Sudden Cardiac Arrest

  • SCA is the leading cause of death in the United States, claiming an estimated 325,000 lives each year; thousands are children.
  • SCA occurs when the electrical system to the heart abruptly and unexpectedly ceases to function.  The ventricles may flutter or quiver (ventricular fibrillation), and blood is not delivered to the body.
  • SCA is not a heart attack. A heart attack occurs when there is blockage in one or more of the heart’s blood vessels, interrupting the flow of oxygen-rich blood.
  • Many victims have no prior history of heart disease and are stricken without warning.
  • When SCA strikes, every minute counts; every minute that a victim goes without defibrillation the chances of survival decrease by 10%.
  • Most cases of SCA can be prevented.
What are some of the risk factors?
  • Premature birth
  • Family history of heart disease
  • Family history of unexplained fainting or seizures
  • Family history of unexplained death (under age 50 years)
What are some of the causes of cardiac arrest?
  • Congenital (run in families) or acquired (viral illness) diseases
  • Heart conditions that result from abnormal heart structure or functions
  • A primary abnormality in the electrical system of the heart
  • An impact to the chest
  • Drugs or stimulants that affect the electrical system of the heart
What are some of the symptoms of a possible cardiac problem?
  • Chest pain or pressure
  • Fainting or seizures
  • Heart Murmur
  • Palpitations (skipping or racing heartbeats)
  • Shortness of breath
  • Tiring easily during exercise or activity
What are the most common diseases/defects that cause cardiac arrest/death?
 
Structural
 
Arrythmogenic Right Ventricular Dysplasia (ARVD) – is a form of cardiomyopathy in which the heart muscle of the right ventricle is replaced by fatty tissue.  As a result, the heart’s ability to pump blood is weakened.

Dilated Cardiomyopathy (DCM) – this is the most common form of the disease and occurs when heart muscle tissue is enlarged and stretched, making it difficult for the heart to function.

Hypertrophic Cardiomyopathy (HCM) – this is the second most common type of cardiomyopathy and result in excessive thickening of the heart walls.  Blood flow is restricted as the heart chambers become smaller and stiffer. Most often, it is inherited but sometimes the cause is not clear.

Kawasaki Disease – is characterized by inflammation of blood vessels throughout the body, especially the coronary arteries of the heart.

Mitral Valve Prolapse (MVP) – is a disorder that affects one of the heart’s valve—the mitral valve.  It occurs when the valve doesn’t close properly allowing backward leaking of blood in your heart.  This may cause some people to get an infection that allocates in the valve when they have dental work or surgery.

Myocarditis – is an inflammation of the muscular wall of the heart that causes the pumping action of the heart to weaken and enough oxygen-rich blood is not supplied to the body. It may be caused by viral, bacterial or fungal infection.

Restrictive Cardiomyopathy (RCM) – this is a condition where the rhythm and pumping action may be healthy, but the stiff walls of heart chambers keeps them from filling normally.  Blood flow is reduced and blood that would normally enter the heart is backed up in the circulatory system.
 
Electrical
 
Brugada Syndrome – an arrhythmia that causes the bottom chambers of the heart (the ventricles) to beat so fast that they can prevent blood from circulating efficiently in the body.  When this occurs it is called ventricular fibrillation.

Catecholamineric Polymorphic Ventricular Tachycardia (CPVT) – is a disorder triggered by exercise or stress in which the heart’s pumping chambers go into uncontrolled rhythms that do not pump blood effectively.

Long Q-T Syndrome (LQTS) – is a disorder of the heart’s conduction system that affects the recharging of the heart after each heartbeat.  LQTS is usually inherited.  In other cases, LQTS can be caused by certain medicines or neurological disorder.

Wolff-Parkinson-White Syndrome (WPW) – is an abnormality of the heart’s electrical system.  In patients with WPW, there is an extra electrical pathway between the upper chambers and the lower chambers.  This condition can create a “short circuit” in the electrical system and lead abnormally fast heart rates (tachycardias).
 
Other
 
Commotio Cordis – is a concussion of the heart that can occur when someone is hit in the chest in the area of the heart.

Drugs or Stimulants – even someone with a completely normal heart can develop ventricular fibrillation and die suddenly due to drug or stimulant use.

What is the best way to treat a cardiac arrest?

  • Early 911 access to help
  • Early CPR to buy time; push hard and fast on the center of the chest
  • Early AED (defibrillation) to restart heart
  • Early Advance Cardiac Life Support (ACLS) to stabilize