Understanding Sudden Cardiac Arrest
With the recurrent stories about young athletes dying suddenly from unexpected heart problems, I thought I would pass along some information about sudden cardiac arrest (SCA). This is a topic very close to my heart, as I am a cardiac arrest survivor. After a short warm-up jog three and a half years ago, the electricity in my heart basically short-circuited, and my heart stopped beating. I was saved by my wife's CPR and four shocks to my heart from Medic One. I was one of the lucky ones.
Unfortunately, only about 7% of people who have a sudden cardiac arrest nationally are lucky enough to survive. Of those who do, many will suffer from some sort of permanent brain injury. In Seattle, the rapid response and training of Medic One results in roughly 40% of out-of-hospital, witnessed SCA victims surviving and having fewer prolonged problems.
SCA occurs when the heart stops beating and may only quiver, and thus not enough blood flows out of the heart carrying vital oxygen to the brain and other organs. The heart stops beating because the electrical impulses through the heart that make it beat do not work normally. In younger athletes, the cause of the change in electrical pattern can be due most commonly to structural problems (like thickened muscle in the heart wall) or undiagnosed electrical problems (where the wiring of the heart does not work normally). In adults, heart disease is the biggest cause of SCA.
A heart attack, or myocardial infarction, is different from SCA, though the two can be related. A heart attack occurs when blood vessels in the heart become blocked from broken-off plaque particles and blood clots. This blockage causes a loss of blood supply and oxygen to a section of the heart, which can then damage the muscle. If enough muscle is damaged, the electricity that flows through the “wiring” of nerves in the heart can stop working properly, and the person could have SCA. Not all heart attacks lead to cardiac arrest. However, in the US, roughly 1,000 people die every day from SCA, and it is our number one killer.
The best way to restart a heart that has stopped is to deliver electrical shocks from an automatic external defibrillator, also called an AED. (You have probably seen these hanging on the wall in public places, especially casinos!) These simple tools talk you through the entire process of applying the pads and delivering the life-saving shocks. For every minute that passes after someone collapses until their heart is restarted, their chance of survival decreases 10%. In my case, I was down for 10 minutes before the medics were able to restart my heart, just one example of how long even a rapid response may take on a quiet Saturday morning. This underlies the importance of rapid access to AED’s in areas where the response may not be as quick.
In the minutes until an AED arrives, whether from the medics responding to your 911 call or from someone retrieving an AED, it is also important to deliver CPR (Cardiopulmonary Resuscitation) to keep blood flowing to the brain and vital organs of the victim. Taking a CPR class can help you save a life some day; check with your local government, fire department, hospitals and the American Heart Association for classes. This short video provides basic tips on hands only CPR, which does not involve giving mouth-to-mouth breathing, and is likely just as effective for cardiac arrest victims: http://handsonlycpr.org.
Several local groups are working to increase awareness of SCA, especially in young athletes. In the Seattle area, the Nick of Time Foundation (nickoftimefoundation.org) is working hard to prevent teenagers from dying from SCA by providing health screenings at local schools. The Heart of Seattle Schools project (www.heartofseattleschools.org) is in the process of supplying AEDs and training to schools to help save those who may suffer an SCA on school grounds. I would encourage you to visit their websites and learn how you can help.
Every day that I get to spend with my growing children and family is due to the fact that my wife knew CPR, I received four life-saving shocks from Medic One, and I was not alone when it happened. These days, I live with a defibrillator planted in my chest that will shock my heart if it ever stops again, and I feel fortunate to have been given the chance to continue to pursue my dreams. I wish all of those unfortunate victims of SCA could have been so lucky.
For more information about sudden cardiac arrest and how to use an AED, go to the Pac Med Health Links site on our webpage and look under heart health, or follow this link.
Dr. Brett Daniel is the Chief of Primary Care at Pacific Medical Centers and the Medical Director of PacMed’s Canyon Park clinic in Bothell. He is a board-certified Family Medicine physician who received his medical degree from the University of Washington and did his training at Valley Medical Center in Renton. He has been in practice at PacMed since 2005. Click here for more information about Dr. Daniel.
March 2011
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