Articles on cardiac arrest

Omg!! He Passed Away? Sudden Cardiac Arrest Is to Be Blamed

Dr. Avinash Vilas Wankhede, Cardiologist
You must have heard about otherwise healthy people who passed away after a sudden collapse. Such events often leave you perplexed. It is hard to accept the fact that someone who was hale and hearty a few hours ago is no more now! Blame it on the sudden cardiac arrest.What is a Sudden Cardiac Arrest?When the heart suddenly, unexpectedly and abruptly stops functioning, it is labelled as a ‘sudden cardiac arrest’. An electrical disturbance in the heart interrupts the pumping of blood, ceasing the flow of blood to the rest of the body. If not treated immediately, it usually causes death within minutes.An important point worth remembering here is that a heart attack is different from sudden cardiac arrest. In the former, the heart muscle dies and people may feel chest pain or breathless or profuse sweating, whereas the latter is due to cessation of an electrical activity in the heart with no prior signs or very brief alert symptoms.Causes of sudden cardiac arrestCoronary heart disease - It is a major risk factor. It occurs because the arteries that supply oxygen-rich blood to the muscles of heart are blocked by waxy plaques. Eventually, heart muscles die because of this blockage due to lack of adequate blood supply. This is called a heart attack. The dead muscles are replaced by a scar tissue that hampers the electrical activity of heart leading to arrhythmias and sudden cardiac arrest.Arrhythmia – It is an irregular electrical activity in the heart. This may be inherited.Intense physical activity - Rush of hormone adrenaline during rigorous exercise triggers sudden cardiac arrest in people with heart diseases.Major blood loss or lack of oxygen supply.Low levels of minerals, like potassium and magnesium, in blood precipitates sudden cardiac arrest.What to do!No blood supply to the brain causes fainting or collapsing as there is no heart beat or pulse as well. At times, minutes before fainting, some people feel dizzy or experience light headedness. This can be accompanied with chest pain, nausea, vomiting or shortness of breath within an hour before cardiac arrest.In such a scenario rush for help as there is not much time in hand. The most important thing you can do in this scenario is to SHOUT FOR HELP. As nobody can help the victim alone! As people gather, one should immediately arrange for urgent medical help. Others should make the victim lie in a flat position on the ground or any other firm surface with due care not to traumatise the victim. If you or someone around you knows to resuscitate the person by using a method called cardiopulmonary resuscitation (CPR), then start it immediately. But always remember, earlier the victims gets medical help, the lesser losses he suffers!If possible, attach an AED (Automated external defibrillators - defibrillator machine) available in a nearby shopping mall, airport, sports venue or school to the victim. If the victim is treatable with the machine, then the machine defibrillates the victim automatically. This makes his heart to start pumping blood again. As early as possible, rush the person to a nearby hospital’s emergency department. Once you are there, let the experts handle the case.If one survives a sudden cardiac arrest, series of investigations are performed to find the cause. For this, electrocardiogram (ECG), 2D ECHO, angiography and various other blood tests are conducted on the patient and the cause is treated.

