The evaluation of aspects of the chain of survival at gymnasiums in the Pretoria area

Abstract

Background Sudden cardiac death related to exercise is an uncommon problem, but is perhaps the single biggest challenge to sports medicine practitioners. Although the overall risk of death due to cardiac causes is substantially reduced in those who exercise regularly, the risk is temporarily increased during exercise. The causes of sudden cardiac death related to exercise vary according to age and are divided into two groups. Firstly, those under 35 years, where structural abnormalities of the heart pose a risk. The most common congenital abnormality is hypertrophic cardiomyopathy (HOCM), which occurs in up to two per 1 000 births. Secondly, those above 35 years, where coronary artery disease is the leading cause of sudden cardiac deaths. The most frequent initial rhythm documented in witnessed cardiac arrest is ventricular fibrillation (VF). The most effective treatment for VF is defibrillation. The probability of successful defibrillation decreases by approximately seven to 10 percent for every minute that defibrillation is delayed. VF tends to convert to asystole within a few minutes if left untreated. No matter what the setting – home, community or hospital – the majority of successful adult resuscitations depend on early defibrillation. 5