The incidence of cardiac arrests has risen manifolds in the recent past, especially due to the COVID emergence. Cardiac arrest happens when the heart stops pumping suddenly. It occurs when the heart does not beat at all or beats so fast that the pumping becomes completely functionally ineffective. Also, in times like these when everyone is tensed and worried about their health in these pandemic times, the extra stress certainly adds pressure on the heart, leading to heart conditions like sudden cardiac heart arrests. To observe Heart Day for raising awareness among masses, Dr Santosh Kumar Dora, Senior Cardiologist, Asian Heart Institute, Mumbai explains about Sudden Cardiac Arrest in details:
What causes sudden cardiac arrest?
One of the most common causes of cardiac arrest is a heart attack. Around 30 per cent of the people suffering from a heart attack may get a cardiac arrest. Other causes of cardiac arrests may also include cardiomyopathy, which a condition when the heart muscle becomes weak because of various reasons, i.e. ischemic, infective, alcoholic, genetic. Another cause can be a heart block, which primarily happens due to lack of current flowing to the heart's lower chamber.
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Who is at risk of sudden cardiac arrest?
The risk of sudden cardiac arrest is very high in a person who has just suffered a heart attack. So these patients should be immediately hospitalized to prevent sudden cardiac arrest and start treatment to prevent heart muscle damage. Patients with low heart pumping function also are at high risk in the coming months and years.
These patients are advised to undergo cardioverter-defibrillator implantation to prevent sudden cardiac death due to sudden cardiac arrest. Some young patients having ion channel abnormality or cardiomyopathy are at risk of sudden cardiac arrest. These problems are to be suspected in young patients who give a history of syncope.
What causes sudden cardiac arrest in youngsters?
Heart attack has become common in the young population (30 to 40 year age) also and remains the most typical cause of heart attack. The other reasons are different types of cardiomyopathies (hypertrophic cardiomyopathy, Arrhythmogenic right ventricular dysplasia), ion channel abnormalities (long QT syndrome, Brugada syndrome, catecholamine mediated polymorphic ventricular tachycardia) etc.
How can sudden cardiac arrest be prevented?
The best way to prevent sudden cardiac arrest is to decrease the risk of a heart attack. This can be done by reducing the risk factors for heart attack. The modifiable risk factors are smoking, efficient control of diabetes and hypertension, control of dyslipidaemia, change in diet habit and regular exercise to avoid obesity etc. Regular health check-up will identify underlying heart problems like cardiomyopathy, heart-pumping abnormality, ECG changes suggesting ion channel abnormality etc. Once these problems are detected, corrective steps can be taken to prevent sudden cardiac arrest.
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How should a sudden cardiac arrest be treated?
If you see somebody collapsing suddenly in front of you, then think of sudden cardiac arrest. Check his status of consciousness, breathing and if possible heartbeat. If he/she is unconscious and not living and you are not able to feel a pulse, then most likely he/she has suffered from sudden cardiac arrest. Immediately alert a person nearby to call for an ambulance and start cardiopulmonary resuscitation. This keeps the victim alive until the defibrillator arrives. Once an ambulance comes with a defibrillator, then the paramedical personnel can deliver shock through the defibrillator to terminate ventricular fibrillation (heart rhythm, which results in cardiac arrest). The victim usually regains consciousness afterwards. These patients should undergo a detailed medical evaluation and be treated accordingly to prevent any further episode of cardiac arrest. Many of them may require an implantable defibrillator, which delivers instant therapy/shock internally as soon as cardiac arrest happens in future.
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