Cardiac arrest/ Heart attack

Cardiac arrest/ Heart attack

There seems to be a Panic after Puneeth Raj Kumar’s sad demise among gym going generation. Puneeth has been a great fitness icon. There seems to be many questions in the minds of general public about the tragic end of their matinee idol. Why did he die? They have assumed doubts about their cardiac status and want to get examined out of fear and anxiety.

But see the greatness of the family! Even in that moment of crushing grief, his brother called the eye bank, asking them to collect the actor’s eyes for donation. Today four People- are able to see the world through the eyes of Puneeth Rajkumar! Eyes are god’s gift to us.

Hello Friends

I am Dr Prabhudev

Former prof and Head of the department cardiothoracic surgery and director of Sri Jayadeva institute of Cardiology

Former Vice chancellor Bangalore University

Former Chairman of Karnataka State Health commission

I want to share some medical facts about Cardiac arrest/ Heart attack.

Cardiac arrest is a sudden loss of blood flow resulting from the failure of the heart to pump effectively. A condition where the heart suddenly stops beating, which results from an electrical conduction disturbance. This is different from a heart attack. Cardiac arrest results in rapid loss of consciousness and can result in abnormal or absent breathing. If not treated within minutes, it typically leads to silent death.

Cardiac arrest is not uncommon! We see More than 10 lakh cases of cardiac arrest in a year in India. In the United States, approximately 535,000 cases cardiac arrests occur a year says the American Heart Association.

Causes of cardiac arrest

In 80% of cases the most common cause of cardiac arrest is coronary artery disease.

Prolonged High intensity interval training –and a state of Anaerobic metabolism. This is the exercise work out Puneeth was following!

Very low potassium levels in blood

WPW syndrome/ long QT syndrome

Heart failure

Major blood loss

Cardiac arrest does not show warning symptoms in nearly half the cases. Sometimes, chest pain, light-headedness, palpitations or vomiting may be seen before the arrest. There is Loss of consciousness in all cases soon after the event.

Immediately before losing consciousness Symptoms may include chest pain, fainting, palpitations and shortness of breath.

They Collapse or faint

There is no breathing

There is no pulse

Some people may experience a racing heartbeat or they may feel dizzy, alerting them that a potentially dangerous heart rhythm problem has started. In over half of the cases, however, sudden cardiac arrest occurs without prior symptoms.

The initial heart rhythm most often leading up to the condition is ventricular fibrillation. The diagnosis is confirmed by finding no pulse — Radial or carotid or any other peripheral pulses and ofcourse an Electrocardiogram is diagnostic!

The percentage of people who survive out-of-hospital cardiac arrest and with treatment by emergency medical services is about 8%.There are some false reports that the recovery rate is around 40 to 50 percent! This may contribute to misinformed expectations.

Treatment for cardiac arrest includes immediate cardiopulmonary resuscitation and most importantly defibrillation.

An implantable cardiac defibrillator may be required to reduce the chance of death from recurrence.

Are there any cardiovascular risks associated with HIIT?

One major cardiovascular adverse event occurred in relation to an HIIT session, equating to 1 major cardiovascular event per 17 083 training sessions (11 333 training hours).

The rate of sudden cardiac arrest during exercise in competitive athletes is about 0.75 per 100 000 athletes per year. It is safe! It should be practiced under the guidance of a qualified trainer. The results are quicker and beneficial.

Post recovery from Cardiac arrest-

In the event that cardiopulmonary resuscitation is successful, this does not guarantee complete recovery as many patients surviving cardiac arrest experience an array of disabilities including partial paralysis, seizures, difficulty with walking, difficulty in speaking, problems with memory, limited consciousness, or persistent vegetative state and brain shrinkage!

Now let us dwell on Heart attack!

A heart attack is a frightening experience. Heart attack occurs when one or more coronary arteries get blocked. Symptoms are tightness or severe pain in the chest, back, neck or arms. In fact, tens of thousands of people survive heart attacks and go on to lead productive, enjoyable lives.

Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because coronary arteries that supply the heart muscle with blood flow can become narrowed from a buildup of fat, cholesterol and other substances that together are called plaque. This happens over years and this slow process is known as atherosclerosis. When plaque fractures within the coronary artery, a blood clot forms around the plaque. This blood clot can block the blood flow through the artery to the heart muscle.

Ischemia results when the heart muscle is starved for oxygen and nutrients. When damage or death of part of the heart muscle occurs as a result of ischemia, it’s called a heart attack, or myocardial infarction (MI).

Heart attacks are on the rise among young across India, Every 40 seconds, someone has a heart attack. We see more than 1 crore heart attacks per year in India. There is also concern over the growing prevalence of heart attacks in the younger population. Lifestyle choices, your diet plan, workout routine and how you manage your stress levels can influence the possibilities of a attack”. Cardiac deaths are 272 per 100 000 population in India

It has been reported that young Indians are at greater risk of heart disease because of a genetic mutation that affects one in 25 people in India.

The heart is a very tough organ. Even though a part of it may have been severely injured, the rest of the heart keeps working. But, because of the damage, your heart may be weakened, and unable to pump as much blood as usual.

Will I recover from my heart attack?

Most likely Yes!

With proper treatment and lifestyle changes after a heart attack, further damage can be limited or prevented.

The heart muscle begins to heal soon after a heart attack. It usually takes about eight weeks to heal.

Scar tissue may form in the damaged area, and that scar tissue does not contract or pump as well as healthy muscle tissue. As a consequence, the extent of damage to the heart muscle can impact how well the heart pumps blood throughout the body.

How is a heart attack different from cardiac arrest?

They are different events. A heart attack is when blood flow to the heart is blocked. It’s a circulation problem. Sudden cardiac arrest is an electrical problem resulting in ventricular fibrillation and there is no effective pumping of blood to brain and other organs.

Cardiac arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed and a defibrillator is used within minutes to shock the heart and restore a normal heart rhythm.

Conventionally A heart blockage needs a cardiological intervention– angiogram and Angioplasty with stent placement or surgical intervention- CABG or coronary revascularization.

In contrast, sudden cardiac arrest the heart beats dangerously fast in the state of ventricular tachycardia. The heart just shivers without any output. It finally degenerates into cardiac arrest. There is no effective cardiac function. There I no blood supply to any organ including to the brain! It results in unconsciousness. If not shocked with Defibrillator there is silent Death!

A strong Family history is a risk factor

Dilated cardiomyopathy — 10%

Hypertrophic cardiomyopathy

What’s the way forward?

India is genetically more prone to cardiovascular diseases due to metabolic syndrome, diabetes, hypertension and sedentary life style! Cardiovascular disease is still the leading cause of death in India, killing 1.7 million people a year.

In heart attack you may have Golden Hour for emergency treatment. In fact, tens of thousands of people survive heart attacks and go on to lead productive, enjoyable lives.

In cardiac arrest you have only Golden seconds to resuscitate!

Cardiac arrest executes life! I suggest to equip all gyms and cardiac clinics with Monitors and Automatic Electrical Defibrillator. It will go a long way in saving many precious lives!

Thank you ladies and gentlemen!

Former director of Sri Jayadeva Institute of Cardiology, Former VC of Bangalore University and former chairman of the Karnataka State Health Commission