Cardiac Rehabilitation

Dr. Mitshu Kapadia, Physiotherapist
When a heart attack arises, people may have to undergo Coronary Artery Bypass Surgery (Bypass) or Angioplasty (Stent) or few with low pumping have to be on medicines. People, who undergo surgery, have lot of complications and emotional distress. Few have emotional problems like –anger, anxiety, loss of confidence, difficulty in returning to work, sleeping problems etc. or complications like any infection, difficulty in breathing, Pneumonia, persisting chest pain, developing a blood clot that could affect the lungs, chronic pain at breastbone-wound site, affected memory and difficulty with cognitive function and thinking etc. All this has a solution: CRP – Cardiac Rehabilitation Program. Cardiac rehab is structured exercise program that can help you increase your physical activity level while under the direct supervision of medical professionals. The program also includes work with cardiac rehab therapists, dieticians, physicians, yoga therapists, psychologists, and other healthcare providers who can help you recover from your surgery and feel confident that you have the skills to adopt a heart-healthy lifestyle. Recent research and my experience in this cardiac rehab field have found that patients who complete cardiac rehab are more likely to be alive five years more than expected after a heart event than those who do not.Who Requires Cardiac Rehabilitation?Those who have undergone the following:Heart AttackCoronary Artery Bypass Surgery or AngioplastyHeart failure Heart valve Replacement Other heart condition (i.e. Stable  Angina, pacemaker)Other vascular conditions (i.e. stroke,peripheral vascular disease)Who wants to control Diabetes and High Blood Pressure. Two Or More Documented Classical Risk Factors For Coronary Heart DiseaseWhat are the benefits of attending a supervised Cardiac Rehab program?Regular physical activity helps your heart and the rest of your body get stronger and work better. Physical activity improves your energy level and lifts your spirits. It also reduces your chances of future heart problems, including heart attack.Counseling and education can help you quit smoking, eat right, lose weight, and lower your blood pressure and cholesterol levels. Counseling may also help you learn to manage stress and to feel better about your health.You have the advice and close supervision of healthcare professionals to help you improve your health and lower your risk of future problems. These professionals can also-communicate with your primary care doctor or cardiologist.Goal is to help heart patients regain good health, so that they may return to work, recreational activities and the tasks of daily living, if possible. What happens during the program?Program starts with your assessment which consists of:a medical and family history questionnaire that helps us identify your heart risk factorsa resting electrocardiogram body composition measurements (height, weight,waist size, body fat) a cardiopulmonary exercise assessment (on a treadmill, stationary bike or-monitored walking adapted to suit your abilities).The patient exercises using portable heart monitoring equipment. With the help of this special equipment, the ECG is continuously transmitted to the monitoring station while the person is exercising. This ensures that the optimal amount of exercise is performed in the safest manner possible. An individualized program of lifestyle modification, including nutrition, stress reduction and counseling is planned for the patient.What kind of exercise will I be doing?You will be using your larger muscle groups of the arms and legs to gain more endurance and strength. This is called aerobic exercise. We’ll select a special group of exercises on machines that best suit your needs. You may exercise on treadmills,bicycles, or use free weights and stretching bands.I’m exercising at home. Why should I come to Cardiac Rehab?You will be connected to an ECG monitor while you exercise, so your heart rate and rhythms are closely watched. Your blood pressure and work load are also tracked. You will be closely supervised and any concerns about your body’s response to exercise, or to your medications will be relayed by our staff to your doctors.We also help you learn what you can do to decrease your risk of a future heart problem.How can I tell, if I am exercising right or not?At rehab, therapist calculates your target heart rate, heart rate reserve which is your exercising zone. If you don’t reach to those target heart rates, then all your activity is just a physical activity and not an exercise. Basically, Aim is to exercise so that your heart rate goes up and you are slightly out of breath. You should still be able to talk. You should not feel exhausted. Slowdown or take a shorter walk if you find that you are uncomfortable and out of breath.How long will I have to attend Cardiac Rehab?Most people come 3 times a week for 6-12 weeks. The length of the program is based on your own rate of progress. For long term benefits and fitness, people continue lifelong as well. But exercising under the watchful eyes of your health care team through a CARDIAC REHABILITATION program will be the ticket to survival and a better quality of life.For further-details: email: dr.mitshu@gmail.com, Contact number: 09892156355

