An Ngo was tired. He had put in a full day as a cook at a Chinese restaurant in the Philadelphia suburbs and all he wanted to do when he got home was relax and go to sleep. He got a beer from the refrigerator, crawled into bed and watched the late news to see whether it would be cold the next morning. In no time, he fell asleep next to his girlfriend, Sang Nguyen. A few hours later, his heart stopped.
Nguyen screamed for her brother, Dung, who was asleep in another room. He called 911. Medics administered CPR and rushed Ngo to the hospital.
Ngo has no memory of that April night a year ago. No memory of his gasping for air. No memory of medics` working for 20 minutes in his bedroom to revive him. No memory of being rushed to the hospital.
”I know just what Sang tells me,” said Ngo, 32.
An Ngo is one of the lucky ones. He escaped the grip of a mysterious syndrome that kills Southeast Asian men with deadly precision. Doctors have given the illness an ominous name, Sudden Unexplained Nocturnal Death Syndrome, and it is just that.
It strikes in the middle of the night and its victims are young men who outwardly are healthy and free of heart disease symptoms such as high blood pressure.
Since 1975, 140 Southeast Asian refugees in the United States have died from the syndrome, according to the Centers for Disease Control in Atlanta. All but one of the victims were men; half of them were Hmong refugees from northern Laos. The average age of victims was 33 and most died within a year of coming here.
In Laos, the syndrome is called ”non-laita,” or sleep death; in the Philippines, it is ”gangungut,” or arise and moan.
Doctors know little about what causes the sudden-death syndrome and they cannot explain why it seems to hit refugees with a higher frequency than others. They have stabilized Ngo`s condition and implanted a device in his chest that will automatically send an electric shock to his heart if it beats irregularly, but still are at a loss for explaining why it happened.
There are only theories.
Roger Marinchak, a cardiologist at Lankenau Hospital, who is treating Ngo, believes that there might be a genetic explanation for the heart condition behind the syndrome.
”Certain illnesses seem to be clustered in certain genetic groups,”
Marinchak said. ”These people may have a genetic susceptibility to the condition.”
Ngo, he said, suffers from an abnormal heartbeat, or arrhythmia, that is caused by a disturbance in the electrical impulses that keep the heart pumping.
Marinchak said part of the problem in studying the syndrome is there are only three or four other people like Ngo who have been revived after going into cardiac arrest. Also, because the syndrome is contained to a relatively small immigrant group, little research on its causes has been conducted by U.S. scientists.
”The medical literature on this is a void,” Marinchak said.
A dearth of information exists in Asia, too. The countries where the syndrome is most prevalent-Laos, Vietnam and Cambodia-are some of the poorest in the world with more pressing health problems that command more attention, U.S. health officials said.
One of the few people to probe the causes of the sudden-death syndrome is Ronald Munger, an epidemiologist with the University of Iowa`s medical school who spent a year studying Laotian victims in Thai refugee camps.
Munger believes the condition is caused most possibly by the lack of thiamine in the diet of victims.
But he said stress also could play a role, which could explain the unusually high incidence among refugees.
