Sudden Cardiac Arrest-What you need to Know Cleveland Clinic
SUDDEN CARDIAC ARREST & DEATH:
What is it & am I at risk?
WHAT IS SUDDEN CARDIAC ARREST?
Sudden cardiac arrest (SCA) is when the electrical function of the heart is suddenly disrupted, leading to an abnormal heart rhythm and/or loss of a heartbeat that disrupts the ability of the heart to pump oxygen-rich blood to vital organs and tissues like the brain and lungs. An individual loses a pulse, becomes unresponsive within seconds, may not be breathing, may appear to have “seizure-like” activity, or may appear to be gasping. Cardiac arrest may be fatal and occur within minutes if individuals do not receive treatment with cardiopulmonary resuscitation (CPR) and/or defibrillation with an automated external defibrillator (AED).
WHAT CAUSES SUDDEN CARDIAC ARREST?
Abnormal heart rhythms like ventricular tachycardia and ventricular fibrillation can cause cardiac arrest. Heart attacks, heart disease, valve disease, cardiomyopathies (heart muscle diseases), medications, drug and alcohol use, severe stress and acute illness, commotio cordis (heavy blow to the chest) can cause sudden cardiac arrest.
WHAT IS THE DIFFERENCE BETWEEN A HEART ATTACK AND CARDIAC ARREST?
A heart attack occurs when the delivery of blood to the heart (a muscle) is disrupted and thus is a circulatory problem. Cardiac arrest is an electrical disturbance where the heart immediately develops an abnormal heart rhythm leading to loss of pulse and loss of consciousness. Heart attacks can cause sudden cardiac arrest. Heart attacks may occur gradually – over minutes and hours – whereas cardiac arrest is sudden – within seconds – and an immediate emergency.
WHO IS AT RISK FOR SUDDEN CARDIAC ARREST/DEATH?
Based upon A 2002-2022 NCAA database of athlete deaths, male, black, basketball players are at highest risk of sudden cardiac arrest/death (SCA/D) at ~ 1/8000 athlete-years.
Additional risk factors for athletes and non-athletes include:
- Family history of SCA/D, prior or acute heart attack
- Cardiomyopathy (heart muscle disease) +/- scarring of the heart (e.g., hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, infiltrative cardiomyopathy
- Inflammation of the heart (myocarditis)
- Electrical disturbances/arrhythmias (e.g., Wolff-Parkinson-White syndrome, Long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, etc)
- Active drug use
- Electrolyte disturbances (e.g., potassium, magnesium)
Uncontrolled cardiac risk factors may also provoke abnormal changes with the heart and increase risk for SCA/D. Risk factors include:
- High blood pressure
- High cholesterol
- Obesity and metabolic syndrome
- Elevated blood sugars, pre-diabetes, and diabetes
- Tobacco use, smoking
WHAT CAN YOU DO TO REDUCE YOUR RISK OF SUDDEN CARDIAC ARREST/DEATH?
1. Know your family history – ask your family members if there is any history of SCA/D, heart attacks or other heart problems and share this information with your doctor.
2. Know whether your cardiac risk factors are controlled or uncontrolled –
a. Check your blood pressure regularly and talk to your doctor about medication use if your blood pressure is abnormal. Normal blood pressure is < 120/80.
b. Check your cholesterol (lipid panel) and hemoglobin A1c (an estimate of blood sugar control over 3 months) at least once a year. A one-time check of lipoprotein (a), a genetically pre-determined type of low-density lipoprotein (LDL, i.e., “bad” cholesterol) that is an independent risk factor for heart attacks and strokes and is more inflammatory than LDL in isolation.
c. Focus on weight management, specifically body composition, the ratio of fat to lean muscle mass. Healthy body fat ranges for biological males are 10-20% (6-13% in athletes). Health body fat ranges for biological females are 18-28% (14-20% in athletes).
3. Avoid alcohol, illicit drugs, and smoking/tobacco use.
4. Talk to your doctors about any potential drug interactions that can increase the risk of abnormal heart rhythms and sudden cardiac arrest.
WHAT CAN YOU DO TO HELP SOMEONE WHO MAY HAVE SUFFERED A CARDIAC ARREST?
If you observe someone who has lost consciousness, may have lost a pulse, get help immediately. Cardiac arrest may look like a seizure – assume the worst and start cardiopulmonary resuscitation with chest compressions immediately. If an automated electronic defibrillator (AED) is available, turn the machine on and follow instructions.
The best thing you can do to empower yourself to be able to help in a witnessed cardiac arrest is to learn how to perform high quality chest compressions and how to use an AED.
For additional information, please contact:
Tamanna K. Singh, MD, FACC
Director, Sports Cardiology Center
Director, Stress ECG Lab
Cleveland Clinic, Cleveland OH
Email: singht2@ccf.org
Office: 216-445-5323