A cardiorespiratory arrest is the sudden loss of breathing, heart function, and therefore consciousness. The condition is typically caused by issues with the electrical system of the heart that often interferes with the normal rhythm of the heart. When the heart stops beating efficiently, the result is a lack of oxygenated blood flowing through the body and is often fatal. Blood flow is the origin of oxygen to every cell of the body and when that fails, the organs and cells don’t get enough oxygen-rich blood to operate.

Sudden cardiac arrest isn’t the same as a heart attack when blood flow to a part of the heart is blocked. A heart attack and sudden cardiac arrest are very different. A heart attack is often described as a plumbing problem with blood flow being reduced or blocked. Cardiac arrest is usually related to a malfunction with the electrical system of the human body.

However, a heart attack can be the cause of an electrical malfunction that leads to sudden cardiac arrest.

Sudden cardiac arrest, if not treated promptly, often results in death. Survival rates are greatly increased with prompt and appropriate medical care. Cardiopulmonary resuscitation (CPR) may increase the chance of surviving until emergency services arrive by using a defibrillator or simply providing chest compressions.

There are many reasons why cardiac arrest takes place and how it can lead to certain death if not treated. However, despite the fact that the condition is treatable, sometimes signs of cardiac arrest go unrecognized. Other reasons like age and substance abuse can also stop the heart’s blood flow.

Besides all these, the main reason for cardiac arrest is considered heart disease. At times, various kinds of heart illnesses can lead to a heart attack and, eventually, cardiac failure. Arrhythmia, vascular fibrillation, and other causes are among the most frequent reasons for cardiac arrest.

Sudden cardiac arrest (SCA)  

Sudden cardiac arrest (SCA) is quite different from general heart attacks. Here the heart stops suddenly and often without a warning or pre-existing illness, stopping the blood flow in the vital organs and the brain. This can lead to sudden cardiac death in minutes if not treated immediately. 

Sudden cardiac arrest is a condition that generally strikes without prior notice. These events can be caused by heart disease or not. Several elements are involved in these situations. The first stage will be a structural change of the heart. When the heart isn’t receiving enough blood flow, it frequently expands, resulting in high blood pressure and eventually a heart attack. And then ventricular fibrillation. This is a type of ventricular tachycardia that develops from an arrhythmia, and the lower half of the heart does not adequately raise blood. Ischemic heart diseases can also lead to sudden cardiac arrest as a waxy plaque builds up in the heart arteries, stopping blood flow.   

And lastly, there is mental and physical stress can lead to Sudden cardiac arrest (SCA). Intense physical activity and adrenaline rush can lead to heart arrest. And extreme mental pressure stops oxygen flow to the brain and can cause this problem.  

Cardiac arrest and sudden cardiac death  

Sudden cardiac arrest can lead to sudden and sudden cardiac death. SCA does not discriminate, and it can strike anybody at any time. SCA affects everyone, from professional athletes to schoolchildren.

Certain factors are used to determine whether someone is susceptible to Sudden cardiac arrest (SCA) and mortality. Mostly older people, especially men, have high rates of getting a sudden cardiac attack. People with chronic diseases and a family history of heart complications can also have sudden cardiac arrest leading to sudden cardiac death. Sudden cardiac arrest can also result from alcohol or drug abuse.

Risk factors of cardiac arrest   

There are several risk factors related to cardiac arrest and heart disease, and most risk factors are quite obvious, such as pre-existing cardiac disease. Other risk factors involved in Sudden cardiac arrest (SCA) are quite similar to the risk factors of ischemic heart diseases.  

Personal or family history of SDC  

If you have a family history of cardiac problems that were caused by an arrest, you may be at risk of heart attacks.

Low Ejection Fraction   

If your ejection fraction is lower than 40, you are quite vulnerable to a cardiac event. A low ejection fraction means your heart is not pumping blood throughout your body efficiently.

