Cardiac arrest

Cardiac arrest occurs when the heart stops pumping blood.

A person threatens to collapse, stop breathing, has no heartbeat and loses consciousness.

If you are lucky, symptoms such as tiredness, fainting, dizziness, chest pain, shortness of breath, palpitations or vomiting may have been preceded, each of which represents alarm bells.
But often there are no signs ahead.
Primary cardiac arrest occurs when the heart stops beating but the lungs continue to function.


Sudden cardiac arrest

Cardiac arrest occurs when the heart suddenly stops beating. In cardiac arrest, the blood no longer travels to the brain and other vital organs.
If not treated in a few minutes, the sudden cardiac arrest leads to death.

Causes of sudden cardiac arrest

  1. Caripathy: It is detected in victims of sudden cardiac death. In 90% of cases, narrowing of the coronary arteries is observed.
  2. Cardiac arrest caused by cardiac medications: Sometimes these drugs lead to a fatal ventricular arrhythmia.
  3. Hyperkalemia or hypokalemia: In the body, insufficient or massively elevated potassium levels can be dangerous.
    This situation occurs especially if the patient suffers from renal insufficiency.
  4. Arrhythmia: There may be a short circuit between the upper and lower chambers of the heart. Tachycardia occurs when electrical conduction is reduced or when the heart stops responding to electrical signals.
    The arrhythmia can lead to sudden cardiac death.
  5. Changes in blood vessels: These include congenital abnormalities of blood vessels. The release of adrenaline during intense exercise can trigger cardiac death.
  6. Cardiac arrest can occur during surgery related to anesthesia or because of problems with endotracheal intubation.

Natural causes of cardiac arrest

The most common and dangerous cause is an irregular heart rhythm called ventricular fibrillation (VF).
Ventricular fibrillation occurs when the electrical activity becomes so irregular that the heart flickers and a pumping failure of the heart occurs. There are several causes of VF.
Causes of cardiac arrest include some heart conditions, for example:

  1. Ischemic cardiopathy
  2. Myocardial infarction
  3. Cardiomyopathy
  4. Congenital heart disease
  5. Valvular heart disease (e.g. aortic valve stenosis)
  6. Acute myocarditis (inflammation of the heart muscle)
  7. Arrhythmia, such as long QT syndrome

Ventricular fibrillation can also occur with:

  1. reduction of oxygen in the body, for example, when suffocating;
  2. taking drugs, such as cocaine or mephedrone;
  3. severe blood loss.

Sometimes the VF can be corrected by electric shock over the wall of the chest using a defibrillator.

Causes of cardiac arrest in children

The main reasons for cardiac arrest in childhood are:

  • Trauma.
  • In infants, it occurs mainly due to drowning or obstruction of the airways.
  • As a rule, cardiac arrest in young people is caused by an arrhythmia and can occur during the day, but also during sleep.
  • Cardiac arrest during sports occurs mainly due to ventricular fibrillation.

Risk factors

Sudden cardiac arrest can be associated with coronary heart disease and often the risk factors overlap.
These include:

  • familial predisposition to coronary heart disease;
  • Smoke;
  • high blood pressure;
  • high cholesterol in the blood;
  • Overweight;
  • Diabetes;
  • Lack;
  • bulimia (especially in adolescents);
  • Alcohol abuse (more than one glass a day).

Other factors that may increase the risk of sudden cardiac death:

  • Previous or familial episodes of cardiac arrest.
  • Previous myocardial infarction.
  • Medical history and family history of other heart conditions such as arrhythmia, congenital cardiopathy, heart failure and cardiomyopathy.
  • Age: The likelihood of sudden cardiac arrest increases with age, especially after age 45 for men and age 55 for women.
  • Male: Men are two or three times more likely to experience sudden cardiac arrest than women.
  • Use of illegal drugs, such as cocaine or amphetamines.
  • Unbalanced nutritional status such as decreased potassium or magnesium.

Cardiac arrest and myocardial infarction

The heart attack (or myocardial infarction) is a disruption of blood flow due to the occlusion of a coronary artery.
Occlusion may occur completely or partially and may affect one or more arteries.

