Cardiac arrest

For other uses, see Cardiac arrest (disambiguation).
Cardiac arrest
Synonyms cardiopulmonary arrest, circulatory arrest, sudden cardiac arrest (SCA), sudden cardiac death (SCD) [1]
US Navy 040421-N-8090G-001 Hospital Corpsman 3rd Class Flowers administers chest compressions to a simulated cardiac arrest victim.jpg
CPR being administered during a simulation of cardiac arrest.
Classification and external resources
Specialty Cardiology
ICD- 10 I46
ICD- 9-CM 427.5
DiseasesDB 2095
MeSH D006323

Cardiac arrest is a sudden stop in effective blood flow due to the failure of the heart to contract effectively. [2] Symptoms include loss of consciousness and abnormal or absent breathing. [1] [3] Some people may have chest pain, shortness of breath, or nausea before this occurs. [3] If not treated within minutes, death usually occurs. [2]

The most common cause of cardiac arrest is coronary artery disease. Less common causes include major blood loss, lack of oxygen, very low potassium, heart failure, and intense physical exercise. A number of inherited disorders may also increase the risk including long QT syndrome. The initial heart rhythm is most often ventricular fibrillation. [4] The diagnosis is confirmed by finding no pulse. [1] While a cardiac arrest may be caused by heart attack or heart failure these are not the same. [2]

Prevention includes not smoking, physical activity, and maintaining a healthy weight. [5] Treatment for cardiac arrest is immediate cardiopulmonary resuscitation (CPR) and if a shockable rhythm is present defibrillation. [6] Among those who survive targeted temperature management may improve outcomes. [7] An implantable cardiac defibrillator may be placed to reduce the chance of death from recurrence. [5]

In the United States cardiac arrest outside of hospital occurs in about 13 per 10,000 people per year (326,000 cases). In hospital cardiac arrest occurs in an additional 209,000 [8] Cardiac arrest becomes more common with age. It affects males more often than females. [9] The percentage of people that survive with treatment is about 8%. Many who survive have significant disability. Many U.S. television shows, however, have portrayed unrealistically high survival rates of 67%. [10]

Signs and symptoms

Cardiac arrest is sometimes preceded by certain symptoms such as fainting, fatigue, blackouts, dizziness, chest pain, shortness of breath, weakness, and vomiting. [11] The arrest may also occur with no warning.

When the arrest occurs, the most obvious sign of its occurrence will be the lack of a palpable pulse in the person experiencing it (since the heart has ceased to contract, the usual indications of its contraction such as a pulse will no longer be detectable). Certain types of prompt intervention can often reverse a cardiac arrest, but without such intervention the event will almost always lead to death. [12] In certain cases, it is an expected outcome of a serious illness where death is expected. [13]

Also, as a result of inadequate cerebral perfusion, the patient will quickly become unconscious and will have stopped breathing. The main diagnostic criterion to diagnose a cardiac arrest (as opposed to respiratory arrest which shares many of the same features) is lack of circulation; however, there are a number of ways of determining this. Near-death experiences are reported by 10–20% of people who survived cardiac arrest. [14]