Coronary Artery Diseases   

This is one of the main risk factors regarding sudden cardiac arrest(SCA). If someone has a blockage in the main artery, it can lead to severe Arrhythmia and ultimately cardiac arrest and sudden cardiac death.  

Previous History of Heart Arrest  

If a person has had a previous heart attack, his or her risk of having another assault is increased by 75%. The time between two episodes may be as little as three to six months. So, if you’re having an episode right now, there’s a good chance it’ll happen again in the near future.

Long QT Syndrome   

Long QT syndrome is one of the rarest forms of heart disease, which can arise from the disorder of irregularity of the heart’s electrical system. LQT is caused by a lack of cardiac electricity that allows the ions to conduct it through the heart muscle.

Heart Blockage  

Heart blockage is another factor that is related to Arrhythmia and sudden cardiac arrest (SCA). Severe blockage can lead to cardiac arrest.  

Ventricular Tachycardia   

Ventricular tachycardia is a type of heart rhythm disturbance caused by the lower chambers and cardiac muscle of the heart. An irregular heartbeat can lead to tachycardia associated with the electric signals.   

Ventricular Fibrillation   

The scar tissue in the myocardial membrane of the heart causes ventricular fibrillation and atrial fibrillation. Atrial fibrillation is a heart rhythm disturbance characterized by an irregular exchange of electricity to the heart. It is one of the most common causes of sudden cardiac arrest and heart failure. This is a severe cardiac illness.

Cardiomyopathy   

Cardiomyopathy happens due to the thickening of heart muscles. Thick muscles can not operate properly and can disrupt the movement of the muscles, and then the flow of oxygen-rich blood is also abrupt.  

Obesity   

This is the main reason for several heart diseases. Being overweight causes blockage in the coronary arteries and weakens the heart muscles. And thus, causes sudden cardiac arrest or heart disease and death.  

These are the serious and obvious risk factors of cardiac arrest. And most of them are at a major risk of sudden cardiac arrest or sudden cardiac death due to the fact. And most important two are coronary artery diseases or ischemic heart diseases and the previous history of a cardiac attack. These two works like a massive factor that can initiate the process leading to heart attacks.  

Symptoms of heart attacks  

There are several symptoms of a heart attack. And some of them are considered silent symptoms. This sign has to be determined carefully, and they are not to be ignored. Most physicians catch up to these symptoms easily, but they are pretty hard for common people. And in case of sudden cardiac arrest, knowing and identifying this symptom works like a lifesaver. 

• Chest pain: there is unusual tightness, pressure, and pain in the chest. It might feel like that someone is crushing your chest. This happens in the center of the chest. The pain lasts for a few moments, and then it passes and comes right on.   
• Pain in other parts: the chest pain travels to different body parts like the neck, arm, armpit, jawline, and abdomen. The left-arm usually gets affected the most. And it gets impossible to move the arm at all.  
• Dizziness: as the sudden cardiac arrest symptoms get severe, people start to feel lightheaded. The oxygen circulation to the brain gets faint, and that leads to dizziness.   
• Heartburn: you can feel the middle of the chest burning, and it can reach the neck at times.  
• Shortness of breath: as the pain increases with time, people get quite disturbed while breathing, and they seem to develop this with the distress and pain of the chest.  
• Sweating: people start to break cold sweats.  
• Nausea and Vomiting: this can or can not occur.   
• Anxiety: people start to lose their reliance and lose their balance eventually.  
• Tiredness: as there is less blood and oxygen circulation in every body organ, people get tired easily, unable to move. Even a short distance seems a lot of obstructions for them.  
• Indigestion: if you have already had a heart attack and you are delaying getting treatment, Indigestion is a symptom you might catch later on.  
• Sleeping problems: people who are perceiving a cardiac arrest can not be at ease, and due to this, they can not get proper sleep or rest. They are quite precarious and uncomfortable throughout the time of occurrence.  
• Coughing: as the person can not breathe properly, they might start Coughing with time.  

