The silent killer: Sudden cardiac arrest

India accounts for one-fifth of the total deaths occurring from stroke, cardiac arrest, and heart attacks, especially in younger adults. As per NCBI, cardiovascular diseases affect Indians a decade earlier than their western counterparts and nearly 3 million people die of cardiac arrest, stroke, and heart attacks every year. The most unfortunate part is that 40% of those who suffer a heart attack, or a cardiac arrest are below the age of 55.

What is sudden cardiac arrest?

A sudden cardiac arrest is an abrupt loss of heart function, breathing and consciousness and it happens when the heart stops beating or does not beat sufficiently to maintain perfusion and life. It is usually due to electrical disturbance in the heart activity. Sudden cardiac arrest isn’t the same as a heart attack when blood flow to a part of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest. Sudden cardiac death (SCD) can happen due to a cardiovascular cause that occurs within one hour of the onset of symptoms.

What are the symptoms?

Signs of sudden cardiac arrest are immediate and drastic and include:
Sudden collapse
No pulse
No breathing
Loss of consciousness

Sometimes other signs and symptoms like chest heaviness, fainting, fast beating palpitations, or breathlessness may occur before sudden cardiac arrest. But sudden cardiac arrest often occurs with no warning. In a cardiac arrest, the patient may gasp for breath or stop breathing altogether and collapse.

What are the risk factors?

Coronary artery disease (CAD), is a common cause (80%)
Risk increases with age
Men have more probability than women
Diabetes, high blood pressure, heart failure, smoking, or chronic kidney disease
Has a personal history of heartbeats that aren’t regular (arrhythmia)
Has a problem with drug or alcohol use
Has had a heart attack
Has heart failure or has low Ejection fraction (blood pumping capacity) -under 40%.

How can we prevent and treat SCA?

If not treated immediately, sudden cardiac arrest can lead to death. Survival is possible with fast, appropriate medical care.

Cardiopulmonary resuscitation (CPR), using a defibrillator to shock the heart, or even just giving compressions to the chest can improve the chances of survival until emergency workers arrive.

In the long term, prompt treatment can increase not only the odds of survival for a patient but also their quality of life. Treatment is most effective within a few minutes of the arrest and the timeframe for recovery varies widely on this. After an episode, to prevent such an attack from recurring and for patients at a higher risk of cardiac arrest, the doctor may implant an ICD (implantable cardioverter-defibrillator). It is a small battery-powered device placed in the chest to detect and stop irregular heartbeats. The ICD is designed to continuously monitor patients’ heart rhythms and detect irregular heartbeats. They also deliver electrical signals and controlled shocks to restore a normal heart rhythm when necessary. ICD is proven to be effective in sudden cardiac arrests.