From bystanders' description of events, it seems likely that Izzy Dezu (16), who collapsed and died while playing for Shelbourne FC in a Dublin and District Schoolboys League football match this week, was a victim of sudden arrhythmic death syndrome (SADS).
The teenager was not directly involved in the match action when he suddenly dropped to the ground. Despite the best efforts of paramedics from the Dublin Fire Brigade, he was subsequently pronounced dead at Beaumont Hospital.
SADS was originally called sudden adult death syndrome, but in recognition that the phenomenon affects infants and children also, its name was changed. "Arrhythmic" is a reference to the fact it is the acute onset of a chaotic rhythm in the heart that leads to the victim's sudden death. Called fibrillation, the heart shakes like a piece of jelly and is unable to function properly. In those under 25, common reasons for the development of an arrhythmia are the presence of different forms of heart muscle disease and problems with the heart's electrical conduction system.
Heart muscle disease
Hypertrophic cardiomyopathy (HCM), a form of heart muscle disease, affects about one in 500 people – although only a small proportion, with a serious form of the disease, are at risk of sudden death. The term HCM describes a thickening (hypertrophy) of the heart muscle (myocardium). Primarily affecting the main pumping chamber of the heart, it also disrupts the dividing wall down the middle of the heart. This wall carries the transmission system that both triggers and spreads the normal beat throughout the heart. So as the heart muscle thickens, both its pumping efficiency and its ability to maintain a smooth heart rate is impaired.
The other principal cardiac cause for sudden death in young people is a heart rhythm disturbance. Since this is essentially an electrical malfunction, it cannot be found or tested for at postmortem. Some families will have to face the additional stress of being told that no cause of death could be found. However, doctors believe most of these are due to a sudden catastrophic malfunctioning of the heart’s electrical pacemaker.
High risk
For those at high risk of the condition, the treatment of choice is to place an implantable cardiac defibrillator in the chest. This device automatically corrects the rhythm disturbance as soon as it starts.
SADS is estimated to occur at an annual rate of approximately 2.5 per 100,000 young people.
If you have any concerns about SADS contact the patient advocacy group CRY on 01 839 5438 or info@cry.ie