A new dedicated unit will offer potentially life-saving screening for families affected by sudden cardiac death. Claire O'Connellreports
Peter Greene was an active, sporty teenager. So when he died suddenly at the age of 15, his family's shock and grief were especially intense.
"We lost our son 10 years ago to sudden cardiac death," explains Peter's father, Michael.
"There was no history, no warnings, he was a normal healthy young man, sports-orientated, full of the joys of life, and he died without any warning."
Driven by their son's memory, Greene and his wife, Marie, set up the awareness and support group Cardiac Risk in the Young (Cry), and are now involved in a new initiative at Tallaght Hospital to target cardiovascular disease in young people.
The dedicated unit, due to open in January, will offer potentially life-saving screening for families affected by sudden cardiac death (SCD) and other heart complications in young people.
In SCD, patients die within an hour from the onset of symptoms, explains consultant cardiologist Prof Ian Graham who, along with Dr David Mulcahy, is spearheading the new Tallaght unit in the Institute of Cardiovascular Science.
He estimates that around 5,000 people in the Republic die from SCD each year, and about 60 of those are under 35 years of age. "In a young person it's terribly tragic, it has terrible, devastating spin-off effects," he says.
In people over 35, the main cause of SCD is coronary heart disease, or hardening of the arteries, says Graham. In younger people, SCD is often due to abnormalities in the heart muscle or valves, or disturbances in the electrical signals that regulate the heartbeat.
This may stem from infection, congenital heart disease or genetics, depending on the condition, he adds.
High-profile SCD cases in seemingly healthy athletes such as Tyrone Gaelic footballer Cormac McAnallen have raised awareness of the problem, and a recent Task Force report recommended that first-degree relatives of people affected by SCD should be screened.
The new unit at Tallaght aims to target the highest-risk groups.
"There are certain clear warnings. If there's any history in the family, they do need to be screened," says Graham, who notes that symptoms on exertion like getting light-headed or fainting or chest pain also need to be taken seriously.
He adds that people can access the unit through their GP or through a support organisation such as Cry. Cardiac screening is also available at Dublin's Mater Misericordiae Hospital.
"Everything is welcome and it's a matter of us all linking our resources," says Graham.
The screening process at Tallaght will involve taking a detailed medical history and investigations such as blood tests and monitoring the heart rate during exercise.
"It's quick and routine. We would try to provide this at a single visit and we would hope that it will be available without charge to anyone," says Graham.
"Those found to be at risk can then be treated through lifestyle change, medication or surgery, depending on the diagnosis, he adds.
Scientists are also beginning to unravel the inherited factors that contribute to SCD in families and the Tallaght unit will benefit from links into research and expertise at Trinity College Dublin and at other teaching hospitals, particularly in the area of genetics.
"You simply cannot counsel these families adequately without expert genetics," says Graham.
At the unit, cardiologist Dr Deirdre Ward will work with families affected by SCD. She is returning from The Heart Hospital in London, where she researched inherited cardiac disorders.
"The important thing is that even though some of these conditions can be fatal in some family members, not everybody in the family who inherits the genetic factors will suffer the same outcome. There are ways of identifying people who are at higher risk," she says.
And while the unit will concentrate on screening younger people, there will be no defined cut-off age, according to Ward. "We're not going to be exclusive and say you are too old to be seen even though you have a rare inherited condition. It will be about trying to focus on young people and being preventative but also managing older relatives, as necessary."
The new unit will be funded for three years through the Department of Health as well as private and philanthropic donations.
"We will keep a close eye on outcome measures and see if we can make a difference, and if we can then we will be looking for more public funding," says Ward.
To date, Cry has been fundraising for the unit and the organisation is delighted to be involved in such a positive step, says Greene.
"SCD is a dreadful tragedy, it's indescribable. The screening is very important to help clear the air for families in the sense that if they are screened for the condition, they may be reassured, or if they have it they can be helped. Screening does save lives."
For more information on Cardiac Risk in the Young (Cry), tel: 01 8395438, visit www.cry.ie or e-mail cryireland@hotmail.com