Sudden cardiac arrest

Diagnosis

Sudden cardiac arrest is an abrupt event that requires immediate emergency care at a hospital. Timely intervention can increase the chances of survival by restoring proper heart function. After stabilization, medical professionals will perform diagnostic tests to determine the underlying cause of the cardiac arrest. These tests help identify the root problem and guide subsequent treatment.

Tests

Tests are conducted to investigate potential heart–related issues and evaluate the effectiveness of blood pumping by the heart.

Commonly used tests for sudden cardiac arrest are:

• Blood tests. Following cardiac damage following a heart attack, some heart proteins gradually leak into the circulation. These proteins can be checked for by blood tests. The levels of potassium, magnesium, hormones, and other bodily components that affect the heart’s functionality are measured using further blood tests.
• Electrocardiogram (ECG or EKG). This short and painless examination examines the heart’s electrical activity. Electrodes, which act as sensors, are frequently attached to  the chest as well as the arms and legs. How quickly or slowly the heart is beating can be determined by an ECG. The test may reveal variations in heartbeat that elevate the risk of unexpected death.
• Echocardiogram. Sound waves can be visualized as moving heartbeats. This examination can demonstrate the blood flow within the heart and its valves. It can reveal damaged cardiac muscle and issues with the heart valves.
• Ejection fraction. A measurement obtained during an echocardiography, assesses the volume of blood expelled by the heart with each contraction. Normally, ejection fractions fall within the range of 50% to 70%. However, when the ejection fraction drops below 40%, the risk of sudden cardiac arrest increases.
• Chest X–ray. The heart and lungs’ dimensions and shapes are revealed through this test. Additionally, it might reveal if you have heart failure.
• Nuclear scan. Normally, a stress test is conducted along with this exam. It aids in the detection of heart–related blood flow issues. IV injections deliver tracer doses, which are small quantities of radioactive material. When radioactive material passes through the heart and lungs, special cameras can capture the event.
• Electrophysiology (EP). An EP investigation is a thorough analysis of your heart’s electrical activity. Electrocardiogram (EKG) tracings and electrical measures from inside your heart are made by your healthcare provider using cardiac catheters, which are tiny tubes.
• Cardiac catheterization. This examination enables medical professionals to spot obstructions in the cardiac arteries. In order to reach the heart, a catheter, which is a long, thin, flexible tube, is placed into a blood vessel, typically in the groin or wrist. Dye passes through the catheter to reach the heart’s arteries. The dye enhances the visibility of the arteries in X–ray and video pictures.

During this examination, if a blockage is identified, a procedure called balloon angioplasty can be performed to clear the obstruction. In this procedure, a medical professional may use a stent to keep the artery open and ensure proper blood flow. The stent acts as a support structure, helping to maintain the artery’s patency.

Treatment

One form of treatment for sudden cardiac death is:

• CPR. To treat sudden cardiac arrest and avoid mortality, CPR must be done right away.
• Defibrillation (resetting the heart rhythm). If an automatic external defibrillator, or AED, is available, you can use it to perform this. They are widespread in public spaces.
• Medicines. Treatment for irregular heartbeats and symptom management.
• Heart procedure or surgery. Implantation of cardiac devices or obstruction treatment.

Doctors do testing in the emergency room to rule out potential causes such a probable heart attack, heart failure, or abnormalities in electrolyte levels. The causes determine the treatments.

Medications

The heart rhythm can be restored with the aid of medications. Anti–arrhythmic drugs are the name for these medications.

The following medications may also be used to treat or reduce the risk of sudden cardiac death:

• Calcium channel blockers.
• Beta blockers.
• Angiotensin–Converting Enzyme (ACE) inhibitors.

Surgery or other procedures

To address cardiac rhythm issues, clear blockages, or enhance heart function, various medical interventions and therapies may be necessary. These may include:

• Implantable Cardioverter–Defibrillator (ICD). Similar to a pacemaker, an ICD is a battery–operated device that is implanted under the skin close to the collarbone. The heart rhythm is continuously monitored by the ICD. The device shocks the heart to restore rhythm if it detects an abnormal heartbeat. It can stop a heartbeat alteration that could be fatal.
• Coronary angioplasty. This procedure, also known as percutaneous coronary intervention, clears clogged or obstructed cardiac arteries. It may be carried out concurrently with a cardiac catheterization, a procedure used by medical professionals to identify heart artery narrowing.

A thin, flexible tube is inserted into a blood vessel by a medical professional, typically in the groin, and moved to the obstruction. The tube’s tip has a little balloon that has been enlarged. As a result, the artery is opened, improving heart–healthy blood flow.

The tube may be passed via a stent, a metal mesh tube. The stent keeps the artery open and stays in place.

• Coronary artery bypass surgery. This procedure, also known as coronary artery bypass grafting or CABG, makes a new passageway for blood to travel through a blocked artery to the heart. The heart’s blood flow is restored as a result.
• Radiofrequency catheter ablation. The goal of this therapy is to stop a dysfunctional cardiac signaling system. An irregular heartbeat might result from an issue with heart signals. Catheters are thin, flexible tubes that are threaded through blood vessels and into the heart. To make tiny scars in the heart, heat or radiofrequency energy is applied to the catheter’s tip. This blocks the abnormal cardiac signal.
• Corrective heart surgery. Surgery may be used to treat heart conditions that are congenitally present, heart valve disease, or a sick heart muscle.