Cardiac Arrest

Cardiac Arrest: Causes, Symptoms, Treatment, and Prevention

~Introduction

Cardiac arrest is one of the most serious and life-threatening medical emergencies. It occurs when the heart suddenly and unexpectedly stops beating, leading to an abrupt loss of blood flow to the brain and other vital organs. Without immediate treatment, cardiac arrest can quickly lead to death within minutes. Unlike a heart attack, which is caused by a blockage in the blood supply to the heart muscle, cardiac arrest is usually due to an electrical malfunction in the heart that disrupts its pumping action.

According to the World Health Organization (WHO) and the American Heart Association (AHA), sudden cardiac arrest is among the leading causes of death worldwide. Millions of people experience cardiac arrest each year, and survival rates remain low despite advances in emergency medicine. Early recognition, immediate cardiopulmonary resuscitation (CPR), and rapid defibrillation can dramatically improve survival chances.

This article explores the causes, risk factors, signs and symptoms, diagnosis, emergency management, long-term treatment, complications, and prevention of cardiac arrest.

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~What is Cardiac Arrest?

Cardiac arrest is defined as the sudden cessation of cardiac activity, resulting in the absence of circulation. During an arrest, the heart is unable to pump blood effectively, leading to a loss of oxygen supply to the brain and vital organs.

It is different from:

• Heart Attack (Myocardial Infarction): A circulation problem caused by a blocked artery. The heart usually continues to beat, though it may become weak.

• Heart Failure: A chronic condition where the heart cannot pump enough blood to meet the body’s needs.

In cardiac arrest, the primary issue is electrical — the heart’s rhythm becomes chaotic or stops entirely.

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~Causes of Cardiac Arrest

The most common causes are linked to abnormal heart rhythms (arrhythmias).

1. Ventricular Fibrillation (VF)

• The most frequent cause of cardiac arrest.

• Characterized by chaotic, irregular electrical activity that prevents the ventricles from pumping blood effectively.

2. Ventricular Tachycardia (VT)

• A rapid heart rhythm originating from the ventricles.

• Can quickly deteriorate into ventricular fibrillation if untreated.

3. Underlying Heart Disease

• Coronary artery disease (blocked arteries).

• Previous heart attack.

• Cardiomyopathy (diseased heart muscle).

4. Other Medical Causes

• Severe blood loss or trauma.

• Respiratory arrest (e.g., from drowning, suffocation).

• Electrolyte imbalances (low potassium or magnesium).

• Severe infections (sepsis).

• Drug overdose (especially opioids, cocaine, or stimulants).

• Electrical shock or lightning strike.

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~Risk Factors for Cardiac Arrest

Certain factors increase the likelihood of experiencing cardiac arrest:

1. Heart-Related Conditions

   • Coronary artery disease.

   • History of heart attack.

   • Heart failure or cardiomyopathy.

   • Congenital heart defects.

2. Lifestyle Factors

   • Smoking.

   • Excessive alcohol use.

   • Sedentary lifestyle.

   • Poor diet leading to obesity.

3. Medical Conditions

   • Diabetes.

   • High blood pressure.

   • High cholesterol.

   • Sleep apnea.

4. Genetic Factors

   • Family history of sudden cardiac death.

   • Inherited arrhythmia syndromes (e.g., Long QT syndrome).

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~Signs and Symptoms of Cardiac Arrest

Cardiac arrest often strikes without warning, but some people may experience symptoms minutes or hours before collapse, such as:

• Chest pain or discomfort.

  
  
  

• Shortness of breath.

• Palpitations (rapid, irregular heartbeat).

• Dizziness or fainting.

When cardiac arrest occurs, the key signs include:

1. Sudden Collapse – The person loses consciousness.

2. No Pulse – The heart has stopped pumping blood.

3. No Breathing or Abnormal Breathing (Gasping) – Known as agonal respirations.

4. Unresponsiveness – No reaction to shouting or shaking.

Without immediate help, irreversible brain damage occurs within 4–6 minutes.

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~Diagnosis of Cardiac Arrest

Since cardiac arrest is a medical emergency, diagnosis is usually based on clinical observation during collapse:

• No pulse (checked at carotid artery).

• No breathing or only abnormal gasping.

