Unravelling the Mystery of Sudden Cardiac Arrest

Overview

Cardiac arrest and heart attack are medical terminologies that are often used interchangeably but they represent different medical conditions related to the heart. According to the American Heart Association, a heart attack, or myocardial infarction, typically occurs when a coronary artery that supplies blood to the heart muscle becomes blocked, leading to a lack of oxygen and damage to the heart tissue. 

On the other hand, sudden cardiac arrest is a sudden, unexpected loss of heart function. It is caused by an electrical malfunction in the heart that disrupts its normal rhythm (arrhythmia). This can lead to a chaotic heartbeat (ventricular fibrillation) and the heart’s inability to pump blood effectively. [1]

While a heart attack can sometimes lead to sudden cardiac arrest, they are distinct events with different causes and treatments. Immediate medical attention is crucial for both conditions, but the approaches to care can vary. People need to be aware of the differences and seek appropriate help based on the specific symptoms and circumstances.

Heart health has garnered attention amidst the recent string of deaths involving well-known figures, including Pepperfry CEO Ambareesh Murty (51), Bodyguard director Siddique Ismail (69), and Prof. Sameer Khandekar (55), Head of the Mechanical Engineering Department at IIT Kanpur. All of these deaths were either confirmed or suspected to be caused by cardiac arrest. According to the statistics issued by the American Heart Association, the incidence of cardiac arrest has been on the rise in recent years, and it continues to be a public health crisis.  

So, let’s delve into this article to learn about the most prevalent causes of cardiac arrest, as well as the signs and symptoms and lifestyle adjustments needed to maintain the health of the heart.

Sudden Cardiac Arrest (SCA)

Cardiac arrest, also known as sudden cardiac arrest (SAC), is a medical emergency wherein the heart stops beating suddenly and unexpectedly due to an electrical abnormality that makes the heart stop pumping blood. [2]

The lack of blood flow to the brain and other vital organs of the body can cause unconsciousness, and it may turn fatal without any immediate treatment. Sudden cardiac arrest is one of the leading causes of natural deaths, and it primarily affects adults between the mid-30s and mid-40s. [3]

Signs and Symptoms of Sudden Cardiac Arrest

While some cases of cardiac arrest don’t show any symptoms prior to the attack, there are other cases that exhibit immediate and severe symptoms, like:

  • Sudden collapsing
  • Fainting (loss of unconsciousness)
  • No pulse
  • No breathing [6]

Some other signs and symptoms experienced prior to the cardiac arrest and fainting include:

  • Chest pain or discomfort
  • Shortness of breath
  • Nausea
  • Vomiting
  • Feeling faint, woozy, weak, or unsteady (dizziness)
  • Light-headedness
  • Fast-beating, fluttering, or pounding heartbeat (heart palpitations) [4]

Causes of Sudden Cardiac Arrest

Cardiac arrest is usually known to be caused either by an underlying structural cardiac disease or by an unexpected occurrence. However, the three main causes of sudden cardiac arrest include:

  • Arrhythmias (ventricular fibrillation): Arrhythmia refers to abnormal heart rhythms caused by an electrical problem. Among the life-threatening arrhythmias, ventricular fibrillation (VF) is notably common and a leading cause of sudden cardiac arrest. Ventricular fibrillation (VF) is rapid, erratic heartbeats in the heart’s ventricle that cause the heart to tremble and quiver instead of pumping normally.
  • Cardiomyopathy (enlarged heart): Cardiomyopathy is a heart condition wherein the heart muscle dilates and thickens, which leads to abnormal contractions of the heart.
  • Coronary artery disease (CAD): Coronary artery disease is a heart condition wherein narrowed or constricted coronary arteries limit the supply of blood to the heart muscle. If left untreated, coronary disease can cause arrhythmias or heart failures, both of which can eventually lead to cardiac arrest. [2]

Some other causes of cardiac arrest may include

 

Heart conditions like:

  • Congenital heart conditions
  • Severe blood loss
  • Intense physical activity: Engaging in intense physical activity can place additional stress on the heart. Excessive physical exertion, especially in individuals with pre-existing heart conditions, may trigger events like arrhythmias or other cardiac issues.
  • Severe lack of oxygen: Deprivation of oxygen can adversely affect the heart, potentially leading to arrhythmias or other complications.
  • Valvular heart disease [2, 3, 4]

Structural heart changes like:

  • Congestive heart failure
  • Left ventricular hypertrophy
  • Right ventricular dysplasia
  • Cardiac tamponade [5]

Non-structural heart changes like:

  • Brugada syndrome
  • Wolf-Parkinson-White syndrome
  • Congenital long Qt syndrome [5]

Management and Treatment of Cardiac Arrest

Cardiac arrest demands immediate intervention to enhance oxygen-rich blood flow to the heart, brain, and other vital organs. The survival rate is notably high, reaching up to 90% if treatment begins within the first minute, with a gradual decrease of about 10% for every minute without intervention.

The standard protocol to follow if you see a person experiencing sudden cardiac arrest is as follows:

  1. Call emergency medical services
  2. Cardiopulmonary resuscitation (CPR): This is the first line of treatment during which another person compresses the chest with their hands in order to maintain oxygen and blood circulation until medical help arrives.
  3. Defibrillator: Upon the arrival of emergency medical personnel, a defibrillator is employed to administer an electric shock to the heart, aiming to restore its normal rhythm. The combination of CPR and defibrillation is highly effective in restoring heart function and saving the individual from cardiac arrest. [2,3]

Prevention of Cardiac Arrest

Sudden cardiac arrest can be prevented by making certain lifestyle changes, like:

  • Eating a healthy diet: A healthy diet includes fruits, vegetables, whole grains, protein, low-fat meals and restricting processed and sugary food items. A healthy diet helps control blood sugar, cholesterol, and blood pressure levels, all of which are known to be risk factors for cardiac arrest. [3]
  • Regular exercise: Engage in regular physical activity to maintain overall health and prevent plaque buildup in the arteries, promoting optimal heart function. [7]
  • Maintaining weight: Keep weight within a healthy range to reduce the risk of cardiac arrest, as obesity is a known contributing factor. [7]
  • Quit smoking and drinking: Smoking and drinking are known to cause cardiomyopathy and a long-term rise in blood pressure which is a risk factor for cardiac arrest. [8, 9]
  • Regular check-ups: Schedule regular check-ups with your healthcare provider to monitor and manage cardiovascular health.

By incorporating these lifestyle changes, individuals can significantly reduce the risk of sudden cardiac arrest and foster a heart-healthy life.

"Ignorance of your body's signals is a silent invitation to cardiac arrest; listen, respect, and respond to the whispers of your heart for a healthier life."

Author: Dr. Anjali Singh

BDS [KGMC, Lucknow]

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