Sudden Cardiac Arrest: Causes, Symptoms, and Prevention

Cardiac arrest and heart attack are often mistaken for the same thing, when in fact they are different. Although a heart attack can cause cardiac arrest, they are different conditions that require different treatment.

Imagine you are going about your day, and suddenly someone near you collapses unconscious. Their heart has stopped beating. What would you do next? A critical situation like this is known as cardiac arrest, and it can happen anytime, anywhere, to anyone.

01 / Heart Disease

What Is Sudden Cardiac Arrest?

Cardiac arrest, commonly known as sudden cardiac arrest, is a medical emergency in which the heart suddenly stops beating, cutting off the blood supply to the whole body. When this happens, the oxygen supply to the brain and other vital organs also stops, which can cause permanent damage or even death if not treated immediately.

What Is the Difference Between Cardiac Arrest and a Heart Attack?

Cardiac arrest and heart attack are often mistaken for the same thing, when in fact they are different. A heart attack, also known as myocardial infarction, occurs due to a blockage of blood flow to part of the heart, causing damage to the heart muscle. During a heart attack, the heart usually keeps beating, although not optimally. Cardiac arrest, on the other hand, is an electrical failure of the heart that suddenly stops it from beating, and it always requires immediate medical treatment. Although a heart attack can cause cardiac arrest, they are different conditions that require different treatment.

02 / Heart Disease

Causes of Cardiac Arrest

Various factors, from heart rhythm disorders to other medical conditions, can contribute to cardiac arrest. Here are the various causes of cardiac arrest that are important for you to know.

1. Arrhythmia (Heart Rhythm Disorders)

Arrhythmia, or a heart rhythm disorder, is a main cause of cardiac arrest. Arrhythmia occurs when the electrical signals that control the heartbeat are disrupted, causing the heart to beat too fast, too slowly, or irregularly.

Arrhythmias cause cardiac arrest by disrupting the heart’s ability to beat effectively. When the heart rhythm becomes irregular, the heart muscle cannot contract effectively, so blood flow to the body stops. In more severe cases, arrhythmias can damage heart tissue, worsening the condition and increasing the risk of cardiac arrest.

Some types of arrhythmia most often linked to cardiac arrest include:

• Ventricular fibrillation (VF): VF is the arrhythmia that most commonly causes sudden cardiac arrest. In VF, the ventricles (the lower chambers of the heart) quiver in an uncoordinated way, so they do not pump blood effectively to the whole body. This condition is very dangerous and requires immediate treatment, usually with defibrillation to restore a normal heart rhythm. A study published in the journal National Library of Medicine found that about 1 in 3 patients who experience sudden cardiac arrest due to ventricular fibrillation cannot be saved because of delays in receiving first aid.
• Ventricular tachycardia: Ventricular tachycardia is an arrhythmia characterized by a fast and irregular ventricular heartbeat. Although ventricular tachycardia can be brief and cause no symptoms, if it lasts a long time, it can reduce blood flow to the brain and other vital organs, increasing the risk of cardiac arrest. According to data from the American College of Cardiology and information reported by several hospitals in Indonesia, ventricular tachycardia (VT) is one of the important causes of sudden cardiac arrest. Research shows that about 10% to 25% of patients with sudden cardiac arrest experience ventricular tachycardia before the event occurs. In Indonesia, the prevalence of this condition is increasing along with the high rate of coronary heart disease. Statistics show that patients with a history of heart disease, especially those who have had a previous heart attack, have a higher risk of developing ventricular tachycardia.
• Bradycardia: Bradycardia is a condition in which the heart beats too slowly. Although it is not always dangerous, severe bradycardia can reduce blood flow to vital organs and trigger cardiac arrest. Heart rhythm disorders, including bradycardia, are fairly common in older adults and can increase the risk of sudden cardiac arrest.

2. Heart Attack (Myocardial Infarction)

A heart attack, or myocardial infarction, is one of the main causes of cardiac arrest. When blood flow to the heart muscle is blocked, heart cells begin to die from lack of oxygen. If not treated immediately, a heart attack can cause severe damage to the heart, which can potentially trigger sudden cardiac arrest.

In Indonesia, according to the Indonesian Ministry of Health (Kemenkes), the prevalence of coronary heart disease continues to rise, and it is one of the most common causes of death. Research shows that patients with a history of heart attack have a higher risk of cardiac arrest in the future.

