Cardiac Arrest

Cardiac arrest is one of the most critical medical emergencies, responsible for a significant percentage of sudden deaths globally. It occurs when the heart suddenly and unexpectedly stops beating, preventing the flow of blood to the brain and other vital organs. This interruption leads to a sudden loss of consciousness and requires immediate medical intervention.

Unlike a heart attack, which is caused by a blockage in the blood supply to the heart, cardiac arrest is usually triggered by an electrical malfunction in the heart that leads to an irregular heartbeat, or arrhythmia. This distinction is crucial because although the conditions are related, they are not the same and require different types of intervention.

In this guide, we will delve into every aspect of cardiac arrest, equipping you with essential knowledge on how to identify, treat, and prevent it.

Cardiac arrest is the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease. It can come on suddenly or as a result of other conditions. When the heart stops beating, it can no longer pump blood to the brain, lungs, and other organs. Without immediate medical attention, death can occur within minutes.

The underlying cause of cardiac arrest is usually an electrical disturbance in the heart that disrupts its pumping action, stopping blood flow to the body. This electrical malfunction is most often due to an arrhythmia called ventricular fibrillation, where the ventricles quiver instead of contracting properly.

Cardiac arrest is a leading cause of death around the world. According to the World Health Organization (WHO), cardiovascular diseases account for an estimated 17.9 million deaths per year, and sudden cardiac arrest is responsible for a significant portion of these. In the United States alone, over 356,000 out-of-hospital cardiac arrests occur annually, with nearly 90% resulting in death.

Statistics in India

In India, cardiac arrest poses a growing concern. A study published in the Indian Heart Journal estimates that sudden cardiac death contributes to 10.3% of all deaths. Additionally, with increasing urbanisation and lifestyle changes, the prevalence of risk factors such as diabetes, hypertension, and obesity has risen, contributing to a higher incidence of cardiac events.

1. Ventricular Fibrillation (VF): A disorganised electrical activity causes the ventricles to quiver ineffectively, preventing the heart from pumping blood.
2. Ventricular Tachycardia (VT): A fast heart rhythm that originates in the ventricles and may lead to VF.
3. Pulseless Electrical Activity (PEA): The heart has electrical activity but fails to contract effectively, resulting in no pulse.
4. Asystole: A state of no electrical activity in the heart, often referred to as a "flatline."
    

Numerous factors can trigger cardiac arrest:

• Coronary Artery Disease: The most common cause, characterised by narrowed arteries that reduce blood flow to the heart.
• Heart Attack: A blockage in one or more of the coronary arteries can disrupt the heart’s electrical system.
• Cardiomyopathy: Abnormal thickening or enlargement of the heart muscle.
• Heart Valve Disease: Can cause strain on the heart muscle.
• Congenital Heart Disease: Structural defects present at birth can lead to arrest.
• Electrical Disorders: Conditions like Long QT Syndrome or Brugada Syndrome.
• Severe Blood Loss or Oxygen Deprivation: Such as in trauma or drowning.
• Drug Abuse or Toxic Exposure: Especially stimulant drugs like cocaine.
   

While cardiac arrest can happen without warning, some symptoms may precede the event:

• Sudden collapse
• Absence of pulse and breathing
• Loss of consciousness
• Chest discomfort
• Rapid or irregular heartbeats
• Dizziness or light-headedness
• Nausea or vomiting

Recognising these early signs, especially in individuals with known heart conditions, can help in preventing fatal outcomes.

Diagnosis is typically made during an emergency. Key indicators include:

• Unresponsiveness: The patient does not respond to touch or sound.
• No Pulse or Breathing: Confirmed using palpation and observation.
• Electrocardiogram (ECG): Identifies the specific arrhythmia causing the arrest.
• Blood Tests: Evaluate cardiac enzyme levels.
• Echocardiogram and Cardiac MRI: Used later to assess structural abnormalities.
• Angiography: May be performed to identify blockages.

Immediate treatment is essential to increase the chances of survival:

• Cardiopulmonary Resuscitation (CPR): Maintains circulation to vital organs.
• Defibrillation: An electric shock delivered to restore a normal rhythm.
• Advanced Life Support: Involves intubation, IV medications, and cardiac monitoring.

Post-recovery treatments include:

• Medications: Beta-blockers, antiarrhythmics, ACE inhibitors. (Brands: Abmetop 50 XL Tablet) Abmetop  
• Implantable Cardioverter Defibrillator (ICD): Monitors and corrects abnormal heart rhythms.
• Cardiac Rehabilitation: Combines physical therapy, dietary counselling, and stress management.
   

While not substitutes for emergency care, alternative therapies can complement recovery:

• Yoga and Meditation: Help manage stress and improve cardiovascular health.
• Nutritional Supplements: Under medical supervision, omega-3s and magnesium may support heart function.
• Homeopathy and Ayurveda: Some practitioners offer supportive therapies, though clinical evidence is limited.
• Acupuncture: May help manage pain and stress in post-recovery phases.
   

Several factors heighten the risk of cardiac arrest:

• Advanced age
• Male gender
• Smoking and alcohol abuse
• Obesity
• Sedentary lifestyle
• High blood pressure and cholesterol
• Diabetes
• Family history of heart disease
• Previous heart attack or stroke

Cardiac arrest survivors may face long-term complications:

• Brain Damage: Due to lack of oxygen during the event.
• Cognitive Impairment: Memory loss or difficulty concentrating.
• Heart Damage: Weakening of the heart muscle.
• Emotional Challenges: Depression, anxiety, PTSD.
• Physical Limitations: Reduced stamina or exercise tolerance.
   

Living after a cardiac arrest requires significant lifestyle adjustments:

• Stick to Medication Regimen: Never skip prescribed treatments.
• Follow-Up Appointments: Monitor heart health and adjust therapy.
• Join Support Groups: Connect with others who have had similar experiences.
• Exercise Safely: Engage in physician-approved activities.
• Educate Family: Ensure they know how to perform CPR.
   

• Myth: Cardiac arrest only affects the elderly.
   Fact: It can strike at any age, even young athletes.
• Myth: It’s the same as a heart attack.
   Fact: A heart attack is a circulation problem; cardiac arrest is electrical.
• Myth: You can’t survive cardiac arrest.
   Fact: With timely CPR and defibrillation, many people survive.
   

It’s important to consult a doctor if you:

• Experience chest pain or shortness of breath
• Have palpitations or fainting episodes
• Have a family history of sudden cardiac death
• Are diagnosed with risk factors like hypertension or diabetes
   

• What caused the cardiac arrest?
• Am I at risk for another episode?
• What lifestyle changes should I make?
• Will I need an implantable defibrillator?
• Are there any activities I should avoid?
• How should my family prepare for emergencies?
   

Supporting a survivor of cardiac arrest can be life-changing for both parties:

• Be Informed: Understand their condition and treatment plan.
• Encourage Rehabilitation: Help them attend cardiac rehab sessions.
• Offer Emotional Support: Be patient and listen actively.
• Promote Healthy Living: Cook nutritious meals and encourage activity.
• Prepare for Emergencies: Learn CPR and keep emergency contacts handy.
  
   

Cardiac arrest is a critical condition requiring immediate medical attention. With timely intervention and proper management, survival is possible, and long-term recovery can be significantly improved. Understanding the risk factors, signs, and preventive strategies empowers individuals to take proactive steps towards heart health. Whether you are a survivor, a caregiver, or someone looking to educate yourself, knowledge is the most powerful tool in combating cardiac arrest.