Save a Life - Learn CPR

Dr. Vishwas Virmani, Physiotherapist
We can find ourselves, our friends or complete strangers in life threatening situations for which we are not prepared. Take the case of sudden cardiac arrest. So many people go to the gym and while they are on the treadmill, they are at the risk of a cardiac arrest. That's what happened recently to David Goldberg, CEO of Survey Monkey and husband of Facebook's Sheryl Sandberg.He died of the sudden trauma while gyming. More than 1000 lives are lost every year due to cardiac arrest in flights. While medical care may not have been available immediately, these lives could have been saved if someone knew how to provide basic emergency care. What can we do as ordinary individuals to save another person in need? Most people who experience a cardiac arrest at home, work or in a public location die because they don't receive immediate CPR, short for Cardio-pulmonary Resuscitation, from someone on the scene.About 92 percent of sudden cardiac arrest victims die before reaching the hospital but statistics prove that if immediate help in the form of CPR could be provided by the bystanders, more lives could be saved.An immediate CPR can double, or even triple a victim's chance of survival. That's what happened to a man flying from Canada to Hong Kong in 2014. He suffered cardiac arrest during the flight and 2 fellow passengers who were trained in CPR swung into action and took him to a more open area near emergency exit and resuscitated him, thereby freeing up his airway. The man survived till the plane landed and later made complete recovery in the hospital.As a concerned individual, it is your turn to take a stand and jump right into the situation before help arrives and save lives. So what is CPR? It is a lifesaving technique useful in many emergencies, including heart attack or near drowning in which someone's breathing or heartbeat has stopped. Though a CPR is unlikely to restart the heart, its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage.Though it seems like a simple procedure to perform, CPR has a certain set of rules and precautions that must be followed and hands-on training is required so you are ready to go.

