What you need to know about sudden cardiac arrest
During sudden cardiac arrest, minutes matter
Sudden Cardiac Arrest Awareness Month is a vital initiative set forth by the Heart Rhythm Society to educate the public and raise awareness for sudden cardiac arrest. Sudden Cardiac Arrest (SCA) can lead to death within just minutes of the event if the victim doesn’t receive immediate medical attention or help. These episodes are aptly named as they happen suddenly, “meaning that there is often no warning ahead of time that there could be a problem,” adds Dr. Kevin Woods, a board-certified cardiologist at Capital Cardiology Associates. He explained how SCA is the leading cause of death, taking more lives than breast cancer, lung cancer, or AIDS in the United States. How the most important person during an SCA event is YOU.
Not a heart attack or stroke
SCA is often confused for a heart attack because they share a cardiac connection due to the instant onset that can strike without warning. What makes cardiac arrest dangerous is that there are underlying causes that trigger the heart to beat out of rhythm or sync. “Usually, it’s a problem when the heart rate beats very fast, not as you see in movies where someone flatlines or needs to be shocked,” explained Dr. Woods. SCA typically originates as an electrical problem, an arrhythmia. When the lower chamber of your heart (ventricle) receives erratic signals, it will throw off the heart from beating and pumping blood efficiently. When an event occurs, the victim may complain of chest pain, discomfort, heart palpitations, shortness or difficulty breathing, feeling faint, lightheaded, or dizzy. Sudden cardiac arrest will cause the heart to beat out of sync, robbing the brain of blood flow, leading to unconsciousness.
The breakdown of a sudden cardiac event sounds very much like a heart attack, but it’s important to note the main difference: SAC is an electrical issue where heart attack is a plumbing problem. In a heart attack, we see blood flow interruptions due to plaque (a fatty substance) clogging arteries. “When plaque ruptures, a blood clot forms that robs the heart muscle of oxygen, inducing a heart attack. That can precipitate sudden cardiac death, which is where a heart attack can overlap with sudden cardiac arrest,” noted Dr. Woods. In both cases, when the heart stops beating, the loss of blood can cause permanent brain or heart muscle damage or death after as few as 10 minutes.
Another distinguishing fact is that sudden cardiac arrest can strike anyone, at any age. Thankfully, cardiac arrest events are rare in children between the ages of 5-19 years old, claiming the lives of over 2,000 children a year. When these deaths are reported, they are tragic, leaving communities to seek what can prevent future loss. Parent Heart Watch is a national organization that strives to protect youth from sudden cardiac arrest. Their website states that 72% of students who suffered from SCA were reported by their parents to have had at least one cardiovascular symptom before the event. They didn’t recognize it as life-threatening. Many young people don’t speak up about possible symptoms because they are not aware of their unusual condition, are afraid of being different, or fear losing playing time.
What can be done
Communication with your teenager is key in creating awareness. As a physician and father, Dr. Woods understands the challenge of talking with teens about their health. “The important point is when you are aware of a family history of heart problems, that is definitely a reason to be specific with your children and your health care provider. With teens, you will have to engage them in the conversation. You should also have an open dialogue with your provider on your concerns.” A grandparent or parent that had a heart attack at a young age, like 50, is information you should share with your children and doctor. “People are labeled as having a heart attack frequently when it might not be exactly what happened. It could be a cardiac symptom or seizure that was misdiagnosed at the time. If it’s an event that happens at 50 or younger, that results in death, that is a major red flag.” You also play a major role in your health. Self-prevention includes regular checkups with your healthcare provider, being screened for heart disease, and making good lifestyle choices.
Quickly reacting to a sudden cardiac arrest can dramatically increase the chance of survival. For every minute in SCA, the chance of survival decreases by about 10%. Health experts point out that calling 9-1-1 isn’t enough to provide support during this health emergency. The amount of time it typically takes emergency medical services to arrive, around 10 minutes in the best estimates, affects survival chances. In his initial setting with patients, Dr. Woods experiences best and worst-case scenarios. “There are patients who come in unconscious due to treatment on the way to the emergency department. Some we have to induce a coma as part of a protocol to cool down their core temperature to improve the chance of having fewer neurological defects or brain damage after their event.” Since an SCA episode contains sudden collapse, unresponsiveness, or loss of breathing, CPR is a life-saver. Beginning hard and face chest compressions at the center of the chest can stimulate the heart to start working again.
The shock of an automated external defibrillator (AED) can re-establish an effective heart rhythm. The American Red Cross is one of many organizations that offer AED training. These small, portable devices deliver a strong shock while waiting for emergency responders. The sooner the AED shock is given, the better the outcome as these devices are most effective if used within three minutes after cardiac arrest. In New York State, every school must have an AED – especially at sports/athletic activities. High school seniors are now required to learn how to administer an AED or CPR. AEDs are also required at beaches, pools, trampoline parks, and state buildings. “The good news is that we do save people. Those numbers are on the rise due to awareness in the general population, the availability of AED’s, more people getting certified in CPR, and new protocols that we follow in the hospital to help people recover. It’s amazing to see how far people can go after an event of this magnitude,” Dr. Woods optimistically added.