These are just some of the symptoms of a heart attack. With sudden cardiac arrest, often there is no warning or symptoms.

Causes of Cardiac Arrest  

There are two typical reasons why cardiac arrest takes place. Cardiac reasons and non-cardiac causes. Some conditions can arise with getting older. A cardiac arrest can strike at any time, even if a person has no prior cardiac disease. Stress and tension are commonly said to be the root of such situations. One of the causes is abnormal heart rhythms or arrhythmia.

However, in each scenario, there are some patterns and symptoms that should not be ignored to preserve a person. Cardiology is the study of heart conditions and treatments, as well as their prevention. Coronary heart disease and sudden cardiac death are both treated with cardiology.

Cardiac reasons   

These reasons are related to heart diseases, and most patients have a previous history of heart diseases. It can also occur in people who have already faced a heart disease or arrest.  

Hypertrophy   

This is one of the most important pictures of heart failure and heart attacks. This is due to abnormalities in the left ventricular Hypertrophy and preserved ejection fraction. People with left ventricular diseases often get myocardial Hypertrophy, which increases mass in the ventricle. This can happen if the geometrical shape of the heart has increased due to less blood flow. Sometimes the wall thickness of the heart can also cause Hypertrophy.   

Healed Myocardial Infarction   

Healed myocardial infarction is one of the most important reasons for heart disease and failure. The complications regarding this are difficult to identify, and they can be chronic to acute. They can involve both the ventricles of the heart or cause with only the left ventricle.   

This happens due to salt retention, fatigue, geometrical and structural changes, dyspnoea, hypertension, diabetes, normal rhythm, fibrillation, and kidney complications. It weakens the heart over time and can lead to demise or other complicated diseases.   

Coronary Artery Disease (CAD)  

Coronary artery disease consists of other coronary abnormalities and cardiovascular diseases such as thrombosis, chronic atherosclerosis, artery spasm, platelet aggression, etc. This can happen due to the blockage in the coronary artery due to fat buildup, which holds up the supply of blood to the heart muscles. If the heart doesn’t get enough blood and oxygen, it loses its natural working environment and can’t function properly. This is why coronary artery disease is known as ischemic heart disease. 

Coronary artery disease can lead to Arrhythmia and eventually angina. Chest pain, dizziness, nausea, weakness are some of the symptoms of coronary artery diseases. And with the severity of the condition can lead to difficulties in speaking and weakness.   

 Valvular Heart Disease  

The valves in the heart make sure that the blood is flowing in the right direction. If one or two of the valves are not working properly, then it is heart valve disease. The valves don’t open and close properly, and the blood flow is disrupted altogether. With the severity of the valve disorders, they might need repairing or replacing.  

The disease can be congenital heart disease or can grow with time. But with the disease on the plate, heart attacks and other heart conditions are quite inevitable. Even infections can take place if not treated properly. Regurgitation is when the blood starts leaking from the valves in a backward direction, and the valves can thicken up and cause them to narrow down the opening path.      

Dilated Cardiomyopathy   

Enlarged heart refers to the problem where both or the left ventricle are affected. This is the disease of the heart muscles. Here the heart thins or the ventricles stretches. This might not be that serious about beginning with, but they can cause irregular normal rhythm and Arrhythmia with time. The blood clot in the coronary arteries can induce heart attacks and sudden cardiac death.   

Genetic Heart Disorders   

Inherited cardiac conditions are umbrella terms for several genetic disorders and have a high risk of sudden cardiac death. Genetic mutations generate these, and here people are born with these disorders and can pass them down to their children. Familial Dilated Cardiomyopathy, restrictive Cardiomyopathy, long and short QT syndrome, polymorphic tachycardia, etc., are some of the notable inherited cardiac conditions or ICC. Congenital heart defects are non-curable but can be tamed. 

