How Can Cardiac Arrest Lead to Death?

 How Can Cardiac Arrest Lead to Death?

"A seemingly healthy person suddenly loses consciousness and dies before even reaching the hospital," "someone collapses and dies while walking down the street," or "someone dies while asleep."

We frequently hear about such incidents. Many people attribute these events to a "heart attack"—a term everyone is familiar with. However, cases where death occurs rapidly—before any medical treatment can be administered—are often the result of cardiac arrest.

Most people are not well-informed about cardiac arrest. Some may even believe that cardiac arrest and a heart attack are the same thing; however, this is certainly not the case. In many instances, a heart attack can lead to cardiac arrest.

What, then, is cardiac arrest?

Cardiac arrest occurs when the heart stops functioning. The term "cardiac" refers to the heart, and "arrest" signifies a complete stop. This is a medical emergency. When the heart stops working, oxygen can no longer be delivered throughout the body, causing the individual to lose consciousness or become semi-conscious.

If immediate treatment is not provided in such a situation, death can occur very quickly. For this reason, it is also referred to as "sudden cardiac arrest." A heart attack is a primary factor that can trigger cardiac arrest.

When a heart attack occurs, the heart's rhythm is disrupted. Once the rhythm is compromised, the heart ceases to function, which leads to the individual's death. In medical terminology, these rhythm disturbances are known as ventricular tachycardia (VT) and ventricular fibrillation (VF). Other Causes

Problems with Heart Valves

There are four valves within the heart. These valves open and close with every heartbeat. Aortic stenosis occurs when one of these valves—specifically the one located in the lower-left section—narrows or fails to open properly. This can restrict or completely block blood flow. If a total blockage occurs, it can lead to cardiac arrest.

Problems with Coronary Arteries

Coronary arteries are responsible for delivering oxygen-rich blood—pumped by the heart—to various parts of the body. If cholesterol and fat begin to accumulate in these arteries for any reason, the arteries narrow. This obstructs or completely halts blood circulation. Either of these scenarios can lead to cardiac arrest.

This is because if blood cannot reach the rest of the body, other parts of the body are deprived of essential oxygen and nutrients.

Thickening of Heart Muscle

This is a condition where the walls of the heart muscle become thickened. In medical terms, this is known as cardiomyopathy. Cardiomyopathy weakens the heart's functional capacity.

When the heart muscle thickens, blood flow within the heart is compromised; the heart may stop functioning, leading to immediate death. This is a congenital (present at birth) but rare condition, affecting approximately one in every 500 people globally.

If such congenital heart conditions are present in parents, there is a possibility that they may also occur in their children.

How can you identify a cardiac arrest? Sudden loss of consciousness can be caused by factors other than cardiac arrest. In such situations, it is possible to determine whether the loss of consciousness is due to cardiac arrest or another cause.

When fainting occurs due to conditions like diabetes, low blood pressure, or other common causes, the pulse can still be felt at the wrist, and breathing remains normal. However, if an unconscious person has no detectable pulse, is not breathing, and shows no signs of movement, it is considered a sign of cardiac arrest.

Is it possible to treat a patient who has suffered a cardiac arrest?

Certainly, it is possible. However, if cardiac arrest is suspected, a trained individual must immediately perform Cardiopulmonary Resuscitation (CPR). This is known as 'Basic Life Support.'

Without CPR, there is no chance of saving the patient. If CPR is administered while the patient is being transported to the nearest hospital, it may be possible to save them, allowing them to return to a normal life.

How is CPR performed?

If you are alone while performing CPR, you should press the center of the chest 30 times using both hands, followed by two rescue breaths (mouth-to-mouth). This is a basic form of CPR that anyone can perform. Furthermore, CPR can also be administered upon arrival at a hospital. Using an Automated External Defibrillator (AED)—an electronic device—the heart's rhythm can be stabilized, and any blockages in the coronary arteries can be addressed through surgery to save the patient's life.

The Need for CPR Training

In developed countries, a wide range of individuals—from airport staff to teachers—receive training in CPR. The goal is to ensure that no one loses their life simply because they did not receive CPR. However, such provisions do not currently exist in Nepal. In urban areas, there are many documented cases where individuals were saved because they received immediate CPR and subsequent medical treatment. Tragically, in many rural regions, there are neither trained healthcare personnel nor hospitals capable of providing immediate care. In such situations, delays in treatment significantly increase the risk of death.

Since cardiac arrest can occur at any time and in any place, the government should provide CPR training to young people—from rural areas to urban centers—to help reduce the risk of fatalities resulting from such events.