Cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs instantly or shortly after symptoms appear.
Reports show that each year, more than 420,000 emergency medical services-assessed out-of-hospital cardiac arrests occur in the United States. The term, "heart attack", is often mistakenly used to describe cardiac arrest.
While a heart attack may cause cardiac arrest and sudden death, the two do not mean the same thing. Heart attacks are caused by a blockage that stops blood flow to the heart. A heart attack (or myocardial infarction) refers to death of heart muscle tissue due to the loss of blood supply, not necessarily resulting in the death of the heart attack victim.
Cardiac arrest is caused when the heart's electrical system malfunctions. In cardiac arrest, death results when the heart suddenly stops working properly. This may be caused by abnormal or irregular, heart rhythms (called arrhythmias). A common arrhythmia in cardiac arrest is ventricular fibrillation.
This is when the heart's lower chambers suddenly start beating chaotically and don't pump blood. Death occurs within minutes after the heart stops. Cardiac arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed and a defibrillator is used to shock the heart and restore a normal heart rhythm within a few minutes.
Experts say cardiac in Latin denotes heart disease and may be caused by almost any known heart condition. Most cardiac arrests occur when the diseased heart's electrical system malfunctions, producing an abnormal rhythm such as ventricular tachycardia or ventricular fibrillation. Extreme slowing of the heart's rhythm causes some cardiac arrests.
Consultant Physician and Cardiologist, Prof Jane Ajuluchukwu, said, "the position of the heart activities can be detected by several means. This can be done by checking the pulse using the stethoscope to listen to the heart sound or use a special equipment like the electrocardiogram (ECG), "Cardiac arrest is the final activity in most deaths whether they are from the heart or not. The heart has to stop. Heart attack is one condition that can lead to death. It is a disease. It is a layman's way of talking about a particular condition that medical practitioners call acute mediocardial infection.
"Heart attack will arise when an artery supplying blood to the heart blocks, and when that part of the heart cannot receive blood, that area will die. It is usually an abrupt thing. For example, somebody may have a heart attack as he is just running and the last thing that happens in the buildup of that artery blockage will just occur and the heart will stop receiving, even though, we have many arteries supplying different parts of the heart.
The heart is not supplied by only one artery, so when there is a heart attack, the artery that is supplying a particular part can be blocked and it is only the area that it is supplying that will die.
"So when that artery blocks suddenly and blood does not get to the muscle of the heart; the muscle will start dying, that is; when we say an infraction has happened. That is what lay people call heart attack. It is almost the same process that happened in the brain and we call that a stroke.
"In the brain, too we have the artery supplying the part of the brain blocking-off and dying. If it is the part of the brain that controls the hand and the leg, then that part will be involved in the stroke.
If it is the part of the brain that controls the face, that part will be involved in the stroke. If it is in the heart, it is only that small part supplied by an artery that will die, but it might lead to other complications.
"Therefore, if the heart cannot pump blood and supply other parts of the body, which is its major function or one side is just fluttering like a butterfly instead of doing the rhythmic regular pumping, then the brain will not receive blood, the heart itself will not receive blood and then the patient can faint because there is no blood coming out to be supplied. And if the brain is not receiving blood, the first thing that happens is fainting.
"However , if there is going to be a heart attack the arthritis blocks some-where and this blockage will affect a part of the heart and that part will die off; and if that zone dies off, it will not contribute to the working of the heart. The artery is a vessel that takes blood from the heart and supplies it, but the heart itself needs blood and it is the artery that is supplying the blood."
Types of heart diseases
Ajuluchukwu said: "We have two types of this heart problem that would lead to arthriterial blockage or closure. It is a silent, quiet thing that can happen over many years and the patient will not know his/her artery is getting blocked. So, a clean open artery is supposed to be 100 per cent, but if we have, like a gutter, some materials settling down on the gutter, it becomes smaller and it will not be able to deliver as much blood.
"The two types of diseases; if a mosquito bites you, you will have malaria that is a direct cause and effect relation-ship, but this type of modern diseases, there are multiple risk factors that work together to result in this blockage.
"And the blockage, we have some risk factors that we call non-modifiable, so you will see that it is more likely that some-body can have artery blockage due to it. It is popular in men and it is common in families.
"The family that will have it, will tend to have it, or if someone's father had a stroke or heart attack at about age 50, in medicine, we will think there is something in that family line, genetic or gene, that is making them prone to that.
"Then, another is called modifiable risk factors, if they are available will have an interplay that in some people they will result to the blockage while in some people, it will not. So, it is not a very direct thing. It is not every man that will have an artery blockage. And it is not every man that will have stroke. But it is commoner in men when you compare men and women.
"So, we think there is something in the gene or in the make-up of hormones of men and women that promotes that problem or protects.
"Women are usually protected. It is rare to hear of woman slumping but you will hear about men slumping in their offices or elsewhere. So, there is something in the genetic or hormonal make-up of men that promotes that aspect of the disease. And women are somehow safe especially at their productive age until their period finishes their risk is also a little bit higher,"
Speaking further, she said, modifiable risk factors are divided into biological and behavioral. Biological is the presence of hypertension (hypertension is like a high pressure in the system), so it can rupture the artery it can break the artery and resolve in the deposition of cholesterol, which will start up this narrowing process that we are talking about.
"And again, cholesterol which is the material that is laid down on the artery, instead of allowing the lumen to be hundred per cent, it will be narrowing it from hundred to eighty per cent, the patient will not know."
Risk factors
Prof. Ajuluchukwu said: "We can prevent heart attack by identifying these risk factors mentioned ealier.
If somebody has a family history of early death, sudden death, these are some of the ways it can occur.
"Another is behavioural. For example, foods that are neither prepared traditionally or otherwise, eating of processed food or food that is not prepared by self. you do not control the amount of fat, salt or all these chemicals that they they put into the food to be delicious, some of these things can damage the heart or the blood vessel.
"Another behavioral factor lack of exercise or physical activities. You don't need to go to the stadium to exercise, but just sitting at one point and ordering people around and not getting to make any moves makes one fat.
"And fat is part of obesity; it is a risk factor and that have been identified. Though, it is not a direct effect like mosquito and malaria. In other words, most people that are having heart attack tend to be men that are fat and old. If we treat them or prevent them, we can reduce the risk .
She, however, noted that there are cardiac centres, though the patronage is not on the rise because, it is a foreign disease.
"In the '60s and '70s, it was a very rare occurrence to hear that a Nigerian or Africans in general had heart attack. What is happening now is that the risk factors are growing. Heart attack is the commonest cause of death in the western world while in Africa, we have infection. How-ever in Nigeria, an indeed in Africa, it is now a sad situation. It is double burden in the sense that we have not cleared the malaria, HIV, tuberculosis burden, we are adopting some of the modem day life of the white people. "Right now, we will not say that heart attack is common in Nigeria, it is just starting. There was. a time it was rare, almost unheard of but now, it is getting commoner. But it is not high now as it is in the western world," she stated.
By: Doris Obinna
Daily Sun News
ABUJA: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
PORTHARCOURT: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
LAGOS: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
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