High blood pressure   

Hypertension or high blood pressure is the general term for increased pressure in the coronary arteries. This is one of the main reasons for several heart conditions, and thus, sudden cardiac arrest occurs, leading to sudden death due to less blood flowing. Both systolic and diastolic blood pressure can induce this disease. If your heart is pumping more blood, it can lead to narrower arteries. Blood pressure has to be controlled to avoid health risks. Braunwald’s heart disease is connected to hypertension.  

Non-Cardiac Reasons   

About one-quarter of the cases of sudden cardiac arrest are related to these criteria. Several reasons are not relevant to heart diseases but still cause heart attacks.  

If the body faces severe trauma, for example, any sort of accident, the heart may stop beating, resulting in a heart attack. Bleeding from any reason like aortic rapture or cranial bleeding can cause heart attacks as the heart is not getting adequate pump blood. Bleeding control is necessary as most accidents in the operation theatre happen for this.   

Diagnosis of Cardiac Arrest  

There are a few ways to determine if the patient had a heart attack. And one of the fastest ways to figure that out is the ECG. Every physician will first reach out for this and later on confirm they can do a blood test. As sudden cardiac arrest occurs in a short time, the diagnosis and the treatment have to be quick.  

Electrocardiogram (ECG)  

Here electrodes are attached to the patient’s chest and arms to determine the heart’s electrical system. The signals are displayed on the monitor. As a sudden cardiac arrest prevents normal blood flow and electrical pulses, this also shows up in the monitor. If the heart signals are different from normal signals, they are diagnosed with sudden cardiac arrest. This is also used in the case of coronary artery disease.  An exercise stress test can also be done to measure out the problems.

Blood Test  

Blood tests are done after the ECG to confirm if the patient has had a cardiac attack. Some enzymes and proteins leak in the blood after a heart attack. So, the doctor s analyses those proteins in the blood.  

Chest X-ray   

With this, the doctor identifies the situation of the heart and what might cause the sudden cardiac arrest. X-ray helps to examine the blood vessels and the size of the heart.   

Echocardiogram (ECHO)  

This is a chest ultrasound. This is done to examine the heart’s internal condition and determine what caused the heart attack. Doctors can easily identify the vessels that are causing the problems.   

Angiogram  

Though this is cardiac catheterization, a catheter is injected via arteries of the heart, and it’s done from the arms of the patient. A dye penetrating the arteries is identified with the X-ray.   

Magnetic Resonance Imaging   

MRI uses Magnetic and radioactive fields to scan the heart. You can get a 2D or a 3D image of the heart with this machine, and it gives the clearest picture of the heart in terms of diagnosing.   

Treatment for Cardiac Arrest   

Proper treatment for sudden cardiac arrest increases the chances of survival for the patients. They can even limit the possibility of another attack as the patients are quite vulnerable for the next six months after one episode. And this is why the treatments should be arranged as soon as possible, or at least the patient should be on internal medicine to avoid further risk of sudden cardiac. The treatments are like treating arrhythmias, such as using an implantable cardioverter-defibrillator or an automated external defibrillator.

If the patient has partially blocked coronary arteries, it is called a non-ST-elevation myocardial infarction (NSTEMI). The complete blockage is known as the ST-elevation myocardial infarction (STEMI). The treatment for both is almost the same, and here, doctors first try to fix the blockage and regulate the normal blood flow. For NSTEMI, balloon angioplasty or medications are used mostly.   

Angioplasty   

This is done to open the blockage of the arteries, and thus heart attack occurs. This is an invasive process that widens the path of blood flow. It is done while the patient is mildly sedated and the Catheter is implanted via arms or legs. This is a process of cardiac catheterization.  

Laser angioplasty  

Here laser is used instead of the Catheter. For laser, there is the Excimer laser, and xenon chloride is inserted through the arteries. With laser angioplasty, the success rate of angioplasty has risen, and there is no need to use chest bypass if the blockage is unclogged by laser. Here a wire is used to pass the laser in the blood vessels of the heart.  