Heart Attack and Cardiac Arrest

Dr. Anil Dhall, Cardiologist
Some heart attacks are sudden and intense — the "filmy heartattack," where no one doubts what's happening. But most heartattacks start slowly, with mild pain or discomfort. Often peopleaffected aren't sure what's wrong and wait too long before gettinghelp. Here are signs that can mean a heart attack is happening: Chest discomfort. Most heart attacks involve discomfort inthe center of the chest that lasts more than a few minutes, orthat goes away and comes back. It can feel likeuncomfortable pressure, squeezing, fullness or pain. Discomfort in other areas of the upper body. Symptomscan include pain or discomfort in one or both arms, the back,neck, jaw or stomach. Shortness of breath with or without chest discomfort. Other signs may include breaking out in a cold sweat,nausea or lightheadedness.As with men, women's most common heart attack symptomis chest pain or discomfort. But women are somewhat morelikely than men to experience some of the other commonsymptoms, particularly shortness of breath, nausea/vomiting,and back or jaw painA HEART ATTACK occurs when blood flow to the heart isblocked.A heart attack is a “CIRCULATION” problem.A blocked artery prevents oxygen-rich blood from reaching asection of the heart. If the blocked artery is not reopened quickly,the part of the heart normally nourished by that artery begins todie.WHAT HAPPENS?Symptoms of a heart attack may be immediate and may includeintense discomfort in the chest or other areas of the upper body,shortness of breath, cold sweats, and/or nausea/vomiting. Moreoften, though, symptoms start slowly and persist for hours, days orweeks before a heart attack. Unlike with cardiac arrest, the heartusually does not stop beating during a heart attack. The longerthe person goes without treatment, the greater the damage.The heart attack symptoms in women can be different thanmen (shortness of breath, nausea/vomiting, and back or jawpain).What is cardiac arrest?Cardiac arrest is the abrupt loss of heart function in a person whomay or may not have diagnosed heart disease. The time andmode of death are unexpected. It occurs instantly or shortly aftersymptoms appear.CARDIAC ARREST occurs when the heart malfunctions andstops beating unexpectedly.Cardiac arrest is an “ELECTRICAL” problem.Cardiac arrest is triggered by an electrical malfunction in the heartthat causes an irregular heartbeat (arrhythmia). With its pumpingaction disrupted, the heart cannot pump blood to the brain, lungsand other organs.WHAT HAPPENSSeconds later, a person becomes unresponsive, is not breathingor is only gasping. Death occurs within minutes if the victimdoes not receive treatment.Is a heart attack the same as cardiac arrest?No. The term "heart attack" is often mistakenly used to describecardiac arrest. While a heart attack may cause cardiac arrest andsudden death, the terms don't mean the same thing. Heart attacksare caused by a blockage that stops blood flow to the heart. Aheart attack (or myocardial infarction) refers to death of heartmuscle tissue due to the loss of blood supply, not necessarilyresulting in the death of the heart attack victim.Cardiac arrest is caused when the heart's electrical systemmalfunctions. In cardiac arrest death results when the heartsuddenly stops working properly. This may be caused byabnormal, or irregular, heart rhythms (calledarrhythmias). A common arrhythmia in cardiac arrest is ventricular fibrillation.This is when the heart's lower chambers suddenly start beatingchaotically and don't pump blood. Death occurs within minutesafter the heart stops. Cardiac arrest may be reversedif CPR (cardiopulmonary resuscitation) is performed and adefibrillator is used to shock the heart and restore a normal heartrhythm within a few minutes.People often use these terms interchangeably, but they are notsynonyms. A heart attack is when blood flow to the heart isblocked, and sudden cardiac arrest is when the heart malfunctionsand suddenly stops beating unexpectedly. A heart attack is a“circulation” problem and sudden cardiac arrest is an “electrical”problem.What is a heart attack?A heart attack occurs when a blocked artery prevents oxygen-richblood from reaching a section of the heart. If the blocked artery isnot reopened quickly, the part of the heart normally nourished bythat artery begins to die. The longer a person goes withouttreatment, the greater the damage.Symptoms of a heartattack may be immediate and intense. More often, though,symptoms start slowly and persist for hours, days or weeks beforea heart attack. Unlike with sudden cardiac arrest, the heart usuallydoes not stop beating during a heart attack. The heart attacksymptoms in women can be different than men.What is cardiac arrest?Sudden cardiac arrest occurs suddenly and often without warning.It is triggered by an electrical malfunction in the heart that causesan irregular heartbeat (arrhythmia). With its pumping actiondisrupted, the heart cannot pump blood to the brain, lungs andother organs. Seconds later, a person loses consciousness andhas no pulse. Death occurs within minutes if the victim does notreceive treatmentWhat is the link?These two distinct heart conditions are linked. Sudden cardiacarrest can occur after a heart attack, or during recovery.  Heartattacks increase the risk for sudden cardiac arrest. Most heartattacks do not lead to sudden cardiac arrest. But when suddencardiac arrest occurs, heart attack is a common cause. Other heartconditions may also disrupt the heart’s rhythm and lead to suddencardiac arrest. These include a thickened heart muscle(cardiomyopathy), heart failure, arrhythmias, particularly ventricularfibrillation, and long Q-T syndrome.

