Download What is cardiac arrest? Cardiac arrest is the abrupt loss of heart

What is cardiac arrest?
Cardiac arrest is the abrupt loss of heart function in a person who
may or may not have diagnosed heart disease. The time and
mode of death are unexpected. It occurs instantly or shortly after
symptoms appear.
Each year about 295,000 emergency medical services-treated
out-of-hospital cardiac arrests occur in the United States.
Recently, a boy from Longview, collapsed during basketball
practice. His heart stopped for five minutes. He is alive today because of the quick actions of his coach and another
parent who were both trained in CPR. This boy had no prior heart issues and was in prime physical condition.
Medical professionals are saying that an electrocardiogram (ECG) may have identified the underlying cause of his
heart stopping. In fact, there is a movement to make an ECG a routine part of a sports physical. I have attached
information from Parent Heart Watch, a group aimed at protecting youth from sudden cardiac arrest. Please take a
moment and familiarize yourself with this syndrome, especially if you have a child who participates in youth sports.
Is a heart attack the same as cardiac arrest?
No. The term "heart attack" is often mistakenly used to describe sudden cardiac arrest. While a heart attack may
cause cardiac arrest and sudden death, the terms don't mean the same thing. Heart attacks are caused by a
blockage that stops blood flow to the heart. A heart attack (or myocardial infarction) refers to death of heart muscle
tissue due to the loss of blood supply, not necessarily resulting in the death of the heart attack victim.
Cardiac arrest is caused when the heart's electrical system malfunctions. In cardiac arrest death results when the
heart suddenly stops working properly. This is caused by abnormal, or irregular, heart rhythms (called arrhythmias).
The most common arrhythmia in cardiac arrest is ventricular fibrillation. This is when the heart's lower chambers
suddenly start beating chaotically and don't pump blood. Death occurs within minutes after the heart stops. Cardiac
arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed or a defibrillator is used to shock the
heart and restore a normal heart rhythm within a few minutes.
Cardiac arrest strikes immediately and without warning.
Here are the signs:
 Sudden loss of responsiveness (no response to tapping on shoulders).
No response to tapping on shoulders.
Does nothing when you ask if he's OK.
If these signs of cardiac arrest are present,
 Yell for help
Tell someone to call 9-1-1 or your emergency response number and get an AED (if one is available).
If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is
available).
 Check breathing:
If the person isn't breathing or is only gasping, give CPR.
 Push hard and Push Fast
Use an AED as soon as it arrives by turning it on and following the prompt.
 Keep pushing until the person starts to breathe or move or someone with more advanced training takes
over.
Sudden cardiac arrest may be caused by almost any known heart condition. Most cardiac arrests occur when the
diseased heart's electrical system malfunctions, producing an abnormal rhythm such as ventricular tachycardia or
fibrillation. Some cardiac arrests are caused by extreme slowing of the heart's rhythm. All these events are called lifethreatening arrhythmias.
 Scarring from a prior heart attack or other causes: A heart that's scarred or enlarged from any cause is
prone to develop life-threatening ventricular arrhythmias. The first six months after a heart attack is a
particularly high-risk period for sudden cardiac arrest in patients with atherosclerotic heart disease.
 A thickened heart muscle (cardiomyopathy) from any cause (typically high blood pressure or valvular
heart disease) — especially if you also have heart failure — can make you more prone to sudden cardiac
arrest.
Read more about cardiomyopathy
Heart medications: Under certain conditions, various heart medications can set the stage for arrhythmias
that cause sudden cardiac arrest. Paradoxically, antiarrhythmic drugs used to treat arrhythmias can
sometimes produce lethal ventricular arrhythmias even at normally prescribed doses. This is called a
"proarrhythmic" effect. Regardless of whether there's organic heart disease, significant changes in blood
levels of potassium and magnesium (from using diuretics, for example) also can cause life-threatening
arrhythmias and cardiac arrest.
 Electrical abnormalities: Certain electrical abnormalities such as Wolff-Parkinson-White syndrome and
long QT syndrome may cause sudden cardiac arrest in children and young people.
 Blood vessel abnormalities: Less often, inborn blood vessel abnormalities, particularly in the coronary
arteries and aorta, may be present in young sudden death victims. Adrenaline released during intense
physical or athletic activity often acts as a trigger for sudden cardiac arrest when these abnormalities are
present.
 Recreational drug use: In people without organic heart disease, recreational drug use is a cause of sudden
cardiac arrest.
Signs of cardiac arrest: It strikes suddenly and without warning.
 Sudden loss of responsiveness
No response to tapping on shoulders
Does nothing when you ask if he is okay
 No normal breathing
The victim does not take a normal breath when you tilt the head up
Check for at least five seconds
If these signs of cardiac arrest are present:
 Call 9-1-1 for emergency medical services.
 Get an automated external defibrillator (AED)
If one is available
 Begin CPR immediately
Continue until professional emergency medical services arrive
 Use the AED as soon as it arrives.
If two people are available to help, one should begin CPR immediately while the other calls 9-1-1 and finds an AED.
Cardiac arrest is reversible in most victims if it's treated within a few minutes. This first became clear in the
early 1960s with the development of coronary care units. Electrical devices that shocked the heart were discovered to
turn an abnormally rapid rhythm into a normal one. Before then, heart attack victims had a 30 percent chance of
dying if they got to the hospital alive; 50 percent of these deaths were due to cardiac arrest. In-hospital survival after
cardiac arrest in heart attack patients improved dramatically when the DC defibrillator and bedside monitoring were
developed. Later, it also became clear that cardiac arrest could be reversed outside a hospital by properly staffed
emergency rescue teams trained to give CPR and defibrillate.
Immediate treatment is essential to survival of cardiac arrest. The problem isn't whether cardiac arrest can be
reversed but reaching the victim in time to do so. The American Heart Association supports implementing a "chain of
survival" to rescue people who suffer cardiac arrest. The chain consists of:
 Early recognition of the emergency and activation of the emergency medical services (EMS).
 Early defibrillation when indicated.
 Early bystander CPR (cardiopulmonary resuscitation).
 Early advanced life support followed by postresuscitation care delivered by healthcare providers
Care for Children
Not as much is known about care for children who experience cardiac arrest, but critical elements include managing
temperature, glucose, blood pressure, ventilation and cardiac output. Survival is higher in hospitals with specialized
pediatric staff.