Esraa Abd Elnasser Hassan

ID:54950
 Cardiac Arrest

A cardiac arrest is the cessation of normal circulation of the blood due to failure of the
ventricles of the heart to contract effectively during systole.

Cardiac arrest is a sudden loss of blood flow resulting from the failure of the heart to

pump effectively.

Cardiac arrest is the abrupt loss of heart function in a person who may or may not have

been diagnosed with heart disease. It can come on suddenly, or in the wake of other

symptoms. Cardiac arrest is often fatal, if appropriate steps aren’t taken immediately. 

The resulting lack of blood supply results in cell death from oxygen starvation.

Cerebral hypoxia, or lack of oxygen supply to the brain, causes victims to lose
consciousness and stop breathing.
[11]
 Signs include loss of consciousness and abnormal or absent breathing.[1][2] Some

individuals may experience chest pain, shortness of breath, or nausea before cardiac

arrest.[2] If not treated within minutes, it typically leads to death.[11]

The most common cause of cardiac arrest is coronary artery disease. Less common

causes include major blood loss, lack of oxygen, very low potassium, heart failure,

and intense physical exercise. A number of inherited disorders may also increase the risk

including long QT syndrome. The initial heart rhythm is most often ventricular

fibrillation. The diagnosis is confirmed by finding no pulse. While a cardiac arrest may

be caused by heart attack or heart failure, these are not the same.

Causes :

Cardiac arrest may be caused by almost any known heart condition.

Most cardiac arrests occur when a diseased heart’s electrical system malfunctions. This

malfunction causes an abnormal heart rhythm such as ventricular

tachycardia or ventricular fibrillation. Some cardiac arrests are also caused by extreme

slowing of the heart’s rhythm (bradycardia).

Irregular heartbeats such as these that can cause cardiac arrest should be considered life-
threatening arrhythmias.

Other causes of cardiac arrest include:

 Scarring of the heart tissue Such scarring may be the result of a prior heart
attack or another cause. A heart that’s scarred or enlarged from any cause is prone
to develop life-threatening ventricular arrhythmias. The first six months after a
heart attack represents a particularly high-risk period for sudden cardiac arrest in
patients with atherosclerotic heart disease.
 A thickened heart muscle (cardiomyopathy) Damage to the heart muscle can
be the result of high blood pressure, heart valve disease or other causes. A
diseased heart muscle can make you more prone to sudden cardiac arrest,
especially if you also have heart failure. Learn more about cardiomyopathy. 
 Heart medications Under certain conditions, various heart medications can set
the stage for arrhythmias that cause sudden cardiac arrest. (As odd as it may
sound, antiarrhythmic drugs used to treat arrhythmias can sometimes produce
ventricular arrhythmias even at normally prescribed doses. This is called a
“proarrhythmic” effect.) Significant changes in blood levels of potassium and
 magnesium (from using diuretics, for example) also can cause life-threatening
arrhythmias and cardiac arrest.
 Electrical abnormalities Certain electrical abnormalities such as Wolff-
Parkinson-White syndrome and Long QT syndrome may cause sudden cardiac
arrest in children and young people.
 Blood vessel abnormalities In rare cases, congenital blood vessel abnormalities,
particularly in the coronary arteries and aorta, may cause cardiac arrest.
Adrenaline released during intense physical activity often acts as a trigger for
sudden cardiac arrest when these abnormalities are present.
 Recreational drug use Use of certain recreational drugs can cause sudden
cardiac arrest, even in otherwise healthy people.
 Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) occur when the
heart abruptly begins to beat in an abnormal or irregular rhythm
(arrhythmia). Without organized electrical activity in the heart muscle, there is no
consistent contraction of the ventricles, which results in the heart's inability to
generate an adequate cardiac output (forward pumping of blood from heart to rest
of the body). There are many different types of arrhythmias, but the ones most
frequently recorded in SCA and SCD are ventricular tachycardia (VT)
or ventricular fibrillation (VF). Less common causes of dysrhythmias in cardiac
arrest include pulseless electrical activity (PEA) or asystole. Such rhythms are
seen when there is prolonged cardiac arrest, progression of ventricular fibrillation,
or due to efforts such as defibrillation to resuscitate the person.
 Sudden cardiac arrest can result from cardiac and non-cardiac causes including
the following:
Coronary artery disease
Coronary artery disease (CAD), also known as ischemic heart disease, is responsible for
62 to 70 percent of all SCDs. CAD is a much less frequent cause of SCD in people under
the age of 40.
Structural heart disease[edit]
Structural heart diseases not related to CAD account for 10% of all SCDs
Inherited arrhythmia syndromes[edit]
Arrhythmias that are not due to structural heart disease account for 5 to 10% of sudden
cardiac arrests
Non-cardiac causes[edit]
SCA due to non-cardiac causes accounts for the remaining 15 to 25%. The most common
non-cardiac causes are trauma, major bleeding (gastrointestinal bleeding, aortic rupture,
or intracranial hemorrhage), hypovolemic shock, overdose, drowning, and pulmonary
embolism. Cardiac arrest can also be caused by poisoning (for example, by the stings of
certain jellyfish), or through electrocution, lightning.
Risk factors:

