What you need to know about cardiac arrest
We recently spoke to Dr. Amartya Kundu, an assistant professor of medicine at the University of Kentucky and an interventional cardiologist at the Gill Heart and Vascular Institute, about the basics of cardiac arrest.
Dr. Kundu brings extensive advanced training in interventional cardiology to the team at Gill, one of the only medical institutions in Kentucky capable of dealing with acute cardiac conditions.
When it comes to surviving sudden cardiac arrest, the first couple of minutes are critical. But so are the next few hours.
Chances of surviving a sudden heart stoppage are extremely low when a patient does not receive urgent medical attention. The fatality rate of out-of-hospital sudden cardiac arrest is almost 90%. In Kentucky, more than 1,800 people die each year from these events.
In order to be part of the 10% who survive, a patient needs to undergo several layers of care, beginning with CPR at the scene. But only some hospitals – like UK HealthCare’s Gill Heart & Vascular Institute – are equipped to provide the top level of specialized care cardiac arrest patients need in the hours, days and weeks afterward.
Those services are key to reducing fatality rates of one of our state’s – and country’s – top public health concerns.
What’s the difference between cardiac arrest and a heart attack?
People may think cardiac arrest and heart attack are the same thing. The terms are often used interchangeably, but the two cardiac events are very different.
Cardiac arrest means that someone’s heart has suddenly stopped beating because of an irregular rhythm. This stops blood flow throughout the body. Within a couple minutes of cardiac arrest, if the heart has not been restarted, the person will die.
A heart attack on the other hand, is a condition where the heart muscle is injured as a result of a blockage which partially or completely obstructs the blood flow to the heart. If the blocked artery is not reopened quickly, the heart muscle in that area begins to die. Heart attacks can sometimes cause sudden cardiac arrest.
Who is most likely to suffer sudden cardiac arrest?
Each year, there are more than 350,000 out-of-hospital cardiac arrests in the U.S. Up to a quarter of those people never experience symptoms until the moment their heart stops. Part of what makes sudden cardiac arrest so hard to predict is it could happen to anyone.
However, there are some risk factors. Those most likely to experience sudden cardiac arrest are patients who have:
• Coronary artery disease
• Certain genetically inherited cardiac rhythm disorders such as Long QT or Short QT syndromes, Brugada syndrome and Wolff-Parkinson-White syndrome
Men could also be at higher risk for sudden cardiac arrest.
“Heart disease tends to develop earlier in men than in women,” said Dr. Amartya Kundu, MD, FACC, FSCAI, who specializes in interventional cardiology at UK HealthCare. “The traditional risk factors for ischemic heart disease, such as hypertension, hyperlipidemia, smoking and diabetes are all more prevalent in men.”
How can someone survive sudden cardiac arrest?
Immediate CPR is the first step of survival. Without getting the heart pumping again and blood flowing, a person will not survive.
“Sudden cardiac arrest is one of the leading causes of death in the United States,” Dr. Kundu said. “Early recognition of the condition and initiation of CPR is paramount for survival.”
After those crucial seconds, however, the complexity of treatment only accelerates.
Once a heartbeat is restored, a patient needs extremely high-level, specialized cardiac services.
Those complex services come at the highest level of medicine: quaternary care. Most people are familiar with primary care (seeing your regular provider). But the top level – quaternary care – is the most advanced level of care for the most complex conditions. This is usually where cardiac arrest patients land – and the services they need for survival.
“UK HealthCare’s Gill Heart & Vascular Institute is one of the leading quaternary referral centers for cardiovascular patients in the United States,” Dr. Kundu said.
“Patients with resuscitated or ongoing cardiac arrest require some of the highest levels of advanced cardiac care, including complex high-risk coronary interventions, emergent cardiac surgery, mechanical circulatory support and even heart transplantation. All of these are available at UK HealthCare.”