Life 73 _ Ngừng tim đột ngột Life 73 _ Arrêt cardiaque soudain Life 73 _ Sudden Cardiac Arrest
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WHAT IS SUDDEN CARDIAC ARREST?

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating, causing blood flow to the brain and organs to stop. And, it is often fatal if not treated within minutes. However, the reality is that most people with sudden cardiac arrest do not survive, the survival rate is very low. Such a death in medicine is also known as “Sudden cardiac death“.

Please note that sudden cardiac arrest is not a heart attack or myocardial infarction as I have mentioned in previous lectures. During these heart attacks, the heart is usually still beating in pain. A heart attack occurs when there is a blockage in the coronary arteries that surround the heart and when heart muscle cells are damaged or gradually die from a lack of blood, oxygen, and nutrients. During this time, sudden cardiac arrest occurs for a completely different reason, related to the EKG machine. The heart stops beating in the condition where the heart muscle cells have not been damaged as in the cases of myocardial infarction mentioned above.

Normally, the heart has a pulse conduction system that helps it beat at a steady rate, meeting the need for pumping blood to nourish the body. When the heart’s electrical system is malfunctioning, the heartbeat is also disturbed, beating too fast, beating too slowly, or suffering from arrhythmia. Among the types of arrhythmias, a phenomenon called “ventricular fibrillation” occurs most frequently. At this point, the ventricular chambers of the heart, although in motion, only convulse disorderly, but are no longer able to pump blood.

So how do you recognize sudden cardiac arrest?

SYMPTOMS OF SUDDEN CARDIAC ARREST

Usually, the signs of sudden cardiac arrest are immediate, extreme, and without warning. Such as :

  • Fainting, ie the patient completely loses consciousness.
  • No pulse or palpable pulse
  • And stop breathing

In addition, there are also a small number of cases where the signs and symptoms can be predicted for a few minutes. Such as :

  • Chest discomfort
  • Heart palpitations, palpitations
  • Nausea or vomiting
  • Shortness of breath
  • Tiredness
  • Stunned

And, do you know why sudden cardiac arrest?

CAUSES OF SUDDEN CARDIAC ARREST

Ventricular fibrillation

First, let’s talk about the most important cause, which causes most sudden cardiac arrests. This is the phenomenon of ventricular fibrillation – a type of heart rhythm disorder.

In ventricular fibrillation, the lower chambers of the heart are the ventricles that beat abnormally. They go from a state of strong, rhythmic contractions that push the blood to nourish the body to a state of shaking, loss of rhythm and no longer having the strength to pump and push the blood as before. In a few minutes in such a state, the patient can die.

Additionally, a number of other medical conditions can also cause electrical issues that can lead to sudden cardiac arrest. For example, ischemic heart disease, severe physical stress, conditions that change the structure of the heart, etc. More precisely :

Ischemic heart disease :

This is a condition in which the heart muscle is ischemic, caused by blockage of the coronary arteries (the arteries that surround the heart and supply the heart) with plaques of fat, bad cholesterol, and other deposits.

When an area of ​​plaque breaks off, a blood clot immediately forms from the platelet cells just on the surface of the broken plaque. This blood clot will block an artery that has been narrowed by previous plaque, partially or completely blocking blood flow to heart muscle cells, immediately causing a heart attack.

During a heart attack, some heart muscle cells die and are replaced by scar tissue, which damages the heart’s electrical system. The presence of scar tissue causes abnormal and incorrect reception and propagation of electrical signals in the heart, directly increasing the risk of arrhythmia and sudden cardiac arrest.

Ischemic heart disease seems to cause most sudden cardiac arrests in adults. However, many adults experience sudden cardiac arrest without any warning signs or symptoms of heart disease.

Physical stress :

Certain types of physical stress can also damage the heart’s electrical system, such as intense physical activity. This phenomenon is common in people who engage in prolonged physical activity, such as marathons, athletics, soccer, etc. During intense physical activity, a hormone called adrenaline is released and can trigger sudden cardiac arrest, especially in a person who already has heart problems.

Blood levels of potassium or magnesium are too low :

Potassium and magnesium in the blood act as electrolytes, which are extremely important in transmitting electrical signals to the heart. Lack of potassium and magnesium, the transmission of electrical signals of the heart is easily affected, erroneous or untimely.

