What are the signs of a cardiac arrest?
A cardiac arrest usually happens without warning. If someone is in cardiac arrest, they collapse suddenly and:
- will be unconscious
- will be unresponsive and
- won’t be breathing or breathing normally – not breathing normally may mean they’re making gasping noises.
Without immediate treatment or medical attention, the person will die. If you see someone having a cardiac arrest, start CPR and call for urgent medical attention.
What causes a cardiac arrest?
A common cause of a cardiac arrest is a life-threatening abnormal heart rhythm called ventricular fibrillation (VF). VF happens when the electrical activity of the heart becomes so chaotic that the heart stops pumping, Instead, it quivers or ‘fibrillates’.
The main causes of cardiac arrest related to the heart are:
- a heart attack (caused by coronary heart disease)
- cardiomyopathy and some inherited heart conditions
- congenital heart disease
- heart valve disease
- acute myocarditis (inflammation of the heart muscle).
Some other causes of cardiac arrest include:
- a drug overdose
- a severe haemorrhage (known as hypovolaemic shock) – losing a large amount of blood
- hypoxia – caused by a severe drop in oxygen levels.
What’s the difference between a cardiac arrest and a heart attack?
A heart attack and cardiac arrest are not the same.
A heart attack happens when the blood supply to the heart muscle is cut off. This is often caused by a clot in one of the coronary arteries. The heart is still pumping blood around the body during a heart attack. The person will be conscious and breathing.
A heart attack can lead to cardiac arrest. It’s vitally important to get medical attention immediately by calling an ambulance if you experience heart attack symptoms.
Sudden Cardiac Arrest: 5 Things Raise Your Risk
5 things that increase risk of sudden cardiac arrest
The heart rhythm disturbances leading to SCA can result from:
- Scarring. Rhythm problems can often be traced to the scarred heart muscle. “Scarring causes the heart’s electrical signals to become confused and fragmented,” explains Dr. Wilkoff. The most common causes are coronary artery disease and cardiomyopathy. Heart attacks starve the heart muscle, causing tissue death and scarring. Viral infections, hereditary or autoimmune conditions, and chemical toxicity can also damage and scar the heart muscle.
- A low ejection fraction. If you have heart failure with an ejection fraction of 35 percent or less, your heart can’t pump out enough blood with each beat. This disrupts your heart rhythm and increases the risk of sudden cardiac death. “Putting in an implantable cardiac defibrillator (ICD) will rescue you from these rapid and irregular heart rhythm episodes, extend your life and allow you to return to normal living,” says Dr. Wilkoff. “ICDs increase survival from sudden cardiac arrest to 98 percent because they respond within seconds, not minutes.”
- Family history. If a first-degree relative — one of your parents or siblings — died young for unknown reasons, then your risk of early, sudden death is higher too. (SCA is often the cause in these cases.)
- Smoking. Smoking dramatically increases your risks of both heart attack and sudden cardiac death. “When we put ICDs in smokers, we find they need more shocks from their devices, which means they’re having more cardiac events,” says Dr. Wilkoff.
- Poorly managed heart failure. “If you have heart failure symptoms (shortness of breath and exercise intolerance) with or without a low ejection fraction, you need medicine,” he says. Drugs such as ACE inhibitors and beta-blockers will keep your heart from working too hard, improve its function, and lower your risk of SCA.
How is a cardiac arrest treated?
Starting immediate CPR is vital as it keeps blood and oxygen circulating to the brain and around the body. A defibrillator will then deliver a controlled electric shock to try and get the heart beating normally again.
Public access defibrillators are often in locations like train stations and shopping centres. Anyone can use one and you don’t need training to do so.
If you’re with someone who’s having a cardiac arrest, start CPR and use a defibrillator if there’s one nearby. Follow instructions from the 999 operators until emergency services take over.
Recovery after a cardiac arrest
After a cardiac arrest, you’ll have been looked after in a coronary care or intensive care unit. You may have been put in an induced coma and kept asleep to allow your body to recover.
Doctors and cardiologists will want to work out what caused the cardiac arrest. They can then recommend medication and treatment, such as a pacemaker or implantable cardioverter-defibrillator (ICD), to reduce the risk of it happening again.
They may also refer you to cardiac rehabilitation to help rebuild your confidence, fitness and strength levels. Each programme is different, but it usually involves regular assessments such as checking your pulse and blood pressure, psychological support, health education talks and exercise sessions.
It will take time to recover after a cardiac arrest, but your doctor will support you during this time. Talk to family and doctors about what will happen once you go home and practical matters, like driving and returning to work.
Your doctor may suggest making lifestyle changes to reduce your risk of another cardiac arrest. This can include:
Because of a lack of oxygen to the brain during a cardiac arrest, you might experience long-term effects to your brain. These can include:
- personality changes
- problems with memory
- dizziness or balance issues
- aphasia/dysphasia (problems with speech and language)
- myoclonus (involuntary movements)
- permanent brain injury.
It’s normal to have no memory of a cardiac arrest. This can be alarming for you and your family members who may have seen it happening.
- It’s also common to feel low, angry, confused or a combination of lots of different emotions due to the shock of the experience. Speak to your doctor if you’re concerned about your mental health as they may be able to refer you to counselling or cognitive behavioural therapy (CBT).
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