(Vol.6 No.6 --- August 2001)

Sudden death is one of the most dreadful conditions that people fear in their daily lives. From time to time one would see reports of such condition occuring in victims who were otherwise healthy. Sudden death could occur in people of all ages, fit or unfit. With the present definition of sudden death, it was found that about 88 percent of these were due to cardiac diseases.

Sudden cardiac death describes the unexpected natural death due to a cardiac cause within a short time period from the onset of symptoms in a person without any prior condition that would appear fatal. The definition of sudden cardiac death should include the time interval from onset of the symptoms leading to collapse and then to death. More recent definitions have focused on time intervals of 1 hour or less, which normally identify sudden cardiac death populations having a high proportion (up to 91 percent) of arrhythmic death. In the United States, the annual incidence of sudden death is estimated to be 18 per 100,000 population, while Asian countries have relatively little published data on sudden death.

Sudden cardiac death is the most common, and often the first, manifestation of coronary heart disease (CHD) and is responsible for half the mortality from cardiovascular disease. Other rarer causes of sudden cardiac death include, hypertrophic cardiomyopathy, mitral valve prolapse, wolff-Parkinson-White syndrome, congenital and acquired long QT syndrome, unrevealed drug intoxication, Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy.

In the Special Feature Section of this issue of the Medical Diary. I have selected an article studying the local scenario of sudden death in Hong Kong and 2 other articles on Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy which may not be familiar to many of our medical colleagues yet they are well recognised causes of sudden cardiac death worldwide including Hong Kong.

In the Medical Bulletin Section I have selected a number of interesting papers presented in the Ninth Annual Scientific Congress of the Hong Kong College of Cardiology which covered important areas like the cardiovascular burden in Mainland of China and strategy for prevention in the new century, new insight in the management of acute coronary syndrome, insulin resistance and cardiovascular risk in type 2 diabetes and rheumatic fever and rheumatic heart disease.

I hope that these papers will refresh the memories of our readers and to bring to their attention some recent advances in the field of Cardiology.

Dr. Chiang Chung Seung