Hereditary disorders :

Some families have a predisposition to arrhythmias, which means that the tendency is passed from parents to the child through the genes. Members of these families may be at greater risk of sudden cardiac arrest.

An example of a genetic condition that makes you more likely to have arrhythmias is long QT syndrome. This is a type of disorder in the electrical activity of the heart, which can cause a sudden and uncontrollable heartbeat.

Certain pathological and structural conditions of the heart:

  • Medical conditions as well as changes in the size or normal structure of the heart can affect its electrical system. For example: Enlarged heart disease, also known as cardiomyopathy, valvular heart disease, heart failure, congenital heart disease, heart infection, etc.
  • Additionally, in some people, the problem lies with the electrical system of the heart itself rather than with the heart muscle or heart valves. These are called primary arrhythmias and include conditions such as Brugada syndrome (a syndrome caused by mutations in the cardiac sodium channel gene) and long QT syndrome (a cardiac arrhythmia as discussed above).

And, some other medical conditions can also cause sudden cardiac arrest like lung problems, kidney problems, diabetes and some conditions of traumatic shock, electric shock, drug shock, etc.

And, in your work or in your everyday life, if you meet someone who has had a sudden cardiac arrest, before you talk about how they are being treated in the hospital, what can you do to help him (her)? help him (her) in a few minutes? I repeat, just a few minutes!

HOW TO GIVE FIRST AID TO SUDDEN CARDIAC ARREST :

First of all, it is very sad to say that among people who experience sudden cardiac arrest, the majority often suffer from death. The reason is also easily understood that the disease often comes on suddenly with little or no warning, but develops rapidly within minutes, making it difficult for both the patient and those around him to respond from the first minute of help.

There are only a few lucky cases that are saved when an emergency and timely treatment is provided by medical personnel or people with knowledge of the matter and conducted under favorable conditions. In fact, for every minute of emergency room delay, survival rates drop by about 10%.

Here are some emergency means of sudden cardiac arrest that you can refer to. Who knows, it might work for you and someone you meet in your day-to-day life as well.
If you witness sudden cardiac arrest, immediately call 911 and immediately follow the following simple first aid steps:

  • First, quickly check the patient’s respiratory rate. If the sick person is not breathing normally, immediately give them CPR.
  • Of course, for those with training, they can perform precise and delicate techniques. However, for you and for those who are not properly trained, in that case the life of a sick person is measured in minutes, while waiting for the arrival of professional emergency personnel, you boldly provide first aid to the patient with all your abilities. Remember that the patient’s life can only be saved in these few minutes! Therefore, you are not allowed to be a perfectionist, even if the techniques are not really precise or standard, you always dare to do them before someone expert arrives.
  • To perform artificial respiration if the patient is no longer breathing normally, or if they stop breathing, have no pulse, immediately perform external chest compressions:
  • Place the patient supine on a firm surface with the head supine, neck flexed, and lower jaw pulled to lift the patient’s chin. Be careful if you suspect or have an injury to the cervical spine, do not pull on the jaws or lift the chin.
  • Remove sputum or foreign objects from the mouth if present.
  • Once you are sure that there is no foreign object in the patient’s airway, begin CPR on the patient.

I would like to stress that the guidelines below are very simple, for those who are not properly trained, to take the time to save the patient’s life before professional staff can deal with it. Even if you can’t do it properly, you can still save them in this case.

In the near future, if conditions allow, we will also publish detailed and methodical first aid and first aid training tutorials in specific cases, with demonstration and practice participation from many people. For now, let’s do everything we can to help save the patient’s life!

Please follow my instructions!

  • Now extend one hand out in front of you.
  • The other hand rests on the back of that hand, fingers intertwined.
  • Then place the breast of the hand on the patient’s breastbone
  • And, straighten your arms, apply pressure with your body weight and perform limited but powerful compressions on the patient’s chest, with a frequency of 100 to 120 times / minute, or about 2 times / second and your pressure causes a compression of the patient. ‘about 4-5 cm for an adult and only a few cm for a child.
  • Pay attention to rapid, strong, uninterrupted pressures and allow the chest to fully inflate after each squeeze.
  • If you have first aid training or knowledge, you can perform CPR on a patient with a cycle of 30 compressions / 2 breaths.
  • Plus, if you don’t have a workout, all you need to do is do chest compressions. Continue chest compressions until a portable defibrillator or paramedics arrive.

