Over­view of sud­den car­diac ar­rest and sud­den car­diac death

Demise of a loved one is a trau­matic ex­pe­ri­ence. More so if the in­di­vid­ual is young and seem­ingly with­out any pre­vi­ous symp­toms.

Woman's Era - - Short Story - Dr S K Sinha MBBS, M.S, MCH Di­rec­tor, Dept. of CTVS, Max Hos­pi­tal, Saket, New Delhi.

Sud­den car­diac death ( SCD) is a con­di­tion in which the heart sud­denly and un­ex­pect­edly stops beat­ing. If this hap­pens, blood stops flow­ing to the brain and other vi­tal or­gans. It usu­ally causes death if not treated within min­utes.

Some in­di­vid­u­als may ex­pe­ri­ence chest pain, short­ness of breath or nau­sea be­fore car­diac ar­rest.

Car­diac ar­rest is pre­ceded by no warn­ing symp­toms in ap­prox­i­mately 50% of the peo­ple. When it oc­curs, the most ob­vi­ous sign is lack of pal­pa­ble pulse, dizzi­ness, loss of con­scious­ness and he would have stopped breath­ing.

Coro­nary artery dis­ease is re­spon­si­ble for 62 to 70 % of all SCD’S. Pa­tient may be hav­ing angina , chest pain which is over­looked or ne­glected . It may be mis­taken as gas for­ma­tion. Left main artery block­age, prox­i­mal LAD ob­struc­tion are the most com­mon an­gio­graphic find­ing if they sur­vive.

Heart dis­ease not re­lated to coro­nary ar­ter­ies like hy­per­trophic car­diomy­opa­thy, My­ocardi­tis, con­ges­tive heart fail­ure. Here it is im­por­tant to men­tion high al­ti­tude pul­monary edema where phys­i­cal ex­er­cise or roam­ing around at high al­ti­tude is done with­out proper ac­clima­ti­za­tion.

Cer­tain rhythm dis­tur­bance of the heart which may oc­cur from birth can lead to sud­den death. Causes may be long QT syn­drome, Bru­gada syn­drome, Wolff Parkin­son- white syn­drome.

Non Car­diac causes 15- 20 % of cases are due to bleed­ing mas­sively like rup­ture of aor­tic aneurysm, gas­tro in­testi­nal bleed, drown­ing. Poi­son­ing like st­ing of cer­tain jelly fish.

Pre­ven­tion of SCD in­cluded main­tain­ing a healthy life style, NOT SMOK­ING, mod­er­ate phys­i­cal ac­tiv­ity, and a healthy weight.

Do not ig­nore car­diac symp­toms, angina has to be taken cog­na­tion of, obe­sity high blood pres­sure, di­a­betic, high choles­terol and a strong fam­ily his­tory of car­diac dis­ease, all are fac­tors to be rec­og­nized and treated if need be.

With more and more un­der­stand­ing of this con­di­tion it is im­por­tant to have re­sus­ci­ta­tive mea­sures in place. Schools, col­leges are taught cardio pul­monary re­sus­ci­ta­tion and any per­son present should start CPR. Nearly all air­ports, rail­way car­diac de­fib­ril­la­tor are in­stalled. By standers should start CPR, by the lay pub­lic im­proves the sur­vival. Chest com­pres­sions by hand till med­i­cal help ar­rives it­self may be some­times suf­fi­cient.

Early recog­ni­tion, ag­gres­sive re­sus­ci­ta­tion and emer­gency med­i­cal help can change the sit­u­a­tion of the per­son. Only 10% of the peo­ple who have sud­den car­diac ar­rest out­side the hos­pi­tal sur­vive. In hos­pi­tal ar­rest nearly 30% have the chances to sur­vive and be are dis­charged from the hos­pi­tal. Ad­vanced ther­apy & with drugs, au­to­matic im­plantable de­fib­ril­la­tor & treat­ment of the cause all are im­por­tant.

For ap­point­ment: Mob: 9811321668, email: sk.sinha@max­health­care.com

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