3. Other Medical Conditions

In addition to arrhythmias and heart attacks, there are several other medical conditions that can also cause cardiac arrest. Here are some of them:

• Coronary heart disease (CHD): Coronary heart disease is a condition in which the blood vessels that supply blood to the heart become narrowed due to a buildup of fat and cholesterol. This can cause chest pain and increase the risk of a heart attack, which in turn can trigger cardiac arrest.
• Cardiomyopathy: Cardiomyopathy is a disease that affects the heart muscle, causing the heart to weaken and become unable to pump blood effectively. Types of cardiomyopathy such as hypertrophic and dilated cardiomyopathy can contribute to cardiac arrest.
• Heart valve disease: Heart valve disease occurs when the heart valves do not work properly, disrupting blood flow through the heart. Problems with these valves can put extra strain on the heart and increase the risk of cardiac arrest.
• Electrolyte abnormalities: An imbalance of electrolytes in the body, such as sodium, potassium, and calcium, can cause serious heart rhythm disorders and potentially lead to cardiac arrest. This condition can be caused by dehydration, kidney problems, or the use of certain medications.
• Hypoxia: Hypoxia is a condition in which the body or certain parts of the body lack oxygen. Hypoxia can result from lung disease, breathing disorders, or airway obstruction. Prolonged lack of oxygen can worsen heart conditions and potentially trigger cardiac arrest.
• Pulmonary embolism: Pulmonary embolism is a condition in which a blood vessel in the lungs is blocked by a blood clot. This can obstruct blood flow and increase pressure in the right side of the heart, which can lead to cardiac arrest.
• Chest trauma: Serious injuries to the chest, such as from an accident or violence, can damage the heart or blood vessels, potentially causing sudden cardiac arrest.
• Drug overdose: The use of illegal drugs or an overdose of prescription medications can disrupt heart function and cause cardiac arrest. Drugs such as opioids, amphetamines, and certain antidepressants can directly affect the heart rhythm.

4. Risk Factors

Cardiac arrest can be triggered by various risk factors that increase a person’s likelihood of experiencing it. Here are some factors to pay attention to:

• Age: Age is a significant risk factor. The older a person is, the higher the risk of heart problems. Data from the American Heart Association show that the risk of cardiac arrest increases with age, especially after age 65.
• Family history: Having a family history of heart disease or cardiac arrest can also increase the risk. Research shows that individuals with close family members who have heart conditions are more likely to experience similar problems.
• Smoking: Smoking is one of the main risk factors that can damage the cardiovascular system. According to data from the World Health Organization (WHO), smoking increases the risk of coronary heart disease and cardiac arrest, with smokers having up to twice the risk of nonsmokers.
• High blood pressure (hypertension): Hypertension, or high blood pressure, increases the heart’s workload and can damage blood vessels. According to data from the Indonesian Ministry of Health, the prevalence of hypertension in Indonesia is increasing, with about 34% of adults having high blood pressure, which can potentially lead to cardiac arrest.
• Diabetes: Diabetes significantly increases the risk of heart disease. According to research, people with diabetes have a two to four times higher risk of having a heart attack or cardiac arrest than people without diabetes.
• Obesity: Being overweight or obese contributes to various health problems, including heart disease. Data from the WHO show that obesity can increase the risk of hypertension, diabetes, and high cholesterol, all of which are linked to cardiac arrest.
• High cholesterol: High cholesterol can cause fat to build up in the blood vessels, which hinders blood flow to the heart. High cholesterol is fairly common among adults in Indonesia and increases the risk of heart disease and cardiac arrest.

03 / Heart Disease

Symptoms of Cardiac Arrest

Recognizing the signs of cardiac arrest, whether they occur suddenly or appear as early symptoms, is very important for responding quickly and appropriately. The speed of treatment is a deciding factor in improving the chances of saving a life. Here are the symptoms of cardiac arrest to watch out for.

Main Signs

When cardiac arrest occurs, there are several main signs that can help you recognize this emergency. These main signs include:

1. Loss of consciousness: A person experiencing cardiac arrest usually loses consciousness suddenly. They are unresponsive and cannot be woken up within a short time. This is one of the clearest indicators of cardiac arrest.
2. No breathing or abnormal breathing: After cardiac arrest occurs, the patient usually does not breathe or shows an abnormal breathing pattern, such as gasping. This indicates that the body is not getting enough oxygen.
3. No pulse: The inability to feel a pulse is a definite sign that the heart has stopped pumping blood. Prompt treatment is needed to address this condition.

