Tag Archives: cardiac arrest

The difference between cardiac arrest and heart attack

While these two terms are used quite interchangeably, they denote different medical events. A heart attack (myocardial infarction) is a circulation problem that involves blood flow being blocked from reaching the heart. During cardiac arrest, an electrical problem causes the heart to stop beating and needs to be restarted.

Image credits Peggy and Marco Lachmann-Anke.

We’ve all heard these terms at one point or another. Because they’re both serious conditions and quite similar in symptoms, we also tend to lump them together and treat them as synonyms. That being said, however, they are not the same thing, and they are not interchangeable.

So let’s dive into the differences between them.

Heart attacks

These occur when one of the coronary arteries supplying oxygenated blood to a section of the heart gets blocked. If this blockage isn’t cleared quickly, cells in the affected area of the heart start dying due to a lack of oxygen. This effect builds up over time so the longer an individual goes without treatment, the more damage accumulates in tissues in that part of their heart.

Blockages are typically caused by build-ups of fat, either cholesterol (that’s why your doctor is so insistent you lower it), or a series of other substances.

While symptoms can definitely be immediate and intense (such as feelings of pressure, tightness, or intense pain in the chest), they can also occur over time, up to weeks in advance of an actual heart attack. There is also quite a large degree of variation in regards to the symptoms of various patients. Women can have different symptoms than men; some patients have no symptoms at all. Angina (recurrent chest pain or pressure) triggered by physical activity and relieved by stress is the most common and earliest warning sign of heart attack.

That being said, it’s important to act quickly in case you’re experiencing these symptoms or think you’re having a heart attack. Call emergency services even if you’re not sure you’re having a heart attack, as every minute matters. Emergency services personnel can begin treatment the moment when they arrive; getting to the hospital by yourself would take a lot longer. They can also provide resuscitation in case a patient’s heart has stopped completely.

Cardiac arrest

Unlike a heart attack, cardiac arrest occurs suddenly and very often without warning. It involves an abrupt loss of heart function and can be extremely dangerous.

It is caused by an electrical malfunction in the heart which produces arrhythmia (irregular heartbeat). Due to this disruption, blood flow to the brain, lungs, and other organs is disrupted — and with it, the flow of oxygen as well. The lack of oxygen supply to the brain can render a person unconscious in mere seconds and stop heart function completely. Victims of cardiac arrest can die within minutes without treatment.

Symptoms of cardiac arrest include dizziness, loss of consciousness, and shortness of breath. Cardiac arrest events can happen in individuals who may or may not have been diagnosed with heart disease. It may be reversed, however, if CPR is performed on the patient, and a defibrillator is used to restore a normal heart rhythm within a few minutes.

If someone near you is experiencing cardiac arrest, first call emergency services. Then, get an automated external defibrillator (AED) if one is available; if not, begin performing CPR on the patient. If two people are available, one should begin CPR immediately, while the other handles the call and retrieves an AED. If AED solutions are available, they must be used as quickly as possible.

It may be needed that you perform CPR on the patient for a longer period of time. If that’s the case, don’t worry. Hands-only CPR to the beat of “Stayin’ Alive” can double or even triple a victim’s chances of survival — hang in there!

Study shows Obamacare expanded health insurance, reducing the number of cardiac arrests

Medical scientists have analyzed some of the impacts of the expanded health insurance implemented under the Obama administration — the hotly debated Obamacare. They found that it significantly reduced the incidence of cardiac arrest by 17 percent.

Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University’s Knight Cardiovascular Institute in Portland, Oregon. Image credits: Kristyna Wentz-Graff/OHSU.

The US health system is unlike any other in the world — and not in a good way. According to both the United Nations (UN) and the World Health Organization (WHO), the US health care spends more money per capita than any other country, and yet is spectacularly ineffective at providing healthcare. They have fewer physicians and fewer hospital beds per capita than any other developed country, and that only begins to tell the story. The country is a leader in obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides, ranking 42nd out of 224 countries in terms of life expectancy. The state doesn’t provide insurance to people, leaving that to be either a part of an employment deal, or a private health insurance (which often costs absurdly high). According to Gallup, at least 11% of all Americans aren’t covered by any form of health insurance.

Obamacare was signed in 2010, with the purpose of driving better health outcomes and lowering associated costs, as well as lowering the uninsurance rate. Since then, that rate has gone significantly down, and results are starting to show. In a recent study, scientists found that one of the most crippling health issues, cardiac arrest, has gone significantly down. While the incidence remained more or less similar for adults over 65 years old, for adults between 45 and 64 years old, it went down by 17 percent.

“Cardiac arrest is devastating and under-recognized cause of premature death for both men and women older than 45 years,” said study lead author Eric Stecker, M.D., M.P.H., associate professor of cardiology at Oregon Health & Science University’s Knight Cardiovascular Institute in Portland, Oregon. “Health insurance allows people to engage in regular medical care, which is crucial for the prevention of cardiovascular disease and the diagnosis and treatment of conditions that can cause cardiac arrest.”

This is not a small figure. Across the country, an estimated 350,000 cases of out-of-hospital cardiac arrest happen each year. If medical assistance isn’t provided immediately (often requiring CPR), the patient’s life is under grave threat.