What to Do When Someone Has a Heart Attack

Dr. Rudradev pandey, Cardiologist
Definition A heart attack occurs when oxygen fails to reach the heart. The vital organ needs oxygen, contained in your blood, which travels through the arteries to the heart. But if an artery has a blockage in it, blood doesn’t reach the heart and the heart’s cells die, resulting in a heart attack.A heart attack is a serious, life-threatening situation — but many people who witness someone experiencing the symptoms of a heart attack don’t treat it that way. IF YOU HAVE SUSPICION OF ANY HEART PROBLEM GO AND CONSULT TO YOUR DOCTOR RATHER THAN SELF-MEDICATION. Symptoms Of Heart Attack: The symptoms of a heart attack aren’t always obvious and often differ between men and women. Those symptoms can be subtle — perhaps one reason why some people don’t make it to an emergency room — or they can be very painful. Knowing what to look for can help you know when to take action for a friend, colleague, or loved one in distress:For men: The typical male symptom is a crushing pressure behind the breastbone, also called the sternum. That pressure, can radiate to your arms (often the left arm) and can go into the back, shoulder blades, and jaw above to umblicus below. Men suffering a heart attack can break out in a sweat, may vomit or feel nauseating.The onset of pain may be gradual and last several minutes or more. Sometimes the pain fades and comes back.For women: Women can have any of the same symptoms that men experience, but women often have more “atypical” symptoms, such as shortness of breath, and they may feel some indigestion. A woman having a heart attack may also experience pain in her jaw, and could feel a little faint.These symptoms are not what most people think are indications of a heart attack, Dr Pandey says. “Doctors and patients have to be very wary when it comes to heart symptoms with women,” he says. And for good reason: Heart disease kills more women than any other health condition.What to doIt’s good to have a plan in place before a heart attack occurs, especially if the person has close relatives who have had heart attacks. According to Dr Pandey, smoking & tobacco chewing play a big part in who has a heart attack and who doesn’t. Genetics of patient also plays important role. especially in young patients with heart attack.Chances of recovery are much better if the affected artery can be opened up within an hour-and-a-half of the heart attack, making it essential to get the person having the attack to the emergency room immediately(Primary PTCA) “By the time 90 minutes go by, you want to get that artery open,” Dr Pandey says. “If you’re in a rural emergency room, and [the medical team can’t open the artery], you need clot-busting drugs.” followed by transfer to hospital with cath lab facilityYou Think It’s A Heart Attack? Dr Pandey says it’s extremely important for caregivers and friends to know the symptoms of a heart attack. Call 108 if you even suspect it's a heart attack and here’s what you can do before help arrives:Stay close. Do not leave the person to find medications to give them . It's better to call for help first; emergency personnel can administer aspirin or any other appropriate treatmentsGive a dose of sublingual nitriglycerine. If the person has been prescribed nitroglycerin in the past for heart disease, and the medication is close at hand, you can give them a dose. BUT NOT MORE THAN TWO TABLETSGo for comfort. Make the heart attack victim more comfortable by placing them in a comfortable position, loosening clothing, and staying close to provide reassuranceIf needed, give CPR. Studies have shown that CPR given by a bystander can double or triple a victim's chance of surviving cardiac arrest. If you are with someone who suddenly collapses, stops breathing, or is unresponsive, start performing hands-only CPR at 100 chest presses a minute with minimal interruptions. It’s just as effective as standard CPR

10 Minutes to a Healthy Heart

Dr. Vishwas Virmani, Physiotherapist
The strongest muscle in the body, the heart, is a wondrous organ that works for us tirelessly from the time of birth till death, break free. Seldom do we appreciate the reason why we are able to do literally everything in our life. A healthy heart is the key, or at least one of the keys to a long life. Cardiac stamina, also known as endurance, is the ability of the heart to deliver oxygen and nutrients to the body during exertion without undue fatigue. An enhanced cardiovascular stamina allows you to pursue physical activities for a longer time.Does climbing a flight of stairs leave you gasping for breath with your heart pounding in your chest? If yes, then take this as a warning sign, and work towards making your heart stronger and healthier by following simple practices that hardly take any time.Ways to increase your cardiac stamina:1. Walk and talkCardiovascular endurance can be enhanced by keeping the heart steadily beating at a faster pace. Try to walk fast and monitor your heart beat at the end of a 10-minute brisk walk. At the end of this routine, try speaking to assess your improvement. Initially, you will find it hard to speak; as your stamina is low, you get tired easily. As your endurance improves, you will experience lesser shortness of breath and will find it easier to speak at the end of your walk.2. Dare to stairThe aim is to reach 50% to 80% of your maximum heart rate and maintain it. Just keep climbing a flight of stairs whenever you can. This can easily be incorporated into your daily life; simply opt for the stairs rather than a lift or an escalator at the office, at home, while at the mall, etc. Keep doing this as often as possible as it improves cardiac blood flow and is a great workout for your body. In 10 minutes of climbing the stairs, you burn 1.5 Kcal for every 10 steps you climb.3. Jog for your heartJogging is an excellent way to increase one’s cardiac stamina. It burns nearly twice as many calories as walking does in the same time. Losing excess weight is also one of the main prerequisites for a well-oiled heart, as obesity leads to all kind of cardiovascular diseases as well as other complications. Jogging helps you stone two birds at a time. Jogging just 10 minutes at the start and end of your day will not just improve your cardiac stamina, but trust us, it is the most underrated anti-depressant and will help calm your mind down significantly.4. Hit the swimming poolSwimming is an extremely popular aerobic sport that utilises all the muscles of the body. It is perfect for summertime and studies indicate that an average of 2 hours of swimming per week will enhance your cardiac endurance drastically. 10-20 minutes of swimming each day is enough to rejuvenate your mind and get your heart thumping.5. Breathe easyTake time out to appreciate the beauty in life and nature and people around you. Spend minimum 10 minutes to meditate or indulge in some form of relaxation. Pamper yourself, work towards reaching your goals as well as on achieving true happiness. Cut yourself off from the world every once in a while to connect with your inner self. A happy you makes a healthy heart.Remember, 10 minutes a day, keeps the cardiologist away! Happy exercising!

