Sudden Cardiac Arrest
Quick Reference
Reviewed by Brian R. Robinson, MDCardiac arrest or sudden cardiac arrest refers to the heartbeat’s permanent or temporary cessation. This failure of the heart to pump blood through the body is dangerous and life threatening if left untreated. Each day, nearly 1000 Americans suffer from sudden cardiac arrest—most of these people are away from the hospital. More than 95% of them die, in many cases, because life-saving defibrillators arrive too late, if at all. The American Heart Association estimates that automatic external defibrillators (AED), if more readily available, could save 20,000 or more lives per year.
Detailed Description
Sudden cardiac arrest can lead to sudden cardiac death, which claims an estimated 250,000 lives each year, and, in the United States, is the leading cause of death. Abnormal heart rhythms called arrhythmias cause most sudden cardiac arrests. Ventrical fibrillation is the most common arrhythmia that causes cardiac arrest, in which the heart’s electrical impulses to become suddenly chaotic, often without warning. This condition causes the heart to stop suddenly. Sufferers collapse and quickly lose consciousness. Death usually follows unless responders restore a normal heart rhythm. If a person does survive, they have an 80% chance of a one year survival, and as much as a 57% survival for five years following the attack.
Cardiac arrest is often confused with a heart attack or myocardial infarction, which is a loss of blood flow to the heart tissue. Cardiac arrest usually occurs without warning. Warning signs of an impending cardiac arrest due to heart disease are:
- Squeezing discomfort or pain in the chest, or behind the breastbone, lasting more than 10 minutes
- Pain spreading up to the neck, out to the shoulders or arms
- Sweating
- Shortness of breath
- The person may feel sick in the stomach
If someone experiences these warning signs, seek medical assistance urgently and get an ambulance. If a cardiac arrest does occur, the person will need CPR from a bystander until the ambulance arrives with a defibrillator.
Emergency medical teams are trained to revive people from cardiac arrest by using the paddles of external defibrillators to apply strong electrical shocks to the chest. These shocks can pass through to the heart, which stops the erratic electrical activity, and allows the heart to return to a more regular rhythm.
Researchers and experts do not fully understand the cause of sudden cardiac arrest. Many victims have no history of heart disease. It can even happen to healthy people in the prime of their life.
Treatment
There is one definitive therapy for sudden cardiac arrest: defibrillation . Several other treatment options exist for survivors of cardiac arrest. A cardiologist or electrophysiologist (a cardiologist with a specialization in the electrical function of the heart) provides these therapies. The American Heart Association advocates using the “chain of survival,” which refers to the four crucial links in the emergency care of sudden cardiac arrest.
- Early access to care: In most commuities, dialing 911 activates the emergency medical system, which dispatches the appropriate emergency personnel to the scene.
- Early cardiopulmonary resuscitation: CPR, when performed properly, can add a few minutes to the time available for successful defibrillation . Millions of people have learned the breathing and chest compression techniques of CPR, but it does not replace defibrillation in saving lives.
- Early defibrillation : The critical link in treating victims in VF is delivering electric shock. Each minute the heart is not returned to the normal pattern of beating decreases the chance of survival by 10 percent. After as little as 10 minutes , few resuscitation attempts are successful.
- Early Advanced Care:After receiving successful defibrillation, some patients require advanced treatments, such as airway control or intravenous drugs, on the way to the hospital.
Last updated: 21-Feb-08
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