Cardiac arrest or sudden cardiac death (SCD) is a sudden, unpredicted death due to a loss of heart function usually within a very short time (one hour) of experiencing symptoms.
It is the number one natural killer among adults in the United States accounting for approximately 300,000 deaths per year.
This represents an incidence of 0.1-0.2% per year in the adult population.
The incidence of sudden cardiac arrest in Western industrialized nations is similar to that of the US. As countries develop the incidence of SCD tends to increase. This increase in developing nations is thought to reflect a change in dietary and lifestyle habits.
This would indicate that sudden cardiac death is greatly influenced by what we eat and how we live.
Sudden cardiac arrest is not the same as a heart attack. A heart attack occurs when one or more of the coronary arteries that feed the heart muscle become blocked usually due to atherosclerosis. The heart muscle becomes damaged due to limited blood flow to itself and eventually gives out.
Sudden cardiac death, by contrast, occurs when the electrical system related to the heart becomes irregular (arrhythmia). The ventricles (the two muscular chambers of the heart that pump blood) may flutter or quiver erratically (ventricular fibrillation). Consequently blood flow to the body and, most importantly, to the brain stops.
The person suffering from sudden cardiac arrest will lose consciousness and die if emergency medical treatment is not immediately administered.
More than 80% of sudden cardiac deaths occur in people with coronary artery disease (CAD).
CAD occurs when the coronary arteries become narrowed or completely occluded due to atherosclerosis.
There is strong evidence to suggest that impairment or abnormal positioning of the left ventricle in patients with coronary heart disease may be a further predictor of sudden cardiac arrest.
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In the US nearly 40% of those who experience SCD do so alone. That is, there is no witness present making the situation particularly dire. Survival depends on the presence of someone competent to administer basic life support aid, such as CPR, in the first moments following the incident. The presence of an automatic external defibrillator and someone trained to use it could greatly increase the patient’s survival chances.
In addition to this it is necessary for the patient to receive advanced life support from trained and equipped medical personnel in a very timely manner followed by prompt transfer to a hospital.
Proper CPR and survival
When a cardiac arrest victim arrives at the hospital his survival and recovery depend on the following elements:
The latter condition is important because in a great number of cases blood supply to the brain has been cut-off for a long enough time to cause irreversible brain damage.
As indicated earlier most cardiac arrests are due to sudden and unpredicted arrhythmias. The most common of these deadly arrhythmias is ventricular fibrillation which can cause a complete shutdown of the circulatory system leading to certain death if emergency treatment isn’t immediately forthcoming.
Though often unpredicted the risk of sudden cardiac death can be assessed based on certain traits.
Eighty percent of SCD is linked to coronary artery disease. Advanced atherosclerosis (clogging of the arteries) is often present in the event of SCD.
… are all factors that negatively influence atherosclerosis development and sudden cardiac death.
Genetics are unavoidable. But lifestyle choices are within our power. We can stop smoking. We can choose healthy diets including quality whole food supplements. Most of us can exercise. Medications are available if blood pressure and atherosclerosis development reach unhealthy levels.
A patient who has already suffered a heart attack and has since experienced abnormally rapid heart rhythm (tachycardia) or fluttering of the lower chambers of the heart (ventricular fibrillation) is at a higher risk for sudden cardiac death.
Someone who has…
… is also in a high risk bracket for suffering from sudden cardiac arrest.
As may be expected sudden cardiac death is more prevalent among men than women, with a ratio of 3:1. This ratio is consistent with the prevalence of coronary artery disease among men in comparison to women indicating that atherosclerosis influences the incidence of SCD.
Cardiac Arrest Triggers Different For Men and Women.
Women and Sudden Cardiac Death.
Alpha Linolenic Acid and Women's Heart Disease.
Age is also a factor, however the statistics are a little surprising. The incidence of SCD parallels that of coronary artery disease (CAD) peaking in people between the ages of 45 and 75. The incidence of SCD increases with age, as does the incidence of CAD.
However the proportion of deaths that are sudden from CAD decreases with age.
One study showed that the proportion of sudden CAD deaths was…
Race may also be a factor. Most studies concerning racial factors are inconclusive. However there is evidence to support the thesis that a greater proportion of coronary deaths are sudden in blacks compared to whites.
Primary prevention of SCD is aimed at decreasing the risk of a first event. The goal is to identify those who are considered to be in a high-risk category and treat the risk factors.
One possibility is for the patient to have an implantable cardioverter-defibrillator (ICD). Patients who have…
… might benefit from such a device. The ICD is a small machine that monitors heart rhythm. When it detects an abnormal rhythm it administers a small charge to the heart muscle in order to normalize its beating. It also records the abnormalities so a physician can study them. The hope is to prevent any abnormally strong irregularity that could cause the heart to suddenly stop beating.
Since sudden cardiac arrest is often associated with coronary artery disease (CAD) it is important to treat the latter condition. In severe cases of atherosclerosis angioplasty or coronary artery bypass surgerymay be required in order to unclog arteries and improve blood flow. Medications are also available, and may be prescribed, for patients who have had a heart attack or other heart failure or those with particular arrhythmias. If a patient has coronary artery disease there are lifestyle modifications that can help reduce the risk of heart failure and sudden cardiac death. These modifications are intended to…
These include a heart healthy diet (with good vitamin supplements), getting proper exercise and of course the cessation of smoking.
Sudden Cardiac Arrest and Omega-3
Secondary prevention is focused on reducing the risk of SCD once the patient has experienced a first instance. Secondary prevention utilizes methods similar to those just discussed.
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