If you own a portable defibrillator, use it boldly, even if it’s the first and possibly the only time in your life to use it to save lives. The advantage of the machine is that it is built to serve the masses for non-specialists like you. Therefore, it has been kept as simple as possible so that as many people as possible can use it. After turning on the machine, it will guide you step by step by voice.

Defibrillation with an AED is considered the best chance to save the patient. It is because of its importance and such a particularly important time factor that you can easily see this machine in easy-to-break boxes or open the cover to take it out in public areas such as supermarkets, large offices, airports, train stations. , hotels, schools, etc., to be able to provide emergency services in the event of sudden cardiac arrest as quickly as possible before emergency personnel arrive.

And the question that inevitably arises is: can sudden cardiac arrest be prevented?

PREVENTION OF SUDDEN CARDIAC ARREST

We can reduce our risk of sudden cardiac arrest by getting regular checkups, getting tested for heart disease, and living a heart healthy lifestyle.
The ways to prevent death from sudden cardiac arrest vary from case to case, as follows:

For people who have survived a sudden cardiac arrest :

If you have had sudden cardiac arrest, you are at a higher risk of having it again. Research shows that an implantable defibrillator (ICD) reduces the risk of dying from a second sudden cardiac arrest. An ICD is surgically placed under the skin of the chest or abdomen. If the ICD detects an unsafe heart rhythm, it delivers an electric shock to restore a normal heart rhythm.

For people who have never had but are at high risk for sudden cardiac arrest :

Si vous souffrez d’une cardiopathie ischémique grave, vous courez un risque accru d’arrêt cardiaque soudain. Cela est particulièrement vrai si vous venez d’avoir une crise cardiaque.

Votre médecin peut vous prescrire un médicament appelé bêta-bloquant pour aider à réduire votre risque d’arrêt cardiaque soudain. Votre médecin peut également discuter du début d’un traitement par une statine si vous présentez un risque élevé de maladie cardiaque ou d’accident vasculaire cérébral. Les médecins prescrivent généralement des statines aux personnes : diabète, maladie cardiaque ou accident vasculaire cérébral antérieur, taux élevés de cholestérol LDL,

D’autre part, votre médecin peut également vous prescrire d’autres médicaments pour réduire votre risque de crise cardiaque ou de mort subite, abaisser votre tension artérielle, prévenir les caillots sanguins à l’origine d’une crise cardiaque ou d’un accident vasculaire cérébral, et prévenir ou retarder le besoin d’une intervention ou d’une intervention chirurgicale, comme une angioplastie ou un pontage aortocoronarien, réduit la charge de travail du cœur et réduit les symptômes de maladie cardiaque.

Prenez tous les médicaments prescrits par votre médecin. Ne modifiez pas la quantité de votre médicament et ne sautez pas de dose à moins que votre médecin ne vous l’ait demandé.

D’autres traitements de la maladie coronarienne, tels que l’intervention coronarienne percutanée, également appelée angioplastie, ou le pontage aorto-coronarien, peuvent également réduire le risque d’arrêt cardiaque soudain. Votre médecin peut également recommander un DAI si vous présentez un risque élevé d’arrêt cardiaque soudain.

For people with no known risk factors for sudden cardiac arrest

Ischemic heart disease appears to be the cause of most cases of sudden cardiac arrest in adults. Heart disease is also a major risk factor for angina (chest pain or discomfort) and heart attack, and it contributes to other heart problems.

For all cases :

  • Living a heart-healthy lifestyle can help lower your risk of heart disease, sudden cardiac arrest, and other heart problems. A heart healthy lifestyle includes:
  • Eat heart-healthy, low-fat, low-salt, and starchy foods.
  • Lose weight if you are overweight.
  • Controls diabetes, bad cholesterol and blood pressure.
  • Exercise regularly with appropriate exercise content and duration
  • Manage stress, learn to self-regulate and manage emotions, maintain mental balance.
  • No addiction to alcohol, no tobacco.

In addition, the education of family members is also very important, especially for families whose members are at risk of sudden cardiac death. All family members should understand the importance of the disease and the need for prompt and timely emergency care. Everyone should learn to practice CPR and call 911 for help in an emergency.

https://youtu.be/KK-vQkHC5po

About Post Author

Maître VIKUDO

Docteur en Physiopathologie
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