Coronary Artery Bypass Grafting

Here a new pathway is created to pass the blood. Bypass doesn’t cure heart disease, and it doesn’t unclog the natural path of the flow of blood; rather, a grafted vein is implanted so the blood can pass through that line. The vessel is usually collected from the patient, but fiber grafted vessels are also used right now. This helps the patient to ease out the symptoms of the heart attack.  

Atherosclerosis   

This is also a process of catheterization where a short and thin catheter is charged on the arteries to remove the blockage of the heart. Here the sharp nip accumulates the clogged blood on the vessels. This is done under mild sedation, and the process can be repeated to remove all the blood clots from the vessels.   

Valve Surgery  

If the heart valve is not working properly, it can lead to heart attack and heart failure. There are four types of valves in the heart, and if they don’t operate correctly, there can be a complication in the flow of blood and normal heart rhythm. Here doctors can replace or repair the heart valves, and this process is done in open-heart surgery.  

Heart Transplant   

For most cases, doctors approach this process of none other treatments seems to work. Here, the victim’s heart is critically damaged due to a sudden cardiac arrest or coronary artery disease, and the heart has to be replaced with a completely new heart. This process takes time, and it is not easy to do as the matching process takes time.  

Minimally Invasive Surgery  

Instead of bypass and open-heart surgery, this is done if the sudden cardiac arrest did small damage to the heart. Instead of cutting the entire rib, a small slash is made on the rib. Here robotic hands are often used as the procedure is quite delicate. An implantable cardioverter-defibrillator is implanted to provide electrical shock this way.  

Radio-Frequency Ablation  

This can be used for patients with sudden cardiac arrest or heart diseases like ventricular tachycardia. Here electric shock is used to heat the part of the heart. This can ablate harmful blockage, tumors, etc. It can relieve pain, and this is a non-surgical process.  

Transmyocardial Revascularization  

Here carbon dioxide laser is used to form holes in the heart’s muscles that improve heart muscle and the heart’s electrical system. This is mostly done in the left ventricle. If coronary bypass or angioplasty does not work, then doctors opt for this procedure.  

Stenting  

Her doctors put a small stent in the blood vessels to regulate blood flow in case of coronary artery disease and attack. The Catheter and balloon are inserted from the stent to remove the clogged blood.  

Prognosis of Cardiac Arrest  

The first seventy-two hours after the heart attack is considered the Prognosis period, and CPR or cardiopulmonary resuscitation increases the chances of survival at a high rate and prevents sudden cardiac deaths. Fifty percent of death happen if there is no medical care in those hours. And the rate comes down to twenty percent if the patient is admitted to the hospital. Primary medical education is important for everyone to prevent cardiac arrest risks. The patient has to receive primary care within twelve hours of the attack; otherwise, the case will be irreversible. Even in the hospital, rapid treatment can increase the survival chances and avoid the long-term consequences of heart disease.  

Life After a Cardiac Arrest  

If you survived sudden cardiac arrest, everything has to be modified from the diet to the initial habits to avoid the risk of sudden cardiac arrest. And that too, according to your physicians.

• Quit smoking, drinking, and anything with increased risk.  
• Stop doing any recreational drugs and pursue healthy living.  
• Exercise regularly but not with excessive passion and pressure.   
• Try and take stress as little as possible. Try meditation and yoga for stress relief.   
• Don’t engage in sensual activities for six to eight weeks after the heart attack.   
• Be careful while you are driving alone. And try and avoid using motorcycles.  
• If you have any mental health problems like anxiety and depression, try and get yourself a therapist.   
• Take your medicines to restore blood flow and check up carefully. Patients are supposed to get a proper check-up every three months after a heart attack.   

 A healthy heart-healthy lifestyle is interconnected.  National heart and blood institute of America holds programs on the rehabilitation of cardiac patients.

Conclusion   

To avoid the chances of death, patients with structural heart diseases should evade getting too much stress, and they should maintain their medications accurately. And people who have a family history of heart diseases should get a proper check-up at least once a year. The foremost path is to take care of one’s physical and mental health.