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LIFESTYLE

Coşmarurile care ucid

June 1st, 2010, com 23 comentarii

Un monstru oribil se îndreaptă spre pat. Ai vrea să fugi, dar nu poţi. Strigi, dar nu te aude nimeni. Te zbaţi să scapi, dar el e mai puternic şi îţi înşfacă inima din piept. Întuneric. Linişte morma^ntală. A fost un coşmar. A murit un om, doborât de SUNDS (Sudden Unexplanied Nocturnal Death Syndrome, adică sindromul morţii subite în somn). Şi nu numai de el.

Coşmar pe Elm Street este poate cel mai cunoscut film despre monştrii care ucid în somn. Adevărul este că ficţiunea aceasta are şi un sâmbure de realitate. Da, unii oameni pot să se culce seara perfect sănătoşi, fără nici o problemă cunoscută, iar a doua zi să fie găsiţi morţi de către membrii familiei. Specialiştii nu pun aceste morţi neaşteptate pe seama unor coşmaruri care bântuie nopţile unora dintre noi, ci dau vina pe o disfuncţie genetică a organismului, care pare să afecteze cu precădere populaţiile de bărbaţi tineri din Asia de Sud-Est. Medicii au numit „coşmarul care ucide“ Sudden Unexplanied Nocturnal Death Syndrome – SUNDS (sindromul morţii subite în somn). Cu o componentă genetică puternică SUNDS este răspunzătoare de absenţa unei coordonări corecte a semnalelor electrice care generează bătăile inimii. Acest fenomen are loc în special noaptea, pe durata somnului, când bătăile inimii sunt oricum încetinite. Inima bate normal un timp, apoi se opreşte brusc, moment în care survine decesul. SUNDS este generat, spun cercetători americani, de modificările apărute la gena SCN5A (cea care codează canalele de sodiu voltaj dependente), iar caracteristicile clinice ale sindromului produs de aceste modificări seamănă foarte mult cu cele ale unei alte probleme genetice denumită de către specialişti sindromul Brugada. Manifestarea majoră a sindromului Brugada este tahicardia ventriculară polimorfă care poate degenera în fibrilaţie ventriculară şi poate determina, de asemenea, deces cardiac subit. Fără a intra în amănunte care ţin de genetică şi cardiologie, amănunte care fac diferenţa dintre cele două tipuri de sindrom, un lucru este cert pentru pacienţii care suferă de aceste defecte genetice: prognosticul acestor afecţiuni este rezervat, mai ales în cazurile simptomatice, determinând cel puţin 10% dintre decesele dintr-un an. Tratamentul medicamentos nu pare a avea vreun succes. Singura soluţie răma^ne implantarea unui defibrilator care să impulsioneze inima să bată mai departe atunci când organismul nu mai găseşte în sine resursele necesare.

La moartea subită mai contribuie: sindromul Q-T lung (tulburare de ritm cardiac rară, ereditară, care apare la persoane fără alte afecţiuni, la copii şi la adulţii tineri), cardiomiopatia hipertrofică obstructivă (un defect genetic în care miocardul/ muşchiul inimii se îngroaşă anormal), cardiomiopatia ventriculară dreaptă (boala este foarte rară, cu incidenţă mai mare la băieţi, în copilărie şi adolescenţă, iar cauza este necunoscută) etc.

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