Sudden Arrhythmic Death Syndrome
Dr. Simon Modi – Consultant Cardiologist/Electrophysiologist, Dr. Robert Cooper –
Cardiology Specialist Registrar, Suzanne Kelly – Heart Rhythm Specialist Nurse
Liverpool Heart and Chest Hospital
Coronary artery disease:
Coronary artery disease (CAD) is common in the Western world, but mainly occurs over the
age of 35 years. Cholesterol and fat build up in the arteries that supply the heart muscle
and cause narrowing and sometimes blockages to the blood supply of the heart. Complete
blockages tend to cause significant heart attacks whereas narrowing tends to cause chest
pains or tightness on exertion (angina). The heart’s rhythm can be disturbed during angina
or due to long-term damage that a heart attack causes to the heart muscle. Coronary artery
disease is very uncommon in young athletes.
Occasionally coronary artery problems occur due to developmental problems (from birth)
where the coronary arteries develop abnormally and become trapped between other
organs in the chest causing narrowing of the arteries from outside pressure. Also, spasm or
cramping (sudden, reversible narrowing of the arteries not caused by fat or cholesterol) of
the arteries can occur leading to disruption of the heart’s rhythm.
Most people with CAD will experience some symptoms of chest pain, tightness, shortness of
breath, arm/jaw/shoulder or neck pain with exertion. There are many tests to investigate
coronary artery disease. ECGs themselves are often normal unless taken during periods of
chest pain or exercise. An angiogram (injecting dye directly into the arteries) is the clearest
way of diagnosing coronary artery disease if doubt exists from other testing.
Angiogram showing Coronary Artery Disease
Left = blockage of right coronary artery (red arrow). Right = normal flow down artery after
implantation of stent