 Coronary Heart Disease

 Large Heart

 Irregular Heart Valves

 Congenital Heart Disease

 Electrical Impulse Problems

 smoking
 sedentary lifestyle

 high blood pressure

 obesity

 family history of heart disease

 history of a previous heart attack

 age over 45 for men, or over 55 for women

 male gender

 substance abuse

 low potassium or magnesium

 diabetes

Mechanism

The mechanism responsible for the majority of sudden cardiac deaths

is ventricular fibrillation. Structural changes in the diseased heart as a result of
inherited factors (mutations in ion-channel coding genes for example) cannot
explain the suddenness of SCD. Also, sudden cardiac death could be the
consequence of electric-mechanical disjunction and bradyarrhythmias.
Signs and Symptoms of Cardiac Arrest

Early symptoms of cardiac arrest are often warning signs. Getting treatment before your

heart stops could save your life.

If you are in cardiac arrest, you may:

 become dizzy

 be short of breath

 feel fatigued or weak

 vomit

 experience heart palpitations

Immediate emergency care is needed if you or someone you are with experiences these
symptoms:

 chest pain

 no pulse

 not breathing or difficulty breathing

 loss of consciousness

 collapse

Cardiac arrest may not have symptoms before it occurs. If you do have symptoms that
persist, seek prompt medical care.
Diagnosing Cardiac Arrest:

Electrocardiogram (ECG)

During an ECG, sensors (electrodes) that can detect the electrical activity of your heart
are attached to your chest and sometimes to your limbs. An ECG can reveal disturbances
in heart rhythm or detect abnormal electrical patterns, such as a prolonged QT interval,
that increase your risk of sudden death.

Blood tests

A sample of your blood might be tested to check the levels of potassium, magnesium,
hormones and other chemicals that can affect your heart's ability to function. Other blood
tests can detect recent heart injury and heart attacks.

Imaging tests

Chest X-ray: can look for other signs of disease in the heart.

Echocardiogram. This test uses sound waves to produce an image of your heart. It can
help identify whether an area of your heart has been damaged by a heart attack and isn't
pumping hard enough or whether there are problems with your heart valves.

Nuclear scan. This test, usually done with a stress test, helps identify blood flow
problems to your heart.

Coronary catheterization (angiogram).

Treatment:

1. CPR

Immediate CPR is crucial for treating sudden cardiac arrest. By maintaining a flow of
oxygen-rich blood to the body's vital organs, CPR can provide a vital link until more-
advanced emergency care is available.
 2. Defibrillation

Advanced care for ventricular fibrillation, a type of arrhythmia that can cause sudden
cardiac arrest, generally includes delivery of an electrical shock through the chest wall to
the heart. The procedure, called defibrillation, momentarily stops the heart and the
chaotic rhythm. This often allows the normal heart rhythm to resume.

At the emergency room

Once you arrive in the emergency room, the medical staff will work to stabilize your
condition and treat a possible heart attack, heart failure or electrolyte imbalances. You
might be given medications to stabilize your heart rhythm

Long-term treatment
After you recover, doctor will discuss with you or your family what other tests might
help determine the cause of the cardiac arrest. Your doctor will also discuss preventive
treatment options with you to reduce your risk of another cardiac arrest

 Drugs: beta blockers.

 Implantable cardioverter-defibrillator (ICD):after the condition is stable.
 Coronary angioplasty. This procedure opens blocked coronary arteries, letting
blood flow more freely to your heart, which might reduce your risk of serious
arrhythmia.
 Coronary bypass surgery. Also called coronary artery bypass grafting, bypass
surgery involves sewing veins or arteries in place at a site beyond a blocked or
narrowed coronary artery (bypassing the narrowed section), restoring blood flow
to your heart.
 Radiofrequency catheter ablation. This procedure can be used to block a single
abnormal electrical pathway.
 Corrective heart surgery. If you have a congenital heart deformity, a faulty
valve or diseased heart muscle tissue due to cardiomyopathy, surgery to correct
the abnormality might improve your heart rate and blood flow, reducing your risk
of fatal arrhythmias.
Reference
Daily science.
American association heart.
Health line.
Mayo clinic.
Wikipedia.