Prior to cardiac arrest, some patients report the following symptoms or warning signs in the weeks before the event:
Pounding in the chest
The first person to respond to a cardiac arrest should check if the person is responsive. Shake the shoulders and ask, "Are you OK?" If there is no response, call 9-1-1. If there are other people around and you can perform
(cardiopulmonary resuscitation), send someone to call 9-1-1 and turn your attention to the victim. Check if the person is breathing. Tilt the head back to open the airway. Put your cheek near the person's mouth and nose; look, listen, and feel for air movement. If no movement is detected, CPR should be started.
Prompt treatment improves the chance of survival. The four steps in the cardiac chain of survival are:
Immediately call for emergency medical support. Call 9-1-1 as soon as you notice cardiac warning signs or suspect a cardiac arrest has occurred.
CPR helps keep blood and oxygen flowing to the heart and brain until other treatment can be given. The heart and brain are very susceptible to low oxygen levels. Permanent damage can occur, even with successful resuscitation. During CPR, the rescuer positions the head to open the airway, breathes air into the patient, and compresses the patient's chest.
Once on the scene, emergency medical technicians or paramedics will assess the heart rhythm and determine whether the rhythm warrants defibrillation (eg, ventricular fibrillation or tachycardia). Defibrillation sends an electrical shock through the chest. The surge of electricity aims to stop the ineffective, irregular heart rhythm. This may allow the heart to resume a more normal electrical pattern. Automated external defibrillators check the heart rhythm before instructing the rescuer to give the shock.
Advanced Medical Care
Paramedics at the scene and doctors at the hospital provide essential medical care and intensive monitoring. They will give drugs, insert a tube to maintain an open airway, and manage emergency care. Epinephrine is often given early to make the heart more receptive to electrical impulses and improve blood flow to the heart and brain. The patient will receive oxygen. Even if an effective heart rhythm is restored, low oxygen levels may cause serious complications, including damage to the heart, brain, and other vital organs. Doctors will attempt to find and correct the underlying cause of the cardiac arrest.
At the hospital, the doctor will ask about:
Symptoms prior to the collapse
The patient's medical and drug history
If the patient survives, the doctor will:
Assess the electrocardiograms performed by the emergency medical personnel
Perform a physical exam
Confirm a cardiac arrest has occurred
Look for the cause
Evaluate the effects of pre-hospital care
Order additional blood and diagnostic tests to help determine the cause of the arrest
A telemetry machine will continually monitor the heart's electrical activity.
Become aware of heart disease warning signs and promptly seek treatment for any that develop. If you do not have a heart condition, follow the rules of primary prevention of heart disease. If you have a heart condition or may be at high risk for one, ask your doctor about how to reduce your risk of sudden cardiac arrest. You might be a right candidate for certain medications that prevent heart arrhythmias or implantation of ICD device.
Also, if you are known to be at high risk, you may consider purchasing an automatic external defibrillator (AED) for home use. Discuss it with your doctor.
Braunwald E, Zipes DP, Libby P, et al.
Heart Disease: A Textbook of Cardiovascular Medicine
. 6th ed. Philadelphia, PA: WB Saunders Company; 2001.
Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 3: adult basic life support. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation.
. 2000; 102:I22
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a