By: Victoria Iyeduala (Freelance Health and Wellness Writer). Medically reviewed by the DLHA Team.
Three young African adults, smiling and posing together indoor. Credit: Photo by Kwizera Theogene. Pexels.
Have you ever said or heard these statements:
“Oh my God! I can't believe he's dead! I saw him yesterday, and he looked fine.”
“What, you mean she slumped and died just like that? This is so sad.”
These are expressions of shock, disbelief and sadness. You may not have said or heard these exact statements, but you've either said or heard something similar, or experienced or heard about similar scenarios
Sudden unexpected natural deaths in young people is of public health interest. It's always tragic when someone you know, especially a young person, dies unexpectedly. We all have roles to play in the public health discussions and actions to reduce the situation in our respective communities. To do so effectively though, we need to be informed about the common causes and prevention of the condition and encourage others around us to do the same.
This article will provide you with basic and accurate infomation that you need to know about this significant health concern of sudden death in young Africa adults, especially those under age 40. Please read on.
There’s no one approved way to describe sudden death. However, the World Health Organisation's (WHO) definition describes sudden death as “sudden, unexpected, natural deaths either witnessed, and within one hour of symptom onset or, if unwitnessed, within 24 hours of having been last seen alive and symptom-free.” [1, 2]
Another definition from the European Heart Journal Supplements, 2023, says that “Sudden death is a natural, unexpected fatal event occurring within one hour from the onset of symptoms, in an apparently healthy subject, or in one whose disease was not so severe to predict such an abrupt outcome.” [3]
The Association for European Cardiovascular Pathology also defines sudden death as “a natural death that occurs within six hours of the beginning of symptoms in an apparently healthy subject or in one whose disease is not so severe that a fatal outcome would be expected.” [2]
So, we can say that sudden death is when a person dies unexpectedly of natural causes, such as an undiagnosed, unnoticed or unrecognised medical condition (they looked healthy) or an illness that is considered minor or not so severe to expect death.
Known natural causes and risk factors of sudden death
Known risk factors and causes of sudden, unexpected natural death. Click on image to enlarge.
Both noncommunicable and communicable diseases of the heart, brain, lungs and metabolic system affecting people of all ages cause sudden, unexpected natural death.
Cardiovascular diseases (CVDs) are chronic health conditions affecting your heart and blood vessels, such as arteries and veins. CVDs are the top causes of death in the world. Hence, it's no surprise that they are known risk factors and causes of sudden death. [1, 2, 4, 5, 6, 7]
Ischaemic heart disease, hypertrophic cardiomyopathy (HCM), ventricular hypertrophy, arrhythmias, pulmonary embolism, aortic aneurysm, myocarditis and congenital heart conditions like coronary artery abnormalities and long QT syndrome are known cardiovascular causes of sudden death. [1, 2, 5, 6 - 11]
Ischaemic heart disease (IHD) is a chronic medical condition where your heart doesn't get enough oxygen because the blood vessels (coronary arteries) carrying blood to your heart are blocked. IHD is also called coronary heart disease (CHD) or coronary artery disease (CAD). IHD can cause heart attack, stroke, cardiac arrest and death. It’s the leading cause of death globally and the most common cause of sudden natural death, according to research. [2, 7, 8, 12]
Ventricular hypertrophy describes the condition where your heart's pumping chambers (ventricles) get thicker than normal. Most often, it's the left ventricle that is affected (left ventricular hypertrophy or LVH). Ventricular hypertrophy impairs heart function and can cause complications such as stroke, cardiac arrest, heart failure and death.
Hypertrophic cardiomyopathy (HCM) is most often a hereditary heart disease. It's a medical condition where your heart muscle thickens. In most cases, HCM restricts blood flow out of the heart. HCM can lead to stroke, heart failure, sudden cardiac arrest and death.
4. Arrhythmias
A person with arrhythmia has an abnormal heartbeat. The heartbeat could be constantly too slow, too fast or have an irregular rhythm. Arrhythmias can affect how your heart works and can cause heart failure, cardiac arrest, stroke and death.
