8 things to know about sudden cardiac arrest

Health
Individual performing CPR

Sudden cardiac arrest occurs when the heart suddenly and unexpectedly stops beating. Blood stops flowing to the brain and other vital organs, and a person usually collapses. If not treated immediately, a person can die within minutes.
The condition – not to be confused with a heart attack – is a leading cause of death in the United States, claiming the lives of about 325,000 people each year.
We sat down with Dr. Michael Malinics, a fellowship-trained heart and vascular physician with Tidelands Health Heart and Vascular Specialists, to learn more about the condition, including how it differs from a heart attack and who is at risk.

What causes sudden cardiac arrest?

A number of factors can lead to sudden cardiac arrest. The most common is coronary artery disease or, if you’ve had a prior heart attack, you’re at high risk. Some inherited disorders also could lead to sudden cardiac arrest, especially in younger patients, but they can occur in older patients as well.

How is sudden cardiac arrest different than a heart attack?

I like to think of it as the electricity versus the plumbing. A heart attack is the plumbing of the heart. With a heart attack, the heart stops receiving blood flow because of a blockage in the coronary artery, and your heart usually doesn’t stop beating when that occurs.

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Sudden cardiac arrest is more of an electrical phenomenon in the heart causing it to stop pumping or beating. The heart basically stops pumping blood to the body so you’re not getting any blood flow or cardiac output to the brain and the organs. You would collapse and go into what we call cardiac arrest.

Are there any symptoms that occur before that happens?

A lot of times – no. Sometimes it can occur suddenly. You could be going about your normal activities feeling completely fine and then suddenly you go into ventricular fibrillation and develop this electrical phenomenon that causes the cardiac arrest.
Other times, patients can feel palpitations. Their heart is flipping, flopping, racing. You may feel short of breath and nauseated, but in most cases, it occurs suddenly when you least expect it.

How common is sudden cardiac arrest?

It’s actually very common. About 325,000 people die a year because of sudden cardiac arrest, so the numbers are pretty high.
This is why you often see AEDs – automated external defibrillators – in airports, malls and even schools. The AED allows you to put an electrical patch on the chest and deliver a potentially life-saving shock.

What can someone do to reduce the risk?

Be evaluated by a doctor. If you have known ischemic heart disease – you’ve had a heart attack – know what your ejection fraction number is. Ejection fraction is a measurement of how much blood the left ventricle pumps out with each contraction. A normal ejection fraction may be between 50 and 70 percent.
If it’s 35 percent or less, you might be a candidate for a defibrillator, which is a small device implanted underneath the skin that can deliver a potentially life-saving shock if your heart suddenly fibrillates. It’s like a pacemaker, but a little bit larger.

What other steps can a person take to help limit risk?

You can also help prevent a heart attack by reducing your risk factors. If you have high blood pressure, keep it under control. If you have high cholesterol, keep your numbers down, and you need to be on a statin. Also, know your family history, especially any inherited disorders such as long QT syndrome, which is an electrical phenomenon in the heart that can lead to sudden cardiac arrest.
Another condition with cardiac arrest is hypertrophic cardiomyopathy, a disease in which the heart muscle becomes abnormally thick and can make it harder for the heart to pump blood.

What else should people know about sudden cardiac arrest?

It’s very important that the public is aware of the disorder and knows that it runs in families. If you have had a heart attack, know your ejection fraction. And, above all, I believe everyone should learn CPR so that you can save a life.

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