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Chapter 91: Sudden Cardiac Death

Which of the following statements is correct regarding the incidence of sudden cardiac death (SCD)?

A. The annual incidence of SCD is higher in whites than in African Americans in the United States

B. SCD accounts for approximately 50% of all sudden deaths in patients younger than age 20

C. The majority of cardiac arrest victims are women

D. The average age for SCD is under the age of 60

E. The incidence of SCD in the United States, Europe, and Asia is approximately 40 to 100 SCDs per 100,000 persons

The answer is E. (Hurst’s The Heart, 14th Edition, Chap. 91) Recent data from the United States, Europe, and Asia have demonstrated an incidence of approximately 40 to 100 SCDs per 100,000 persons1-6 (option E), with significant geographical variation. The majority of cardiac arrest victims are men (option C), and the average age is more than 60 years (option D).1,2,7 The incidence of SCD increases along with the prevalence of ischemic heart disease at older ages.8,9 This trend is independent of gender or race. SCD accounts for approximately 20% of all sudden deaths in patients younger than age 20 (option B).10 Structural cardiac abnormalities can be identified in the majority of young victims of SCD11; however, autopsy-based studies suggest that 20% to 35% of sudden deaths in young adults occur in the absence of identifiable structural abnormalities.12,13 Many of these deaths are likely caused by genetically based arrhythmogenic disorders. The annual incidence of SCD has been shown to be higher in African Americans than in whites in numerous studies.8,14-16

A 60-year-old man presents to your clinic for his yearly visit. You are counseling him on lifestyle factors and their correlation with the risk for SCD. Which of the following statements is incorrect?

A. The Physicians’ Health Study demonstrated a decreased risk of SCD in men who consumed light to moderate amounts of alcohol (two to six drinks per week) compared with those who drank rarely or never

B. Smoking decreases the ventricular fibrillation (VF) threshold

C. Those that stop smoking have a prompt reduction in coronary heart disease mortality rate irrespective of the duration of previous tobacco use

D. In a substudy of the Physicians’ Health Study, increased levels of omega-3 fatty acids were associated with a reduced risk of SCD, but fish consumption and omega-3 fatty acid ...

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