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Sudden Cardiac Death
Also known as Sudden Cardiac Arrest or Cardiac Arrest
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Sudden cardiac arrest takes about 300,000 lives in the US each year. The amount of people lost is greater than those with lung cancer, breast cancer and AIDS all together. Of those who suffer cardiac arrest, more than 90 percent of these people actually die. It often signals a first vascular event in someone without a history of coronary heart disease and is often their only event in their lifetime.
The heart is an electrical pump that uses electrical signals in pacemakers of the heart in order to signal to the heart muscles to contract in a regular fashion. If something happens to the pacemaker of the heart due to blockage of the heart arteries or due to electrocution or other interruption of the electrical signals of the heart, the heart fibrillates and stops beating in the usual fashion. The end result is sudden cardiac death because the heart has no way of sending oxygen to its own blood vessels or to the brain and death ensues. Sudden cardiac death can be due to ventricular fibrillation as well as to asystole or complete lack of movement of the heart. Ventricular fibrillation can degenerate into asystole after a period of time.
The symptoms of sudden cardiac arrest may involve a brief period of chest pain and shortness of breath or it can have no pre-warning symptoms at all. The individual with sudden cardiac death simply collapses to the ground and is not breathing nor does he or she have a definable pulse. The person is rapidly unconscious and requires instant medical attention.
The diagnosis of cardiac arrest is usually based on signs of collapse and a lack of pulse but, in medical settings, the heart rhythm will change on the monitor, showing ventricular fibrillation or asystole.
The causes of sudden cardiac arrest include a heart attack in which a blood vessel in the coronary arteries is blocked and it affects the pacemaker of the heart. This is also called a myocardial infarction. Ventricular fibrillation is the usual result of this pacemaker dysfunction. Congestive heart failure, aortic stenosis and other cardiac valvular problems can lead to sudden cardiac arrest. Because sudden cardiac arrest is a side effect of having a heart attack, all people with suspected heart attack are monitored for the first several days after the attack so that they can be treated immediately in cases of sudden cardiac arrest.
Myocarditis is inflammation of the heart that can lead to sudden cardiac death. Certain diseases like sarcoidosis and amyloidosis can cause myocarditis leading to cardiac arrest. Electrical heart diseases like Wolff-Parkinson-White syndrome can result in a heart arrhythmia leading to death. Marfan syndrome can lead to valvular abnormalities that can, in turn, lead to cardiac arrest. A pulmonary embolus can cause a blood clot to travel to the lungs so that no oxygenated blood can go to the heart. The heart stops relatively quickly when a pulmonary embolus happens. In addition, blunt chest trauma can result in immediate cardiac arrest.
In rare cases, young people involved in athletics can have sudden cardiac death. Many of these cases result from having undiagnosed hypertrophic cardiomyopathy. This means that the heart muscle is enlarged. This is often a hereditary disease. It causes decreased blood flow to the heart during heavy exercise. The heart muscle becomes irritated and electrical problems occur. In young people, there can be the presence of anomalous coronary arteries, leading to sudden death. The heart doesn't get enough oxygen in certain places and arrhythmias can occur.
The treatment of sudden cardiac arrest involves quickly reestablishing a pulse. This can be done with an automatic external defibrillator or AED. They are found in airplanes, airports and sporting places so that a heart can be started quickly if the rhythm indicates that cardiac arrest has occurred. It specifically looks for ventricular fibrillation and delivers a shock to defibrillate the individual. The EMTs who respond to a home arrest can quickly defibrillate the individual and can save their life. There is a risk of severe and permanent brain injury if defibrillation is not done promptly. Following the resuming of the heart rhythm, tests can be done to determine the cause of the cardiac arrest so as to prevent and treat any further episodes. This often involves an echocardiogram and cardiac catheterization to check on the stability of the heart vessels and the heart muscles and valves.