sudden cardiac arrest


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sudden cardiac arrest (SCA)

an abrupt, complete loss of heart function that results in loss of blood circulation within the body. An episode of sudden cardiac arrest may be preceded by arrhythmias, including ventricular tachycardia or fibrillation. It is not caused by the blockage of coronary arteries. Within the United States, as many as 450,000 persons may experience sudden cardiac arrest each year; survivors face a 30% to 50% chance of experiencing a repeat episode. Sudden cardiac arrest is reversible in most patients if it is treated within minutes. Compare myocardial infarction and acute myocardial infarction.

arrest

(a-rest') [Fr. arester fr L. arrestare, to stop]
1. The state of being stopped.
2. To bring to a stop.

active phase arrest

Cessation of the progress of labor despite treatment with appropriate doses of oxytocin. It is an indication of the need for cesarean delivery.

bradyasystolic arrest

Cardiac arrest marked by an extremely slow pulse, usually less than 30 beats/min. This can be due to increased vagal stimulation, progressive heart block, hypoxemia, drugs such as beta blockers, or other causes.

cardiac arrest

Sudden cessation of functional circulation. In the U.S., about 1000 people die daily as a result of cardiac arrest. Synonym: cardiopulmonary arrest; sudden cardiac arrest See: arrhythmia; myocardial infarction

Etiology

Coronary artery disease is present in most victims. Cardiac arrest is usually caused by myocardial infarction or ventricular arrhythmias. Contributing causes include cardiomyopathies, valvular heart disease, diseases of the electrical conducting system of the heart (such as the long QT syndrome or the Wolff-Parkinson-White syndrome), myocarditis, chest trauma, severe electrolyte disturbances, and intoxications with drugs of abuse or prescribed agents, e.g., digitalis. Physical exertion or extreme emotional stress sometimes precipitates cardiac arrest.

Symptoms

Abrupt loss of consciousness, followed by death within an hour of onset, is the typical presentation of cardiac arrest.

Treatment

Opening the airway, establishing effective respiration, and restoring circulation (with chest compression and defibrillation) are the keys to treating cardiac arrest. The effectiveness of treatment depends upon the speed with which resuscitation begins and upon the patient's underlying condition. Because most episodes of sudden cardiac arrest are unwitnessed, most patients die without treatment (spontaneous recovery from cardiac arrest in the absence of advanced cardiac life support is very rare). For resuscitated patients, therapies include implantable defibrillators, beta blockers, antiarrhythmic drugs, and, in patients with coronary artery disease, modification of risk factors, i.e., treatment of hypertension, smoking cessation, and lipid-lowering diets and drugs. See: table, advanced cardiac life support

* IO=intraosseous † IV=intravenous cannula ‡ ET=endotracheal
RouteProsCons
Peripheral IVEasiest to insert during chest compressions; least traumatic to the patient.Drugs infused into a peripheral vein take several minutes to reach the heart.
Central IVDrugs and fluids infused into central veins reach the heart in seconds.Insertion may be difficult during chest compressions, intubation, and defibrillation. Arterial injury, pneumothorax, hemothorax, and other complications are common in emergency insertions.
IntraosseousDrugs and fluids infused into marrow reach the central circulation rapidly.Clinical experience with IO* insertion is limited relative to IV† insertion.
EndotrachealMay be used for drug administration when an airway is present, but other forms of access have not been established.Double or triple the IV† dose is needed to achieve similar drug effect. Drugs given ET‡ should be diluted in 5–10 ml of sterile water. Correct placement of the ET tube must be confirmed before use. Unlike the other modes of access, this route cannot be used to infuse high volumes of fluids.

cardiopulmonary arrest

Cardiac arrest.

cleavage arrest

In embryology, an obstruction to or a halt in cell division.

deep hypothermic circulatory arrest

Abbreviation: DHCA
The induction of profoundly low body temperatures, e.g. 20°C (68°F), during surgery to reduce the impact of low organ perfusion and ischemic damage.

epiphyseal arrest

Cessation of the growth of long bones.

pelvic arrest

A condition in which the presenting part of the fetus becomes fixed in the maternal pelvis.

pulseless arrest

An umbrella term for asystole and pulseless electrical activity.

respiratory arrest

Cessation of spontaneous respiration.

sinus arrest

A condition in which the sinus node of the heart does not initiate impulses for heartbeat. If this condition persists, it usually requires implantation of a permanent cardiac pacemaker.
See: artificial cardiac pacemaker

sudden cardiac arrest

Cardiac arrest.
References in periodicals archive ?
A sudden cardiac arrest is the result of the defective electrical activity of the heart.
In the UK, up to 250 people a day suffer a sudden cardiac arrest, often due to the heart going into ventricular fibrillation (VF), a form of arrhythmia, or abnormal heart rhythm.
Sudden cardiac arrest, which accounts for half of all deaths caused by heart disease, is triggered by an electrical malfunction in the heart that causes an irregular heartbeat, called arrhythmia, which causes a disruption in the flow of blood to other organs throughout the body.
Brief seizure activity, which is present in about half of young athletes who suffer sudden cardiac arrest, and that can misdirect a potential rescuer from properly recognizing the cardiac emergency
We are a critical part of any sudden cardiac arrest response and need to ensure that our vantage point is taken into consideration during these important activities.
Some health care settings, such as dialysis centers and potentially some high-risk cardiac specialty practices, have sudden cardiac arrest rates in that range.
Approximately what percentage of people have no prior cardiac history when sudden cardiac arrest and death occur?
According to the Sudden Cardiac Arrest Foundation, sudden cardiac arrest affects more Americans than breast cancer, prostate cancer, colorectal cancer, AIDS, traffic accidents, house fires and gunshot wounds combined.
Despite years of significant advances in emergency medicine and resuscitation, just five percent of those who suffer sudden cardiac arrest survive.
While both heart attack and sudden cardiac arrest are medical emergencies, a person suffering SCA literally has only minutes to live.
One relatively new approach to prevent or reduce brain damage involves the use of hypothermia - forced cooling - of the patient as soon as possible following sudden cardiac arrest.
American Airlines is installing fixtures on 278 aircraft - about 40 percent of its fleet - to hold defibrillators, the medical devices for reviving victims of sudden cardiac arrest.