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The sudden cardiac death (SCD) of Zhang Xuefeng, an online influencer and well-known tutor specializing in China's college entrance examinations, has triggered an outpouring of grief online while also drawing widespread attention to the heart health risks. Chinese medical experts say the condition is showing a worrying trend toward younger generations, often linked to high-risk factors such as chronic sleep deprivation, excessive fatigue and unhealthy lifestyles.

According to China Youth Daily, following Zhang's passing on Tuesday, searches for quick-acting heart rescue pills on a major e-commerce platform surged 30-fold year-on-year starting at 8 pm, while searches for automated external defibrillators (AEDs) jumped tenfold from the previous period. Related keywords also quickly went viral on social media.

Many netizens said the incident once again sounded an alarm over public health. "No matter how busy you are, respect life and pay attention to heart health," one user wrote. "Take care of your body, maintain a regular routine, and don't ignore warning signs from your heart," another commented.

"People may call you old at this age for many things, but only in death will they say you were too young," another netizen wrote, reflecting public shock at Zhang's passing at 42 due to cardiac arrest. Defined as unexpected death within one hour of symptom onset, SCD has also raised concerns over why such a fatal condition could strike someone relatively young, and whether it signals a broader trend after Zhang's death.

"The most common culprit behind SCD is malignant arrhythmia, such as ventricular fibrillation, where the heart suddenly beats chaotically and stops pumping blood effectively. The brain can suffer irreversible damage within minutes," Li Bo, an executive deputy director of the department of cardiovascular surgery at Beijing Chao-Yang Hospital, told the Global Times on Wednesday. 

"The likelihood of such events is closely tied to the heart's workload and condition. In recent years, there has indeed been a trend toward younger populations. Heart health does not grant immunity based on age," Li said.

According to an epidemiological survey on SCD in China reported by Life Times, approximately 550,000 people die from SCD annually in China. The proportion among individuals aged 18 to 35 has surged from 12 percent in 2015 to 28 percent in 2024.

Experts noted that SCD in younger individuals can be even more dangerous than in older populations. 

"Older patients often have chronic conditions such as hypertension or heart disease, and their bodies may develop a degree of ischemic preconditioning as blood vessels age. In contrast, younger victims often present three key characteristics: no clear history of heart disease, atypical warning symptoms, and extremely rapid disease progression, all of which significantly complicate early detection and intervention," Li said.

He added that health risks are in fact often rooted in harmful chronic habits related to difficulties in maintaining life balance. Factors such as long-term sleep deprivation, excessive fatigue, smoking, alcohol consumption, inappropriate exercise and emotional fluctuations are major triggers among young people. However, many tend to dismiss mild discomfort due to a belief in their own physical resilience.

China's Ministry of Emergency Management issued a notice on Wednesday noting that individuals with a history of heart conditions such as arrhythmia or cardiomyopathy, a family history of inherited arrhythmias, athletes, as well as those with unhealthy lifestyles including smoking, heavy drinking, or lack of exercise, are at higher risk.

Wang Fang, a physician at Peking Union Medical College Hospital, emphasized that both athletes and those with sedentary lifestyles fall into high-risk categories, underscoring the importance of balanced physical activity. "Young people should avoid both extremes, pushing themselves into excessive high-intensity exercise or avoiding physical activity altogether. Cardiopulmonary exercise testing is the preferred method to accurately assess exercise intensity," Wang told the Global Times.

Although SCD often strikes without warning, medical experts cautioned that many patients do exhibit early signs that are frequently overlooked, and the ongoing health pro. These may include chest tightness or pain, palpitations or irregular heartbeat, sudden fainting, or noticeable shortness of breath or extreme fatigue after activity. 

Wang added that symptoms such as bluish lips or fingernails, jaw or gum pain after exercise, may also serve as warning signals. In some cases, carrying nitroglycerin tablets may be advisable. She also stressed the importance of learning how to use an AED, which can be critical during the "golden four minutes" for emergency response.

"An AED essentially delivers a 'restart' to the heart, helping restore a normal rhythm. Every minute earlier that it is applied significantly increases the chances of survival," Wang said.