An emergency cardiac episode is an abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease. It may appear unexpectedly or follow other symptoms. If immediate medical help is not sought right away, cardiac arrest can be fatal. Some patients may require emergency heart surgery.
Symptoms of an Emergency Cardiac Episode
- Loss of consciousness
- Collapse
- No pulse
- No breathing
Before the abrupt cardiac arrest, various indications and symptoms can appear. These could consist of:
- Shortness of breath
- Weakness
- Chest discomfort
- Fast-beating, fluttering, or pounding heart
Heart Conditions that Can lead to Sudden Cardiac Arrest
- Heart attack: A heart attack can result in ventricular fibrillation and abrupt cardiac arrest, which is frequently caused by severe coronary artery disease. Additionally, a cardiac attack might leave scar tissue. Electrical short circuits near the scar tissue might cause irregular heartbeats.
- Enlarged heart (Cardiomyopathy): This mainly happens when the muscle walls of the heart expand, grow, or thicken. If a person’s heart muscle is defective, it leads to arrhythmias.
- Coronary artery disease: People with coronary artery disease, in which the arteries narrow and get clogged with cholesterol and other deposits are more at risk of experiencing sudden cardiac arrest.
- Valvular heart disease: This condition results from the heart muscle becoming strained or thickened as a result of leaking or constriction of the heart valves. There’s an increased risk of developing arrhythmia should the chambers become enlarged. In some patients who sustain a heart attack, the supporting pillars of one of valves of the heart (Mitral valve) may rupture and the valve becomes incompetent. This is usually not very well tolerated, and the patient experiences significant breathing difficulty as well as a reduced heart function.
- Heart electrical system issues: In some patients, the issue is with the heart’s electrical system instead of a problem with the heart muscle or valve. These are called primary heart rhythm abnormalities.
- Ventricular wall rupture: Ventricular wall rupture can occur when the patient has a heart attack. The lack of blood supply to the ventricular muscle leads to a weakness in the muscle and can cause a rupture. It is referred to as an ischaemic Ventricular Septal Defect (VSD) if this occurs within the heart chambers. Otherwise, it is referred to as a ventricular free wall rupture.
- Aortic rupture: This can happen when there is a sudden, sustained rise in the blood pressure. The walls of the aorta (the main pipe taking blood away from the heart) becomes weakened and start to leak blood and eventually rupture. This is usually referred to as aortic dissection.
Risk Factors of an Emergency Cardiac Episode
The same factors that put a person at risk for coronary artery disease can also put one at risk for sudden cardiac arrest. These include:
- Smoking
- High blood pressure
- Obesity
- Diabetes
- A sedentary lifestyle
- A family history of coronary artery disease
Other elements that could raise a person’s risk of sudden cardiac arrest include:
- Being male
- A previous heart attack
- Having experienced cardiac arrest before or having cardiac arrest history in the family.
- Obstructive sleep apnoea
- Chronic kidney disease
Diagnosis of Sudden Cardiac Episode
The doctor may recommend the following tests to an individual who survived a heart attack to ascertain what caused it.
- Electrocardiogram (EKG): The test is used to detect electrical activity and aid in revealing disturbances in heart rhythm.
- Blood tests: The test involves taking a sample of the patient’s blood to be tested for markers of heart muscle damage (Troponin), potassium & magnesium and other chemicals that can affect the heart’s ability to function.
The following imaging tests can also be used in the diagnosis of cardiac arrest:
- Chest X-ray
- Echocardiogram
- Nuclear scan
- Coronary angiography
- Contrast CT scan
Treatment of a Sudden Cardiac Episode
Sudden cardiac arrest can be treated and reversed. However, immediate emergency action must be taken. If treatment is administered within the first few minutes following a sudden cardiac arrest, the chances of survival are extremely high.
In a scenario of cardiac arrest, do the following:
- Call an ambulance immediately.
- Check for breathing: Start CPR compressions if the victim isn’t breathing or is simply gasping.
- Begin high-quality CPR: At a rate of 100 to 120 pushes each minute, lower the patient’s chest at least two inches. After each push, let the chest rise to its usual posture.
- Apply an AED (automated external defibrillator) if you have it. Turn it on as soon as it arrives, then follow the instructions.
- Keep doing CPR until the patient begins to breathe again.
Once the patient is in a hospital setting the cause for the cardiac arrest will be investigated and elucidated. Treatment modalities will be evaluated as per our Heart-Team approach and the best evidenced-based treatment option will be offered to the patient. This may include medical therapy, percutaneous therapy (PCI or TAVI) or emergency heart surgery.