This type of interruption of blood supply leads to the death of part of the heart muscle.
Usually, this condition occurs along with serious symptoms such as chest tightness, shortness of breath, anxiety, etc.
As a rule, the reduced blood flow is caused by a clot in the coronary artery.
The therapy of heart attack consists in the dissolution of this clot.

Difference between Cardiac Arrest and Infarction
Not all cardiac arrests are the same.
One of the causes of cardiac arrest is hypoxia and the severe lack of oxygen in the heart muscle, which stops functioning. The heart attack is therefore not always a precursor of cardiac arrest.

Diagnostic tests to detect cardiac arrest

The first sign of sudden cardiac arrest is a loss of consciousness, but it is often diagnosed far too late.

Diagnostic examinations include:

  • Electrocardiogram (ECG): a simple examination in which the electrical activity of the heart is measured from the surface of the body
  • Echocardiogram: Sound waves are used to display moving images. The echocardiogram provides information about the size, shape and functionality of the heart chambers and heart valves.

What to do? Immediate treatment

Sudden cardiac arrest is a medical emergency that requires immediate treatment. If help is provided quickly, the chances of survival are greater.
If the heart stops, the oxygenated blood does not reach the brain, which can lead to brain damage in a few minutes.
Death occurs within 8-10 minutes.

Anyone who notices sudden cardiac arrest in a person must immediately call 112 and begin resuscitation measures.

While waiting for the emergency doctor, the basic resuscitation measures (BLS / Basic Life Support) or a cardiac massage (HDM) must be performed.

Cardiopulmonary resuscitation (CPR) can save a person’s life because this procedure keeps blood and oxygen circulating until emergency responders arrive.

  1. To prevent the tongue from sliding backwards into the throat, the neck must be overstretched by lifting the chin with two fingers.
  2. For HDM, the person’s chest is simply pressed down firmly and quickly and released completely after each compression.
  3. If the speed until the emergency doctor arrives is about 2 compressions per second, the person’s mouth-to-mouth resuscitation can be omitted.

This process must continue until the emergency team has arrived or the person has regained consciousness.

If an automated external defibrillator (AED) is present, the best way to save lives is to defibrillate with this device.

Portable automated external defibrillators (AED) are available in many places, such as airports and shopping malls. The presence of such defibrillators in emergency situations is ideal only for those who know how to use them.

The application is to administer an electric shock, as recommended by the device. Then the cardiac massage is started or continued for about 2 minutes.

The sooner you start defibrillation, the higher the probability of survival.
When the rescue personnel arrive, defibrillation can be used to resuscitate the patient.
This is done by an electric shock addressed to the heart via electrodes that are placed on the chest.

In the emergency room, an attempt is made to stabilize the patient’s condition and treat a possible heart attack, heart failure or electrolyte imbalances.

In many cases, medication is given to stabilize the heart rhythm.
After the patient has been stabilized, other tests may be necessary to find the cause of the disease.

It is very important that people know the symptoms of asystole in order to be able to act immediately.
This disorder can be prevented with treatment within a few minutes of the onset of the episode.

How to stop a heart attack alone?
There is no effective way to stop a heart attack when the affected person is alone. This requires appropriate medical intervention. The only way to prevent a heart attack is to follow a healthy lifestyle, a healthy diet for the heart, and carefully follow therapy if cardiovascular disease has been diagnosed.

How long can you withstand cardiac arrest? Prognosis in cardiac arrest (asystole)

The prognosis varies from case to case.
Some patients fall into a coma, awakening can occur after a few days, weeks or after an indefinite period of time.
For others, the functionality is only partially restored.

The mortality rate increases proportionally to the period in which the heart does not beat.

The survival rate can approach 90% if therapy starts in the first minutes after fulminant cardiac arrest.
The survival rate decreases by about 10% with every minute that passes.
Those who survive have a good and long-term perspective.
Intervention in the first few minutes can save a person, but after 9-10 minutes he dies.

To prevent a heart attack, one should stop smoking, reduce body weight and lower cholesterol and blood sugar.

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