What is Sudden Cardiac Arrest

By  Eric Taylor, MD, FACC

NOTE: This article was originally published in Decisive Magazine. Reprinted with permission.

Each year sudden cardiac arrest claims over 300,000 victims in the United States. It is the number-one cause of death, accounting for more deaths than breast cancer, lung cancer, and HIV combined. This unfortunately affects the young and the old alike. How often do we hear about a loved one, friends, or acquaintances suddenly dying? How often do we hear about a young amateur professional athlete dying suddenly during an athletic contest or on the practice field? Sudden cardiac arrest is indeed a severe problem with consequences not only for the victim but also for the family members. 


Sudden cardiac arrest is defined as the abrupt sensation of cardiac function, typically secondary to a rapidly beating heart, where the heart stops beating or when the heart mechanically stops functioning. Its end result is typically death within an hour. Although the majority of cases occur in the general population, we know that there are some conditions that predispose to the development of these lethal arrhythmias. What has to be understood is that conditions like acute myocardial infarctions, myocardial ischemia, old myocardial infarctions, disorders that affect not only the structure of the heart but also may disruptive of electrical condition, and genetic conditions that affect the way the heart electrically relaxes. 


The first step is to be honest with yourself regarding how you feel and whether or not you are having any symptoms potentially linked to cardiac disease. A detailed history and physical done by your physician should reveal whether you have hypertension, diabetes mellitus, hypercholesterolemia, evidence of cardiomyopathy, or indeed an abnormal electrocardiogram. If you have been diagnosed with hypertension, diabetes mellitus or elevated cholesterol, it would be essential that you are compliant with your medicines, diet, and exercise as prescribed by your physicians, and indeed dutiful to attend your physician appointments. The goal of adherence to prescribed therapy for patients with risk factors is essential in that if these conditions are tightly controlled, it will in turn reduce your risk of rapid acceleration of developing heart disease and in turn reduce your risk of sudden cardiac arrest. 


It is important that you insure your adult family members have seen a doctor and have access to health care. It is equally essential to be aware of what your parents’ medical conditions are and to insure that they are being compliant with the regimen as prescribed by their physician. This is particularly relevant in families with early risk of sudden cardiac arrest in the absence of heart disease. This has typically suggested a genetic predisposition to sudden death. In some instances it is recommended that multiple family members undergo risk stratification. In some cases, this can be done via electrocardiogram ruling out long QT syndrome or Brugada syndrome. In other cases, it can be done via a 2-D echocardiogram to rule out evidence of hypertrophic cardiomyopathy. 


When sudden cardiac arrest strikes a member of your community, it is worth noting that the only effective therapy at the time of the arrest is CPR, as prescribed by the American Heart Association, and rapid defibrillation. Hence, it is essential to lobby for the placement of portable defibrillators at community centers, recreational facilities, or other community venues. 

In closing, sudden cardiac arrest is a common lethal disorder that is typically the end result of the confluence of multiple medical conditions. To improve one’s risk for sudden cardiac arrest, one must dutifully modify the potential risk factors including hypertension, diabetes mellitus, obesity, and hypercholesterolemia as well as know your family history. In addition, it is important to lobby for the placement of portable defibrillators at heavily used community venues.

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