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Death in sleep, while doing everyday work or while driving a car, basically, sudden death, is a cause of concern. In most cases, it is due to undetected heart rhythm disorder or an underlying coronary artery disease. Experts state that there is limited awareness both among people and healthcare providers to reduce the risk of sudden death due to cardiac arrest.
In India, the numbers are high due to the increasing burden of coronary artery disease, heart blockages and episodes of fainting and sudden loss of consciousness, which require effective treatment. Senior cardiothoracic surgeon and heart and lung transplant specialist Dr A G K Gokhale from Apollo Hospitals, explains in detail.
Q. What is sudden cardiac arrest? When does it occur?
Sudden cardiac arrest is when the heart stops working suddenly. Due to that, blood does not get pumped into the body from the heart. If it is not reversed in 3 to 5 minutes, the person dies. It may be due to several reasons. The most common is sudden heart attack. This is due to a sudden blockage in the artery that takes the blood to the heart, the heart muscle does not get its blood supply and the muscle dies. The other reasons include abnormalities of electrolytes like potassium, viral infections of the heart, injuries of the heart, severe infections in the body, major lung problems, electric shock, etc.
Q. What is the difference between a heart attack and cardiac arrest?
Cardiac arrest means that the heart has stopped working. Heart attack is when the blood supply to one chamber of the heart stops. This causes one of the parts of the heart muscles to die. Heart attack is one of the many reasons for cardiac arrest.
Q. What are the risk factors of sudden cardiac arrest? How can these factors be minimised?
All the risk factors for heart attack like diabetes, hypertension, obesity and viral infections are the same for cardiac arrest too. Previous heart attack, weak heart function, kidney failure, electrolyte abnormalities — all these predispose to cardiac arrest.
Q. After a cardiac arrest, what are the revival chances of the patient if in the hospital?
Revival chances are very high in a hospital. Some of the major hospitals have a cardiac resuscitation team — that means, whenever a patient has a cardiac arrest, the team gets a code red message and the team will be with the patient in 1 to 2 minutes. Revival chances depend on the condition of the patient and age. Generally younger patients with short term problems can be resuscitated much easier compared to people more than 70 years and suffering from chronic conditions like kidney failure, multiple organ problems, obesity and other multiple complications. Patients in intensive care situation are likely to be resuscitated much faster than those in the wards and rooms.
Q. After revival, what are the survival chances of the patients?
After revival from cardiac arrest, the chances of survival are better if resuscitated within 3 minutes of cardiac arrest and if patient has a reversible cause for the cardiac arrest.
Q. It is stated that sudden fainting episodes are an indication of slow functioning of the heart?
Sudden fainting episodes need urgent attention. It may mean a major heart or brain problem that needs to be evaluated properly.
Tips to take care:
Control your weight: People who are over overweight, especially those who have fat at the abdomen, are at high risk of cardiovascular disease.
Control diabetes, hypertension and cholesterol: Diabetes, hypertension and bad cholesterol magnify risk of both coronary artery disease and sudden cardiac arrest.
Exercise: 45 minutes of moderate daily exercise, at least five days a week, performing yoga or meditation, will go a long way to preventing heart attacks.
Manage heart health: People who already have suffered damage to their left ventricle (ejection fraction 35 per cent or less) can prevent sudden death by implantation of small pacemaker like device called ICD. ICD is a highly effective device which can revive more than 95 per cent of cardiac patients.
Avoid smoking: Smoking increases the risk of coronary heart disease by narrowing arteries over a sustained period. It is important to quit the habit.
