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October is Sudden Cardiac Arrest Awareness Month

Listening to Your Heart—and Quick Action—Can Save Your Life

Every year in this country more than 380,000 people die due to sudden cardiac arrest (SCA). According to the Sudden Cardiac Awareness Foundation, this number is almost equal to the amount of lives claimed by Alzheimer’s disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicide—combined.

These deaths occur in all ages, genders, ethnicities, and geographic area—SCA can strike anyone, anytime. If the availability of timely and appropriate care is increased, survival rates will improve.

Understanding Sudden Cardiac Arrest

SCA occurs when the heart stops beating, abruptly and without warning. If this happens, blood stops flowing to the brain and other vital organs. The Centers for Disease Control and Prevention (CDC) reports SCA claims one life every 90 seconds. Unfortunately, 95 percent of people who experience SCA die as a result, mainly because treatment within minutes is not accessible. Having automated external defibrillators (AEDs) accessible in schools and places of public gathering increases an SCA victim’s chance of survival.

SCA is Not the Same as a Heart Attack

Most people don’t know the difference between SCA and a heart attack. Because time is crucial to saving someone suffering sudden cardiac arrest, the Heart Rhythm Society urges the public to learn the difference between the two.

The heart’s electrical system is affected when SCA occurs. The heart stops beating and no blood is pumped to the rest of the body; it’s like losing electricity in your house. The heart “electricity” must be turned back on, typically through electrical shock.

A heart attack, typically known as a myocardial infarction (MI), affects the “plumbing” of the heart. A heart attack is caused by a blockage in a blood vessel that interrupts the flow of blood causing an area of the heart muscle to die. This causes a “blood backup” in the heart; just like a backup in a plumbing line in your house. The heart must be “unclogged,” with drug therapy or surgery to continue the blood flow to the rest of the body.

While both cause serious health problems and possible death, SCA often occurs abruptly and without warning. In fact, two-thirds of SCA deaths occur without any prior indications of heart disease, while heart attacks often have previous signs and symptoms.

Causes of SCA

The immediate cause of sudden cardiac arrest is usually an abnormality in your heart rhythm (arrhythmia), the result of a problem with the heart’s electrical system.

Unlike other muscles in your body, which rely on nerve connections to receive the electrical stimulation they need to function, your heart has its own electrical stimulator—a specialized group of cells called the sinus node located in the upper right chamber of your heart. The sinus node generates electrical impulses that flow through your heart to synchronize the heart rate and coordinate the pumping of blood from your heart to the rest of your body.

If something goes wrong with the sinus node or the flow of electric impulses through your heart, an arrhythmia can result, causing your heart to beat too fast, too slow, or in an irregular fashion. Often these interruptions in rhythm are harmless. But some types of arrhythmia can be serious and lead to SCA.

The most common cause is ventricular fibrillation: Rapid, erratic electrical impulses cause ventricles to quiver uselessly instead of pumping blood.

Most of the time, such arrhythmias don’t occur on their own. In someone with a normal, healthy heart, a lasting irregular heart rhythm isn’t likely to develop without an outside trigger, such as an electrical shock, the use of illegal drugs, or trauma to the chest at just the wrong time of the heart’s cycle.

It’s important to note that a life-threatening arrhythmia usually develops in a person with a pre-existing heart condition, which can include: Coronary artery disease, heart attack, enlarged heart (cardiomyopathy), valvular heart disease, congenital heart disease, and electrical problems in the heart.

Are You at Risk?

If you have any of the following risk factors or symptoms, ask your doctor if additional testing is needed:

  • History of early heart disease, heart attack, or sudden cardiac death in your family;
  • Unexplained fainting or near fainting or palpitations;
  • Chest pain, shortness of breath or fainting with exertion (such as during exercise);
  • Heart failure or heart attack;
  • Weak heart muscle, or a cardiac “ejection fraction” of less than 40 percent; and
  • Cardiac risk factors such as high blood pressure, smoking, diabetes, excessive alcohol use, obesity, or high cholesterol.

Take your risk assessment here.

Know the Warning Signs

Sudden cardiac arrest may not be as sudden as doctors previously thought, according to a report published in Annals of Internal Medicine. Roughly half of cardiac arrest patients experience telltale warning signs that their heart is in danger of stopping in the month preceding their attack, new study findings suggest.

Researchers say those symptoms can include:

  • Any combination of chest pain and pressure;
  • Shortness of breath;
  • Heart palpitations; and
  • Flu-like sensations (nausea, back pain and/or abdominal pain).

The problem is that less than one in five of those who experience symptoms reach out for potentially lifesaving emergency medical assistance.

Study co-author Dr. Sumeet Chugh says chest pain is the most common symptom among men, while shortness of breath is the most common among women. More than nine in 10 of those who had symptoms say they resurfaced 24 hours before their cardiac arrest, according to the study.

Prevention

Reducing your risk for SCA is the best prevention strategy. Steps to take include regular checkups, screening for heart disease, and living a heart-healthy lifestyle with the following approaches:

  • Don’t smoke;
  • Use alcohol in moderation (no more than one to two drinks a day);
  • Eat a nutritious, balanced diet; and
  • Stay physically active.

If you have heart disease or conditions that make you more vulnerable, your doctor may recommend you take appropriate steps to improve your health, such as taking medications for high cholesterol or carefully managing diabetes.

In some with a known high risk of SCA, such as those with a heart condition, doctors may recommend anti-arrhythmic drugs or an implantable cardioverter-defibrillator (ICD) as primary prevention.

Some at risk may consider purchasing an automated external defibrillator (AED) for home use. Before purchasing one, discuss the decision with your doctor. AEDs can be expensive and aren’t always covered by health insurance.

If you live with someone vulnerable to SCA, it’s important that you be trained in CPR. Being trained will help not only your loved one, but also those in your community. The more people who know how to respond to a cardiac emergency, the more the survival rate for sudden cardiac arrest can be improved.

For more information on keeping your heart healthy or to schedule an appointment to discuss any heart concerns you may have, contact the caring providers of CCHC Heart and Vascular Specialists at 252-63-HEART (634-3278).

(Sources: American Heart Association; National Heart, Lung, and Blood Institute; Heart Rhythm Society; The Mayo Clinic; Sudden Arrhythmia Death Syndromes Foundation; Sudden Cardiac Arrest Association; AED.com; and Time, Inc.)