Cardiac Arrest/Cardiopulmonary arrest/Circulatory arrest

Def:is the cessation of normal circulation of blood due to failure of heart to

contract effectively
-may be referred as sudden cardiac arrest (SCA)
-different from heart attack where blood flow to muscle of heart is impaired
-it is a medical emergency

Pathophysiology
Arrest blood circulation
Prevents delivery of oxygen to blood
Lack of oxygen in brain cause loss of consciousness

Result in abnormal and absent in breathing

-brain injury caused when cardiac arrest goes untreated for more than 5 mins
Classification

Sign and symptoms

-absence of palpable pulse
-unconscious due to inadequate cerebral perfusion
-stop breathing
-prompt intervention can usually reverse a cardiac arrest

Cause
1.coronary heart disease (60-70%)
2.ischaemic heart disease (30%)
3.non ischaemic heart disease
Eg:cardiomyopathy,hypertension,heart disease,congestive heart
failure,coronary artery abnormal
4.non cardiac cause
Eg:trauma,GI bleed,aortic rupture,pulmonary embolism

Risk factor:
-smoking
-obesity
-diabetes
-lack of exercise
-family history
Diagnosis
-diagnosed clinically by absence of pulse
-absence of carotid pulse
-look for sign of circulation eg:coughing,gasping,twitching
-unconscious or not breathing normally
Management
1.cardiopulmonary resuscitation (CPR)
2.defibrillation
3.therapeutic hypothermia
-cooling of person after cardiac arrest with return of spontaneous circulation
but without return of consciousness
-patients are cooled over 24 hrs,with a target of 32-34 degree celcius

Prevention
-implantable cardioverter defibrillator