What you should know about cardiac arrest

 BY STEPHEN SEMUJJU 

 

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Bolton Wanderers’ Fabrice Muamba being carried off the pitch during a football match against Tottenham after he suffered a cardiac arrest.

Every October 16 is marked as the World Heart Day. So this brings us to the attention of the devastation the heart diseases have on our health.

The country has watched in shock of recent as ministers and one General died and the cause of death for all the three was said to be cardiovascular in nature.

With great concern, it has been confirmed that world over, heart problems are now the leading cause of both ill-health and death globally, overtaking the communicable diseases.

The increase in heartrelated morbidity and mortality has not only increased in the west but even the southern hemisphere including our sub-Saharan Africa.

This does not only lead to high numbers of patients who die from cardiovascular conditions but also a dilemma in the health care in that while we are still prioritizing our scarce resources on the infectious (diseases of the poor) a large chunk is being spent on CVDs.

Sudden cardiac death (SCD) is an unexpected death caused by loss of heart function.

Is sudden cardiac arrest different from a heart attack? 

Sudden cardiac arrest is not a heart attack (myocardial infarction) but can occur during a heart attack.

A heart attack occurs when there is a blockage in one or more of the arteries to the heart, preventing the heart from receiving enough oxygen-rich blood.

If the oxygen in the blood cannot reach the heart muscle, the heart becomes damaged.

In contrast, sudden cardiac arrest occurs when the electrical system to the heart malfunctions and suddenly becomes very irregular.

The heart beats dangerously fast. The ventricles may flutter or quiver (ventricular fibrillation), and blood is not delivered to the body.

In the first few minutes, the greatest concern is that blood flow to the brain will be reduced so drastically that a person will lose consciousness.

Death follows unless emergency treatment is begun immediately.

Emergency treatment includes cardiopulmonary resuscitation (CPR) and defibrillation.

CPR is a manual technique using repetitive pressing to the chest and breathing into the person’s airways that keeps enough oxygen and blood flowing to the brain until the normal heart rhythm is restored with an electric shock to the chest, a procedure called defibrillation.

Emergency squads use portable defibrillators and frequently there are public access defibrillators (AEDs, ambulatory external defibrillators) in public locations that are intended to be available for use by citizens who observe cardiac arrest.

Symptoms of sudden cardiac arrest? 

Some people may experience symptoms of sudden cardiac arrest, such as a racing heartbeat or feeling dizzy, alerting them that a potentially dangerous heart rhythm problem has started.

If you have any of the risk factors for sudden cardiac death (listed above), it is important that you speak with your doctor about possible steps to reduce your risk.

Keeping regular follow-up appointments with your doctor, making certain lifestyle changes, taking medications as prescribed, and having interventional procedures or surgery (as recommended) are ways you can reduce your risk.

Your doctor will tell you how often you need to have follow-up visits. To prevent future episodes of sudden cardiac arrest, your doctor will want to perform diagnostic tests to determine what caused the cardiac event.

Tests may include electrocardiogram (ECG or EKG), ambulatory monitoring, echocardiogram, cardiac catheterization, and electrophysiology studies.

Can sudden cardiac death be prevented? 

Ejection Fraction (EF): EF is a measurement of the percentage (fraction) of blood pumped (ejected) out of the heart with each beat.

EF can be measured in your doctor’s office during an echocardiogram (echo) or during other tests such as a MUGA (multiple gated acquisition) scan, cardiac catheterization, nuclear stress test, or magnetic resonance imaging (MRI) scan of the heart.

The EF of a healthy heart ranges from 55% to 75%. Your EF can go up and down, based on your heart condition and the effectiveness of the therapies that have been prescribed.

If you have heart disease, it is important to have your EF measured initially, and then as needed, based on changes in your condition. Ask your doctor how often you should have your EF checked.

Reducing your risk factors 

If you have coronary artery disease — and even if you do not — there are certain lifestyle changes you can make to reduce your risk of sudden cardiac arrest.

These lifestyle changes include:

  • Quitting smoking
  • Losing weight
  • Exercising regularly
  • Following a low-fat diet
  • Managing other health conditions including high blood pressure and cholesterol

If you have questions or are unsure how to make these changes, talk to your doctor.  Patients and families should know the signs and symptoms of coronary artery disease and the steps to take if symptoms occur.

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