Did you know! Each year, up to 54,000 people die from heart disease, averaging 6 people per hour. Heart disease is the third leading cause of death, after cancer and accidents. We want everyone to get to know this disease better to find ways to protect themselves and their loved ones.
What is “Sudden Cardiac Arrest”?
Sudden Cardiac Arrest (SCA) is a condition where the heart malfunctions and stops beating immediately without any warning signs. When this occurs, blood circulation to various parts of the body ceases, causing organ dysfunction. One clear effect is on the brain, which loses blood supply and leads to unconsciousness. Immediate assistance is crucial.
How common is “Sudden Cardiac Arrest”?
Although Thailand does not have clear statistics on sudden cardiac arrest, data from the United States shows that there are 300,000-400,000 cases annually, with a higher incidence among athletes.
Causes of Sudden Cardiac Arrest
Most cases are due to abnormal heart rhythms called Ventricular Fibrillation. Normally, the heart generates electrical impulses to contract rhythmically and pump blood to organs. In Ventricular Fibrillation, the electrical signals are rapid and irregular, causing the heart to stop contracting and blood flow to cease. The patient loses consciousness within seconds and can die immediately.
However, help can be provided by delivering an electrical shock using a device called a Defibrillator. Previously, this device was only available in hospitals or ambulances, but now Automatic External Defibrillators (AEDs) are commonly found in public places such as airports, schools, sports stadiums, and shopping malls.
Who is at risk of sudden cardiac arrest?
Sudden cardiac arrest often occurs in apparently healthy individuals who are unaware they have heart disease. In reality, they usually have underlying heart conditions without knowing it. The main causes include:
- Coronary artery disease, found in patients with diabetes, high blood pressure, high cholesterol, and smokers.
- Weak heart muscle (low ejection fraction, EF). Ejection Fraction measures the percentage of blood pumped out of the heart with each beat. A normal EF is about 50-70%, but those at risk of sudden cardiac arrest have an EF less than 35%. In younger patients, especially under 30, causes often include electrical conduction abnormalities such as Congenital Long QT Syndrome (LQTS), heart muscle abnormalities like Hypertrophic Cardiomyopathy, or coronary artery abnormalities.
What to do if you find someone “unconscious”
The first step is to check the unconscious person by calling out or shaking them to see if they respond. If there is no response, observe if the person has any twitching or convulsions, gasping, or stops breathing. If so, assume the person may have sudden cardiac arrest. Immediately call for emergency help from the hospital and start basic life support by performing chest compressions. Mouth-to-mouth breathing may not be necessary at this stage. This alone can reduce the risk of death. If an Automated External Defibrillator (AED) is available nearby, use it immediately.
“Risk Assessment” for Heart Disease with Tests
Several tests can help assess risk, such as:
- Blood tests for sugar and cholesterol levels
- Electrocardiogram (ECG)
- Echocardiogram, which measures Ejection Fraction
- Holter Monitoring, using a small device about the size of a mobile phone attached to the chest to record heartbeats continuously for 24-48 hours
Prevention with a “Heart Healthy Life” Lifestyle
Healthy lifestyle habits can reduce the risk of sudden cardiac arrest and heart disease. Start by eating healthy foods such as vegetables, fruits, nuts, and fish. Exercise regularly, such as brisk walking for about 30 minutes almost every day. Maintain a healthy weight, avoid smoking, and manage chronic diseases, especially diabetes, high blood pressure, and high cholesterol.
“Sudden Cardiac Arrest” VS “Heart Attack”
Sudden Cardiac Arrest (SCA) differs from Heart Attack (Acute Myocardial Infarction; AMI) in that a heart attack occurs when blood flow to part of the heart muscle is blocked, causing that muscle to die. This is usually due to blockage of the coronary arteries supplying the heart. The heart may not stop beating during a heart attack. Without treatment, heart muscle death and death can occur. In fact, heart attacks are the most common cause of sudden cardiac arrest, but other causes also exist.
Learn more about “Acute Myocardial Infarction”
Most acute myocardial infarctions result from heart muscle death and are a leading cause of death worldwide for both men and women. Important risk factors include age, diabetes, high blood pressure, high cholesterol, and smoking.
Common symptoms of acute myocardial infarction include sudden chest pain, often radiating to the left arm or left side of the neck, shortness of breath, nausea, vomiting, palpitations, and sweating. Alarmingly, about 1 in 4 patients with a heart attack have few or no symptoms, including chest pain or other warning signs.
If suspected, call an ambulance immediately to take the patient to the emergency room for an electrocardiogram, chest X-ray, and blood tests to assess heart muscle damage. Common markers for heart muscle damage include creatine kinase-MB (CK-MB) and troponin levels.
Treatment for suspected acute myocardial infarction
Treatment includes oxygen, aspirin, and sublingual nitroglycerin. Then, consideration is given to thrombolytic therapy or percutaneous coronary intervention (PCI) to open the coronary arteries as quickly as possible.
