Introduction[edit | edit source]
Cardiac arrest is the sudden cessation of cardiac activity so that the victim becomes unresponsive, with no normal breathing and no signs of circulation. If corrective measures are not taken rapidly, this condition progresses to sudden death. Cardiac arrest is an event that can be reversed, usually by CPR and/or defibrillation or cardioversion, or cardiac pacing.
Unlike heart attacks (AKA myocardial infarction) which are due to blocked arteries, this condition occurs when there’s a problem with the heart’s electrical system. It is life threatening and requires immediate treatment.
Bystander CPR and advances within emergency medical services save lives. However approximately 10% of those suffering from cardiac arrest leave the hospital alive, most of which are neurologically impaired
Etiology[edit | edit source]
Arrhythmias eg ventricular fibrillation and ventricular tachycardia, are the immediate cause of cardiac arrest.
Conditions and situations that can lead to ventricular tachycardia and ventricular fibrillation are the underlying causes of sudden cardiac arrest. These include:
- Myocardial Infaction (aka heart attack)
- Heart failure.
- Illegal drugs, like cocaine.
- Inherited heart disorders, eg Brugada syndrome, a condition that can disrupt the rhythm of the heart.
- Major blood loss from severe illness or trauma.
Presentation[edit | edit source]
Warning symptoms may precede a cardiac arrest but many times these symptoms are unrecognized or ignored by the individual. The most common symptom is chest pain, mirroring the most common presentations of a myocardial infaction. An individual found to be in cardiac arrest will be unresponsive, without a pulse, and will not be breathing.
Diagnosis[edit | edit source]
Cardiac arrest symptoms come on suddenly, with minimal time for tests and evaluations. The condition can become fatal within minutes, which is why it’s essential to make a quick diagnosis. A person’s symptoms are often the best way to diagnose cardiac arrest, especially if they are unconscious and have no pulse.
Treatment[edit | edit source]
Once a victim is identified, immediate CPR and activation of the emergency response system should be of priority. More recently, public access defibrillation has added another layer of response. Care includes using:
- Cardiopulmonary resuscitation (CPR): Immediate CPR is one of the most important treatments to improve survival during cardiac arrest and is often performed until an automatic or external defibrillator can be used.
- Automatic defibrillator or external defibrillator: Once connected, this device delivers a brief electrical current to the chest, halting the abnormal impulses and restoring the normal impulses that make the heart beat. It may take more than one round of defibrillation for the heart to resume pumping on its own.
Prognosis[edit | edit source]
Factors that increase chance of survival include witnessed cardiac arrest with immediate CPR and use of defibrillation when indicated. Young and healthy patients are more likely to regain circulation compared to the elderly and those who have more co-morbidities.
Despite the many treatments available for cardiac arrest, the majority of patients have a poor prognosis. Lives can still be saved with defibrillation and bystander CPR. Promotion of such education to loved ones and others interested can be lifesaving.
Physiotherapy[edit | edit source]
Physiotherapists play a vital role within the multidisciplinary team (MDT) delivering comprehensive cardiac rehabilitation (CR) to cardiac patients. If clients survive cardiac arrest CR in vital for their best recovery.
References[edit | edit source]
- Patel K, Hipskind JE. Cardiac Arrest. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK534866/ (accessed 2.3.2022)
- Cleveland Clinic cardiac arrest Available: https://my.clevelandclinic.org/health/diseases/21736-cardiac-arrest(accessed 2.3.2022)
- APICR Role of PT in CR Available: https://www.acpicr.com/data/Page_Downloads/ACPICRRoleofPhysio.pdf (accessed 3.2.2022)