Sudden Cardiac Arrest: How to identify underlying conditions that lead to it?

 Sudden cardiac arrest represents a grave medical crisis claiming nearly 5 to 10 lakh lives each year in India, representing almost 10% of all deaths. While sudden cardiac arrest can occur in people of all ages, it predominantly occurs in adults, particularly in people with underlying cardiac disease. Although sudden cardiac arrest can occur without prior symptoms, more than 50% of individuals who succumb to sudden cardiac arrest experience cardiac symptoms in the prior 24 hours. Common symptoms include chest pain, unusual shortness of breath or fatigue, palpitations, dizziness or loss of consciousness, excessive sweating, and restlessness.

One of the most important risk factors for sudden cardiac arrest is a ‘weak’ heart, medically referred to as LV systolic dysfunction. Other comorbidities that contribute to an increased risk of sudden cardiac arrest include high blood pressure, uncontrolled blood sugar, high blood cholesterol, cigarette smoking, obesity, or an inactive lifestyle.

Recognizing and optimizing these underlying risk factors represents the cornerstone of all healthy heart strategies and is strongly advocated by the American Heart Association as part of its life’s simple 8 campaign.

Conditions that may lead to sudden cardiac arrest

Electrolyte Imbalances

Essential minerals known as electrolytes regulate diverse bodily functions, including heart rhythm. Aberrant levels of potassium, calcium, and magnesium can lead to arrhythmias increasing sudden cardiac arrest risk. Individuals with chronic kidney disease or those on specific medications are particularly susceptible to electrolyte imbalances. Monitoring and managing electrolyte levels through dietary adjustments and medications can mitigate this risk.

Diabetes

Diabetes, particularly when poorly controlled, can impair blood vessels and nerves that oversee heart function. This can result in coronary artery disease, nerve impairment impacting heart rate, and heightened sudden cardiac arrest risk. Effectively managing blood sugar levels through a healthy lifestyle, medication, and routine check-ups is pivotal for curtailing these risks.

Substance Abuse

The consumption of substances, particularly stimulants like cocaine and amphetamines, can trigger arrhythmias and heighten sudden cardiac arrest risk. These substances can disrupt the heart's electrical system, resulting in fatal consequences even for individuals lacking any prior heart issues.

 

Coronary Artery Disease (CAD)

Dr. Darshan Krishnappa, MD DM FACC, Cardiac Electrophysiologist, Bangalore says, “Often termed atherosclerosis or heart artery disease, this condition arises when arteries supplying blood to the heart become constricted or obstructed due to the accumulation of fatty deposits due to high cholesterol, curtailing blood flow. These blockages can result in heart attacks, arrhythmias, and ultimately, sudden cardiac arrest. Identifying and managing CAD in a timely manner through lifestyle adjustments, medications, and procedures like angioplasty might reduce the risk of sudden cardiac arrest.”

Left Ventricular (LV) Dysfunction

LV dysfunction is the single most important risk factor for sudden cardiac arrest. This condition is characterized by the weakening of the pumping function of the heart. It is frequently caused by CAD, however. It can also be caused by a number of other conditions like tachycardia (PVC, atrial fibrillation), sarcoidosis and other metabolic conditions.

Arrhythmias

Irregular heart rhythms, or arrhythmias, disturb the heart's usual electrical patterns, causing abnormal heartbeats. Ventricular fibrillation, characterized by chaotic and ineffective heartbeats, is the prevalent arrhythmia linked to sudden cardiac arrest. Monitoring heart rhythms through devices like pacemakers or defibrillators, along with medications, can assist in managing arrhythmias and averting cardiac incidents.

Family History

A familial history of sudden cardiac arrest or specific cardiac conditions can amplify an individual's risk of experiencing sudden cardiac arrest. Genetic inclinations can impact the development of conditions like CAD, arrhythmias, and cardiomyopathies. Genetic analysis and counselling can offer valuable insights into familial susceptibilities, enabling proactive steps to mitigate the likelihood of sudden cardiac arrest.

Can sudden cardiac arrest be managed?

Strategies for sudden cardiac arrest prevention differ in individuals with a weak heart compared to individuals with a normal heart. In people with a normal heart, correcting life's simple 8 risk factors is the most important strategy to lower the risk of all heart ailments including sudden cardiac arrest. Regular screening for these risk factors as advised by your physician represents the first step in identifying and optimising these risk factors.

In individuals with a weak heart, compliance with recommended medications is of paramount importance in addition to strategies for optimising risk factors. Technological advances by trained cardiac electrophysiologists have contributed considerably to lowering the rates of sudden cardiac arrest in the western world and are increasingly being adopted in India.

 

 

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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