Warning Signs Before Cardiac Arrest

Before cardiac arrest occurs, some signs may appear as a warning. Recognizing these signs can provide an opportunity to get medical help. Signs before cardiac arrest include:

1. Shortness of breath: Many people who experience cardiac arrest have difficulty breathing beforehand, which can indicate a serious heart problem.
2. Dizziness: Feeling dizzy or losing your balance can be an indicator that blood flow to the brain is disrupted, which can potentially be a sign of cardiac arrest.
3. Chest pain: Pain or discomfort in the chest area is a common symptom often experienced before cardiac arrest and can indicate a heart problem.
4. Temporary loss of consciousness: Some people may faint or feel as if they are about to faint before cardiac arrest occurs.
5. Irregular heartbeat: Changes in heart rhythm, such as a heartbeat that is too fast or too slow, can be a signal of a potentially dangerous problem.

04 / Heart Disease

First Aid Measures

In this section, we will discuss the important first aid measures to take when faced with a person in cardiac arrest. Knowing the right steps can save lives, especially in emergencies where every second counts. With this knowledge, we can be better prepared and more confident in providing the necessary help until professional help arrives.

A. Quick & Simple Steps

When faced with a cardiac arrest situation, following the right first aid steps is very important. Here are quick and simple steps you can take:

1. Make sure you and the victim are safe and secure: The first thing to do is make sure the area around you is safe. If the victim is in a dangerous environment, such as a road or an area at risk of fire, move to a safer place if possible. Make sure you and the patient are not in danger before giving help.
2. Call for medical help (an ambulance) immediately: Immediately contact emergency services by dialing the emergency number 112 to request medical help. Give clear and accurate information about the location, the victim’s condition, and the fact that the victim is in cardiac arrest. A quick call can help make sure the medical team arrives promptly to provide further treatment.
3. Perform cardiopulmonary resuscitation (CPR): After making sure everyone is safe and calling for help, the next step is to perform CPR. Here are the basic steps to follow:
   1. Position your hands: Place your hands in the center of the victim’s chest. Place one hand on top of the other and make sure your fingers do not touch the chest.
   2. Press on the chest: Push hard and fast in the center of the chest. Compressions should be about 5 to 6 cm deep, at a rate of 100 to 120 compressions per minute.
   3. Compression rhythm: Continue these compressions without stopping until medical help arrives or until the victim starts breathing again. If you are trained, give 2 rescue breaths after every 30 compressions; if not, focus on chest compressions only.

B. Using an Automated External Defibrillator (AED)

An automated external defibrillator (AED) is a medical device used to treat sudden cardiac arrest by delivering an electric shock that can restore a normal heart rhythm. AEDs are designed for use by laypeople, so they are easy to operate even without prior medical training.

Using an AED is very simple:

1. Turn on the device: Switch on the AED by pressing the power button.
2. Follow the voice prompts: The AED provides voice and visual instructions that guide you through each step.
3. Attach the electrodes: Place the electrodes on the victim’s chest according to the instructions on the device. One electrode is placed on the upper chest (on the right side) and the other on the lower chest (on the left side).
4. Heart rhythm analysis: The AED will analyze the patient’s heart rhythm. Make sure no one is touching the victim during the analysis.
5. Deliver a shock if needed: If the AED determines that a shock is needed, follow the instructions to press the shock button. Make sure everyone stands clear of the victim when the shock is delivered.

Using an AED is very important because it can improve the chances of survival for someone in sudden cardiac arrest. According to the American Heart Association, using an AED quickly can raise the likelihood of survival by up to 70%. Therefore, knowing how to use an AED and having access to these devices is crucial in emergencies.

05 / Heart Disease

Medical Treatment of Cardiac Arrest

After a patient has had cardiac arrest and is brought to the hospital, the medical team will immediately take a series of measures to stabilize the patient’s condition. One of the first steps is defibrillation, which delivers an electric shock to restore a normal heart rhythm. This procedure is especially important if the patient has ventricular fibrillation or ventricular tachycardia.