• Loss of consciousness.

In hospital settings, diagnostic tools may include:

• Electrocardiogram (ECG/EKG): To identify arrhythmias like VF or VT.

• Blood tests: To check for electrolyte imbalances, heart damage, or drug levels.

• Imaging: Echocardiogram or coronary angiography to assess underlying causes after resuscitation.

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~Emergency Treatment of Cardiac Arrest

Immediate action is critical — every second counts.

1. Call for Help

• Dial emergency services immediately.

2. CPR (Cardiopulmonary Resuscitation)

• Start chest compressions immediately.

• Push hard and fast in the center of the chest (100–120 compressions per minute).

• Provide rescue breaths if trained, otherwise perform hands-only CPR.

3. Defibrillation

• Use an AED (Automated External Defibrillator) if available.

• The device delivers an electric shock to restore normal rhythm.

• Public places like airports, gyms, and malls often have AEDs.

4. Advanced Medical Care

• Emergency personnel provide advanced airway support, IV medications (e.g., epinephrine, amiodarone), and hospital transfer.

Survival is strongly linked to time to defibrillation — every minute without CPR and defibrillation reduces survival chances by about 7–10%.

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~Hospital Treatment After Resuscitation

If the patient is successfully resuscitated, doctors will work to prevent another episode:

• Medications: Beta-blockers, anti-arrhythmics, ACE inhibitors.

• Implantable Cardioverter Defibrillator (ICD): A small device placed under the skin to detect and correct dangerous rhythms.

• Cardiac Catheterization: To identify and open blocked arteries.

• Surgery: Coronary artery bypass graft (CABG) or valve repair if needed.

• Therapeutic Hypothermia: Cooling the body to reduce brain injury after resuscitation.

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~Complications of Cardiac Arrest

Even when patients survive, complications may occur due to lack of oxygen during arrest:

1. Neurological Damage – Ranging from mild memory problems to severe brain injury or coma.

2. Heart Damage – Risk of recurrent arrhythmias or heart failure.

3. Organ Failure – Kidney or liver damage due to lack of circulation.

4. Psychological Effects – Anxiety, depression, or post-traumatic stress in survivors.

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~Prevention of Cardiac Arrest

While not all cases can be prevented, risk can be greatly reduced through lifestyle and medical interventions.

1. Lifestyle Modifications

• Quit smoking.

• Limit alcohol intake.

• Eat a heart-healthy diet (low in saturated fat, sugar, and sodium).

• Exercise regularly.

• Maintain a healthy weight.

2. Managing Medical Conditions

• Control blood pressure, diabetes, and cholesterol with medication and lifestyle.

• Regular check-ups for those with a family history of heart disease.

3. Medical Devices & Medications

• ICDs for high-risk individuals.

• Regular use of prescribed medications (e.g., beta-blockers, anti-arrhythmics).

4. Community Awareness

• Widespread CPR training.

• Easy availability of AEDs in public spaces.

• Public health campaigns about cardiac arrest recognition.

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~Difference Between Cardiac Arrest and Heart Attack (Quick Comparison)

Feature	Heart Attack (Myocardial Infarction)	Cardiac Arrest
Cause	Blocked artery reduces blood flow to heart	Electrical malfunction stops heart beat
Symptoms	Chest pain, sweating, nausea, shortness of breath	Sudden collapse, no pulse, no breathing
Onset	Gradual, may be hours or days	Sudden, without warning
Emergency Action	Call emergency services, give aspirin if advised	Call emergency services, start CPR, defibrillation
Survival	Higher if treated promptly with angioplasty/medications	Depends on immediate CPR and defibrillation

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~Conclusion

Cardiac arrest is a sudden, life-threatening event that requires immediate medical intervention. Unlike a heart attack, it results from an electrical malfunction in the heart that stops blood circulation. Quick action — calling emergency services, performing CPR, and using an AED — can make the difference between life and death.

Long-term management includes medications, lifestyle modifications, and sometimes implantable devices like defibrillators. Public education on CPR and widespread availability of AEDs are crucial to improving survival rates worldwide.

Ultimately, preventing cardiac arrest means taking good care of the heart — managing risk factors, leading a healthy lifestyle, and being prepared to act swiftly if an emergency arises.