Pulmonary embolism (PE), or lung embolism, occurs when a blood clot blocks the arteries in your lungs. Most times, the blood clot forms in a vein in your leg — deep vein thrombosis (DVT) — and travels to your lungs. PE can cause lung damage, cardiac arrest, arrhythmia, heart attack, stroke and death.
Aortic aneurysm is a condition of the aorta, the main artery carrying blood from your heart to supply other arteries. In an aortic aneurysm, the aorta walls become weak and swell up. Over time, the swellings could burst or tear and damage the aorta. Complications can include internal bleeding, multiple organ damage, stroke, heart attack and death.
Myocarditis is a heart condition most commonly caused by viral infections, such as flu, parvovirus, human herpesvirus 6 (HHV 6), adenovirus, COVID-19 virus and HIV.
Myocarditis is the inflammation of the heart muscle (myocardium). Viruses, bacteria, fungi, parasites, drug reactions or autoimmune diseases can cause it. It can cause arrhythmias, heart failure, cardiac arrest and death.
Congenital heart conditions are birth defects affecting the heart's structure and how it works. Congenital heart conditions causing coronary artery abnormalities and long QT syndrome (fast and irregular heartbeat) can cause death.
Stroke, intracranial haemorrhage (brain bleeds) such as intracerebral haemorrhage and subarachnoid haemorrhage, and epilepsy are known central nervous system disorders that can cause sudden unexpected death. 2, 5, 6, 7, 9]
A cerebrovascular accident (CVA), or stroke, is a medical emergency that happens when a part of your brain doesn't receive enough blood. It could be due to a heart condition or a blockage of an artery carrying blood to the brain by a blood clot (ischaemic stroke) or a brain bleed (haemorrhagic stroke). Stroke can cause brain damage and death.
Intracranial haemorrhage, or brain bleed, is when bleeding occurs inside your brain or within your skull. Intracerebral haemorrhage and subarachnoid haemorrhage are two examples of brain bleeds. The first is a type of bleeding inside your brain, and the second is a type of bleeding between the tissues covering your brain. Both can cause stroke, seizures and death. [13]
Epilepsy is a long-term brain disease that causes seizures. It's a result of electrical disturbances in the brain. Epilepsy is known to cause sudden, unexpected death in some patients (Sudden unexpected death in epilepsy, SUDEP). [5]
Chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) and anaphylaxis are known respiratory causes of sudden death. [2, 5, 6, 9]
Asthma is a respiratory condition where the airways in your lungs swell up and narrow, causing difficulty in breathing. Severe damage to the lungs and an attack left unattended can result in death in asthma patients.
Chronic obstructive pulmonary disease (COPD) is a common lung disease where the airways in your lungs narrow and make breathing difficult. COPD can lead to death if left untreated.
Anaphylaxis is a severe allergic reaction that requires immediate medical attention. A person having an anaphylactic attack can experience difficulty in breathing, hard, fast or noisy breathing, wheezing, coughing, hoarse speech, swollen throat or tongue, difficulty swallowing, pale skin, tiredness, dizziness, fainting and cold skin. It happens very quickly and can cause death if first aid or treatment isn't given immediately.
IV. Metabolic disorders
Metabolic syndrome, hypertension and diabetes are metabolic disorders known to increase the risk of sudden, unexpected natural death. [1, 7, 9]
A person with metabolic syndrome has at least three of these five metabolic disorders14:
Metabolic syndrome can cause cardiovascular diseases and death. [14]
High blood pressure (HBP), or hypertension, is when your blood pressure is consistently higher than normal. If left undiagnosed, untreated or not well managed, hypertension causes cardiovascular diseases, stroke and death. [2. 9]
Diabetes is a long-term condition where your body doesn't produce enough insulin or can't use it effectively. Insulin is a hormone that controls your blood sugar. Diabetes causes high blood sugar, cardiovascular diseases, stroke and kidney disease. Complications from diabetes can cause death.
Prevention of Unexpected, Sudden Natural Death →
Additional Related Resources:
Type 1 Diabetes Mellitus: An Explainer for Africans
Type 2 Diabetes: What Africans Need to Know
Published: September 25, 2024
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