The study focused on an area of Oregon, but Mary Fran Hazinsky and Carole R. Myers found similar results in other states. This seems to be a trend that carries out across the entire country, but researchers also highlight that correlation does not imply causation. In other words, the incidence of cardiac arrests is a complex process with many associated factors, and it can be difficult to say with certainty that Obamacare is preventing cardiac arrests — but at the very least, it seems to be doing so.

“The hypothesized relationship between healthcare expansion and decline in [out-of-hospital cardiac arrest] incidence is certainly a timely question that requires further study,” they wrote. “A follow-up study should be based on a framework that looks more broadly at a complement of social and other determinants of health, and accounts for the various dimensions of access, and evaluates access by looking at utilization.”

It’s also important to note that while ‘cardiac arrest’ and ‘heart attack’ are sometimes used interchangeably, they are not by any means the same thing. A heart attack occurs when oxygen-rich blood is not permitted to reach the heart, generally due to a blocked artery. The heart doesn’t usually stop during a heart attack. A cardiac arrest, on the other hand, is triggered by an electrical malfunction in the heart that causes an irregular heartbeat. In mere seconds, the person goes unconscious and the heart stops. Fatality can occur quickly, in minutes.

Because the problem is so often fatal, prevention is key — and this is where Obamacare seems to be improving things. Basically, 17 percent fewer cases can translate into 17 percent fewer lives lost.

“These findings underscore the important role of prevention in the battle against sudden cardiac arrest, which affects almost a thousand Americans every day,” said Sumeet Chugh, M.D., senior author and director of the Heart Rhythm Center at Cedars-Sinai Heart Institute in Los Angeles, who carries a broader study on the effects of Obamacare on cardiac arrests.  “Less than 10 percent of these patients make it out of the hospital alive, so by the time we dial 9-1-1 it is much too late. For this reason, effective primary prevention is vital.”

Findings appeared in the Journal of the American Heart Association

Defibrillator drone.

Drones in Sweden carry defibrillators to save cardiac arrest victims

Researchers at the Karolinska Institute in Sweden hope to lower the response time for cardiac arrest patients by equipping drones with defibrillators to carry them wherever they’re needed — much faster than a conventional ambulance could.

Defibrillator drone.

Image credits Andreas Claesson et al., JAMA, 2017.

Response time is paramount in cases of cardiac arrest, as every minute without CPR and defibrillation reduces a patient’s survival chance by 10%. Having someone perform CPR improves these odds but usually doesn’t cut it by itself, and a defibrillator shock must be applied to jump-start the heart. Even in hospitals, where help is just around the corner only roughly one in ten people survive a cardiac arrest. Outside of the hospital, though, that rate drops even lower.

A team of researchers led by Jacob Hollenberg at the Karolinska Institute in Sweden hope to stack the odds in the patients’ favor by attaching defibrillators to drones which can fly wherever they’re needed, around the clock, much faster than an ambulance. They’re currently testing the prototype at a fire station in Norrtälje, a rural location near Stockholm, by testing its performance against that of ambulances in previous cases of cardiac arrest.

Flying4Life

All objectives were selected from cases that had taken place in the past 8 years within a 10-kilometer radius around the station. The prototype defibrillator-wielding drone performed 18 flights with an average arrival time to the emergency location of 5 minutes 21 seconds. By contrast, the average arrival time of ambulances at the time the emergencies took place was 22 minutes.

“If we can decrease the time in cardiac arrest from collapse to defibrillation by a few minutes, hundreds of lives would be saved each year,” Hollenberg said.

Hollenberg’s team is now working with local emergency services for the drone’s baptism by fire — real-emergency dispatches — to see if it can improve on the response time. If all goes well, the team plans to have the drone system up and running within a year or two, they add.

But no matter how quickly the drones get there, first response should remain a top priority. Teaching people how to properly perform CPR could prove to be a very cheap, low-tech way to save a lot of lives in the long run. And many people have recognized its importance, with cities such as Stockholm or London trialing apps that alert people trained in CPR of nearby cases of cardiac arrest.

But the drones have an undeniably huge potential in the field of emergency response. Hollenberg’s team has also tested drones’ efficacy in searching for people who are drowning, and these flying bots could prove invaluable for applications in rugged areas, in emergencies involving chemical, biological or nuclear materials, or simply for delivering precious medical supplies in otherwise inaccessible areas.

The full paper “Time to Delivery of an Automated External Defibrillator Using a Drone for Simulated Out-of-Hospital Cardiac Arrests vs Emergency Medical Services” has been published in the journal JAMA.

New type of CPR is more effective and easier to perform

The number of people that die from sudden cardiac arrest growing larger and larger every year. Just so you can make an idea, only in America, more people die from sudden cardiac arrest every three days than the people that died in 9/11. Thing is, many of those deaths could be avoided, if local bystanders wouldn’t be bystanders, and would instead perform CPR.

This new type of CPR is called Continuous Chest Compression, was developed by Gordon A. Ewy, MD, and Karl Kern, MD; it’s a hands only method, no mouth to mouth. You also don’t have to be certified to do it, and it’s really really easy to learn. It may very well be the thing that saves a life. Just watch this video: