Sudden

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Sudden Cardiac Arrest

Sudden Cardiac Arrest (SCA) is a critical medical emergency characterized by the abrupt loss of heart function, breathing, and consciousness. It is a leading cause of death and requires immediate medical intervention to prevent fatal outcomes.

Pathophysiology

Sudden cardiac arrest occurs when the heart's electrical system malfunctions, leading to an irregular heartbeat (arrhythmia). The most common arrhythmia associated with SCA is ventricular fibrillation, where the heart's ventricles quiver ineffectively instead of pumping blood. This results in the cessation of blood flow to the brain and other vital organs.

Causes

Several factors can precipitate sudden cardiac arrest, including:

  • Coronary artery disease: The most common cause of SCA, where the arteries supplying blood to the heart become narrowed or blocked.
  • Cardiomyopathy: A disease of the heart muscle that can lead to heart failure and arrhythmias.
  • Congenital heart defects: Structural problems with the heart present from birth.
  • Electrolyte imbalances: Abnormal levels of potassium, magnesium, or calcium can affect heart rhythm.
  • Drug abuse: Use of certain drugs, such as cocaine or amphetamines, can trigger SCA.

Symptoms

Sudden cardiac arrest often occurs without warning. However, some individuals may experience symptoms such as:

  • Chest pain
  • Shortness of breath
  • Weakness
  • Palpitations
  • Loss of consciousness

Diagnosis

Diagnosis of SCA is primarily clinical, based on the sudden collapse and absence of a pulse. Further evaluation may include:

  • Electrocardiogram (ECG): To identify arrhythmias.
  • Echocardiogram: To assess heart structure and function.
  • Blood tests: To check for electrolyte imbalances or cardiac biomarkers.

Treatment

Immediate treatment is crucial for survival and includes:

  • Cardiopulmonary resuscitation (CPR): To maintain blood flow to the brain and organs.
  • Defibrillation: Use of an automated external defibrillator (AED) to restore normal heart rhythm.
  • Advanced cardiac life support (ACLS): Includes medications and advanced airway management.

Prevention

Preventive measures for those at risk of SCA include:

  • Implantable cardioverter-defibrillator (ICD): A device implanted in the chest to detect and correct arrhythmias.
  • Lifestyle modifications: Such as diet, exercise, and smoking cessation.
  • Medications: To manage underlying heart conditions and reduce arrhythmia risk.

Prognosis

The prognosis for sudden cardiac arrest depends on the speed and effectiveness of treatment. Survival rates improve significantly with prompt CPR and defibrillation.

Also see



Cardiovascular disease A-Z

Most common cardiac diseases

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Contributors: Prab R. Tumpati, MD