In addition to defibrillation, doctors will also give the necessary medications to address the heart problem. Some commonly used medications include adrenaline and amiodarone, which work to increase blood flow to the heart and restore a normal heart rhythm.

The medical team will also provide breathing support if the patient has difficulty breathing. This can include the use of breathing aids or a ventilator to make sure the patient gets enough oxygen. All of these steps aim to improve the patient’s condition and prevent further damage to the brain and other vital organs.

Post-Cardiac Arrest Care

Once the patient is stable, post-cardiac arrest care becomes very important. The patient may need intensive monitoring in a cardiac care unit or ICCU (intensive coronary care unit) to make sure the heart and other organs are working properly.

During the recovery period, doctors will carry out continuous monitoring to detect potential complications, such as heart failure or heart rhythm problems. Additional procedures such as cardiac catheterization or stent placement may also be performed to open blocked arteries.

In addition, patients will usually be given a cardiac rehabilitation program to help them recover and regain their strength. This rehabilitation includes education about lifestyle changes, stress management, and a structured exercise program to prevent cardiac arrest from happening again in the future.

06 / Heart Disease

Preventing Cardiac Arrest

Here are important steps you can take to reduce your risk of cardiac arrest.

1. Lifestyle Modifications

Changing to a healthier lifestyle is one of the important steps in preventing cardiac arrest. Some modifications you can make include:

1. Healthy diet: Eating nutritious foods rich in vegetables, fruits, whole grains, and healthy fats can help maintain heart health. Reducing your intake of salt, sugar, and saturated fat is also strongly recommended. A balanced diet can reduce the risk of heart disease.
2. Regular exercise: Regular physical activity, such as walking, running, cycling, or swimming, is very important for maintaining heart health. Do at least 150 minutes of moderate exercise every week to maintain your physical condition and heart health.
3. Avoiding smoking: Smoking is a major risk factor for heart disease. Quitting smoking can improve heart health within a short time.
4. Managing stress: High levels of stress can affect heart health. Adopting relaxation techniques such as meditation, yoga, or enjoyable hobbies can help reduce stress and improve overall well-being.
5. Controlling blood pressure, cholesterol, and blood sugar: Monitoring and controlling your blood pressure, cholesterol, and blood sugar levels is very important for preventing heart disease. Having regular checkups and following your doctor’s treatment recommendations can prevent more serious conditions.

2. Routine Health Checkups

Having regular health checkups is an important step in preventing cardiac arrest, especially for individuals with risk factors. These checkups can help detect health problems early, such as hypertension, diabetes, and high cholesterol levels, which can increase the risk of heart disease.

In addition, consultation sessions with a doctor can provide valuable information about more specific preventive steps based on your personal medical history. By having routine health checkups, we can take proactive steps to maintain heart health and reduce the likelihood of cardiac arrest.

Awareness and proper preventive measures can greatly influence heart health and reduce the risk of cardiac arrest. By making lifestyle changes and having regular health checkups, we can lead healthier and more active lives.

07 / Heart Disease

Conclusion

Cardiac arrest is a life-threatening emergency, but with good understanding and the right actions, we can improve the chances of saving lives.

Cardiac arrest is caused by various factors, including arrhythmias (such as ventricular fibrillation), heart attacks, and other medical conditions. Recognizing the main signs of cardiac arrest, namely loss of consciousness, no breathing, and no pulse, is very important. Early symptoms such as shortness of breath, dizziness, and chest pain also need attention. Cardiac arrest prevention can be carried out through a healthy lifestyle, including a balanced diet, regular exercise, avoiding smoking, and managing stress. Routine health checkups are also very important, especially for those with risk factors.

A quick response and proper first aid, including performing cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) if available, are crucial for improving the chances of successfully treating cardiac arrest. Every minute lost reduces the chance of survival.

Remember that the information in this article is educational and is not a substitute for professional medical advice. If you have symptoms or risk factors for cardiac arrest, consult a doctor promptly or visit Heartology Cardiovascular Hospital for proper evaluation and care. Only a doctor can diagnose the condition of your heart and blood vessels and determine the right care or treatment plan.

At Heartology Cardiovascular Hospital, cardiologists can explain the condition, risks, and preventive steps for cardiac arrest, and discuss your questions about heart health.