every parent’s worst nightmare, but it nonetheless happens with alarming frequency in Ireland. Every year, an estimated 40 otherwise healthy young people in this State will die from Sudden Adult Death Syndrome (Sads) or Sudden Arrhythmic Death Syndrome. Who does it affect – and is screening an effective way to protect you and your family?

What is Sads?

Sads is typically used to refer to a sudden death when a postmortem has shown no other potential cause of death. It is sometimes confused with a sudden cardiac death, which is when someone dies suddenly and unexpectedly, but there is a cardiac issue behind the death.

When it’s a sudden cardiac death, for example, a postmortem will typically show up problems such as a blockage in a coronary artery.

With a Sads death, however, there can be little to indicate what caused the death, which is often due to electrical problems in the heart known as “channelopathies” or “ion channel disorders”.

“There’s nothing to find on a postmortem and there’s no answer. It’s horrendous for a family,” says Dr Catherine McGorrian, a consultant cardiologist and physician with the Mater Misericordiae University Hospital.

How common is it?

With about 40 deaths a year in Ireland, deaths from Sads are not as common as might be perceived.

However, as McGorrian notes, while they might be rare, “they are also absolutely devastating”.

Moreover, when it comes to deaths of those aged under 35, Ireland appears to have a higher incidence than other countries. “We do have numbers that may suggest we have an elevated rate in Ireland, but we don’t really know why,” she says.

Is there a screening programme?

The Family Heart Screening Clinic at the Mater is a charitable venture and survives only because of donations.

Given its limited resources, it focuses on screening high-risk patients – families where there has been a diagnosis of a condition, or where someone old or young died for no known cause.

While there have been many calls for a broader screening programme in Ireland, the challenge is who would do it – and, more importantly, who would pay for it.

There is little public funding for screening, and while the Government published a report by a taskforce on sudden cardiac death in 2006, little has been done since. As McGorrian notes, while the report made some “great recommendations”, it has largely languished since publication.

The one area where there has been progress is in screening for high-risk patients, which are carried out in the Mater and at the Cry screening centre in Tallaght.

It is for these reasons that Ed Donovan founded Heartaid, which provides a mobile screening service, 2½ years ago.

Typically, he provides a screening service in a group setting, and given high-profile Sads deaths among GAA athletes, has joined up with the Gaelic Players Association to screen all inter-county players.