Sudden Cardiac Arrest:
Killing Thousands Without Warning

Cardiac Arrest Is Top Killer In US

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.

Cardiac Arrest Not The Same As A Heart Attack

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.

Coronary Artery Disease:
Leading Cause Of Sudden Cardiac Death

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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SCD Survival Depends Upon Immediate Action

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:

  • His systolic blood pressure must be greater than 90 mm Hg.
  • The time between losing consciousness and regaining blood circulation should not exceed 25 minutes.
  • He must be neurologically responsive.

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.

Indicators of Sudden Cardiac Death Risk

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…

  • other heart defects
  • a history of faintinghypertrophic cardiomyopathy (a congenital heart disease that results in abnormal thickening of the ventricular septum and left ventricular wall)
  • dilated cardiomyopathy (dilation of the cardiac chambers or enlarged heart)
  • a history of certain abnormal heart rhythms
  • diabetes
  • obesity

… is also in a high risk bracket for suffering from sudden cardiac arrest.

SCD Risk By Group

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…

  • 31% in men ages 20-29 years
  • 62% in men ages 45-54 years
  • 58% in men between the ages of 55 and 64 years
  • 42% for men between the ages of 65 and 74 years

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.

Preventing Sudden Cardiac Deaths

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…

  • A history of ventricular tachycardia (rapid heart rhythm)
  • One of several particular genetic heart defects
  • A poorly functioning left ventricle

… 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. 

Implantable defibrillators 

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…

  • Reduce high blood pressure
  • Lower total cholesterol
  • Reduce weight if necessary
  • Keep the body free of the damaging influence of smoking

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.

  • Bypass surgery
  • Angioplasty
  • Medications
  • Implantable cardioverter-defibrillators
In addition to these, reconstructive surgery may be utilized to repair damage done by an initial cardiac event. In the event of a heart attack involving the left ventricle scar tissue may form making irregular heart rhythms more prevalent. 

An electophysiologist (a doctor specializing in electrical disorders of the heart) can determine the exact cause of the arrhythmia and will perhaps use a process called ablation to correct the problem. Ablation uses a high-energy electrical current to disconnect abnormal electrical pathways within the heart. If areas of the heart are physically damaged surgical removal of these areas may also be performed. 

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