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SUDDEN CARDIAC ARREST AND SHOCK

Dr. B.G.K. Sudhakar, Friday, October 25, 2019

WHAT IS SUDDENT CARDIC ARREST?

Sudden cardiac arrest (SCA) is not a heart attack (myocardial infarction). Heart attacks occur when there is a blockage in one or more of the coronary arteries, preventing the heart from receiving enough oxygen-rich blood. If the oxygen in the blood cannot reach the heart muscle, the heart becomes damaged.

In contrast, Sudden Cardiac Arrest occurs when the electrical system to the heart malfunctions and suddenly becomes very irregular. The heart beats dangerously fast. The ventricles may flutter or quiver (ventricular fibrillation), and blood is not delivered to the body.


What causes SCA?

Sudden cardiac arrest happens most often in adults in their mid-30s to mid-40s. It affects men twice as often as it affects women. It hardly ever affects children, unless they have an inherited problem that increases their risk.

People with heart disease have a greater chance of SCA, but it can happen in people who appear healthy and do not know they have any heart problems.

Irregular heart rhythms, called arrhythmias, may cause the heart to stop beating. Another type of arrhythmia, called bradycardia, which is a very slow heart rate, can also cause SCA.


WHAT ARE THE OTHER CAUSES OF SCA?

Other reported causes of SCA are:

  • Coronary Artery Disease (CAD): Any scarring or damage to the heart after a heart attack increases the risk of arrhythmia and SCA.
  • Physical Stress: Intense physical activity or exercise in patients with coronary disorders can lead to SCA because the release of the hormone adrenalin acts as a trigger for SCA.
  • Inherited Disorders: Some types of arrhythmias tend to run in families. Also, people born with heart defects, a coronary artery anomaly (CAA), or Brugada Syndrome may be at greater risk of SCA.


WHAT ARE THE SIGNS AND SYMPTOMS OF SCA?

The first sign of SCA is fainting or a loss of consciousness, which happens when the heart stops beating. Breathing may also stop at this time. Some people may experience dizziness or lightheadedness just before they faint.


HOW IS SCA DIAGNOSED?

SCA happens quickly and without warning, so it usually cannot be diagnosed. But there are tests that doctors use to determine if patients are at risk of SCA:

  • Electrocardiography (ECG or EKG): This test can help your doctor learn more about your heart rhythm, the size, and function of the chambers of your heart, and your heart muscle.
  • Echocardiography: This uses sound waves to produce an image of the heart to see how it is working.
  • Cardiac Catheterization: It involves threading a long, thin tube (called a catheter) through an artery or vein in the leg or arm and into the heart.
  • Electrophysiology Studies: This uses cardiac catheterization techniques to study patients with arrhythmias.
  • Gated Blood Pool Scan or MUGA: This shows how well your heart is pumping blood.
  • Magnetic Resonance Imaging: This gives doctors detailed pictures of your heart.


How is SCA treated?

Sudden cardiac arrest should be treated right away with a defibrillator, which is a device that sends an electrical shock to the heart to restore its normal rhythm.

If there are no defibrillators available, cardiopulmonary resuscitation (CPR) should be performed. The chest compressions given during CPR move a small amount of blood to the heart and brain, “buying time” until a normal heartbeat can be restored.

In some patients, balloon angioplasty or coronary artery bypass surgery may be performed to treat their CAD and prevent the heart damage that can lead to arrhythmias and SCA.


WHY KIMS?

Emergency medical personnel and doctors at KIMS Hospital will provide essential medical care and intensive monitoring. They will give drugs, insert a tube to maintain an open airway, and manage emergency care. With such prompt care and quick responsive team, patients with SCA are rarely in danger.

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