Cardiac Arrest by Debra Wood, RN

En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Cardiac arrest refers to the loss of heart function. In many cases, it is an expected outcome to a serious illness. Cardiac arrest often results in death.

• Sudden cardiac arrest refers to the heart unexpectedly stopping activity due to a potentially reversible cause. Brain death occurs within a few minutes if the situation is not reversed.
  • Sudden cardiac arrest may be caused by many different conditions. It does not necessarily mean that the person has had a heart attack .
• Sudden cardiac death refers to an unexpected, heart-related death within 1 hour from the start of symptoms.

Causes

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Symptoms

Diagnosis

Treatment

Prompt treatment improves the chance of survival. The four steps in the cardiac chain of survival are:

Call 911

Immediately call for emergency medical support. Call 911 as soon as you notice cardiac warning signs or suspect a cardiac arrest has occurred.

Start CPR

CPR helps keep blood and oxygen flowing to the heart and brain until other treatment can be given. The heart and brain are very susceptible to low oxygen levels. Permanent damage can occur, even with successful resuscitation.

During CPR, the rescuer positions the head to open the airway, breathes air into the patient, and compresses the patient's chest. In 2008, the American Heart Association began recommending a simplified version of CPR. There is no rescue breathing in this version. This version was created to encourage previously reluctant by-standers to help.

Defibrillation

Once on the scene, emergency medical technicians or paramedics will assess the heart rhythm and determine whether the rhythm warrants defibrillation (eg, ventricular fibrillation or tachycardia). Defibrillation sends an electrical shock through the chest. The surge of electricity aims to stop the ineffective, irregular heart rhythm. This may allow the heart to resume a more normal electrical pattern. Automated external defibrillators check the heart rhythm before instructing the rescuer to give the shock.

Advanced Medical Care

Paramedics at the scene and doctors at the hospital provide essential medical care and intensive monitoring. They will give drugs, insert a tube to maintain an open airway, and manage emergency care. Epinephrine is often given early to make the heart more receptive to electrical impulses and improve blood flow to the heart and brain. The patient will receive oxygen. Even if an effective heart rhythm is restored, low oxygen levels may cause serious complications, including damage to the heart, brain, and other vital organs. The emergency medical personnel may perform an electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle.

Doctors will attempt to find and correct the underlying cause of the cardiac arrest. At the hospital, the doctor will ask about symptoms prior to the collapse and the patient's medical and drug history.

A telemetry machine will continually monitor the heart's electrical activity.

Prevention

Become aware of heart disease warning signs and promptly seek treatment for any that develop. If you do not have a heart condition, follow the rules of primary prevention of heart disease. If you have a heart condition or may be at high risk for one, ask your doctor about how to reduce your risk of sudden cardiac arrest. You might be a right candidate for certain medications that prevent heart arrhythmias or implantation of an implantable cardioverter defibrillator (ICD) device.

Also, if you are known to be at high risk, you may consider purchasing an automatic external defibrillator (AED) for home use. Discuss it with your doctor.