7 Everyday Tips for Taking Care of Your Bleeding Gums

Dr. Parul, Cardiac Surgeon
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Know About Heart Failure

Dr. V.Ganesh, Cardiologist
Heart failure is a life-threatening condition in which the heart is unable to pump enough blood to different parts of the body.It can affect the left side or right side or both sides of the heart.Causes of heart failure Coronary artery disease:  narrowing of blood vessels that supply oxygen-rich blood to the heart.Cardiomyopathy : diseases of heart muscle that cause enlargement of the heart.Hypertension: High blood pressure.Valvular heart disease: diseases affecting valves between chambers of heart.Myocarditis : Inflammation of heart muscle caused by a virus.Heavy consumption of alcohol.Diabetes.Thyroid diseases.heavy alcohol consumption SIGNS AND SYMPTOMS OF HEART FAILUREShortness of breath while walking ,climbing stairs or at rest.Swelling of legs,edema( leg swelling).General tiredness or weakness,A chronic cough,Chest discomfort.Walking up during the night with sudden breathing difficulty.PHYSICAL EXAMINATION revealsIrregular or rapid heartbeat,Distended neck veins,Signs of fluid around the lungs,Lung crackles,Blood pressure may be normal, high , or low.INVESTIGATIONSX-RAY:Chest X-RAY helps to find out fluid accumulation in lungs, and heart enlargement.X-RAY CHESTElectrocardiogram (ECG)This test helps to detect any heart abnormality that may be associated with heart failure. Electrocardiogram(ECG).EchocardiogramUses ultrasonic waves to produce a video image of the heart,The image helps in assessment of pumping capacity of heart as well as any abnormality in heart muscle, heart valves etc.echocardiogramCoronary angiogramThis procedure is used to identify narrowing of arteries(blood vessels) which supply the heart which may be the cause of heart failure.In this procedure a thin flexible tube is inserted into the blood vessel through arm or groin which is passed to blood vessels of heart and dye is injected and the picture is obtained.Other investigations:Chest CT, Cardiac MRI, Blood tests to identify chemical markers of heart failure such as BNP.TREATMENT:Avoid smoking.Regular exercise such as walking, jogging, cycling etc.Reduce salt intake.Control blood pressureControl DiabetesControl thyroid diseases.Limit alcohol intake.Control cholesterol.DRUGSACE Inhibitors: these dilate blood vessels , improve blood flow, decrease workload on the heart.Diuretics: These group helps remove excess fluids and sodium from the body.Beta blockers: Slows heart rate and reduce blood pressure.Digitalis: Increase ability of heart muscle to contract properly.SURGERY AND MEDICAL DEVICES:CABG(Coronary artery bypass grafting) and ANGIOPLASTY  :Used to treat severely narrowed coronary arteries that contribute to heart failure.Implantable cardioverter - defibrillators(ICD).ICD monitors irregular heart rhythm and sends electrical shocks to correct this irregularity.they are implanted under the skin and attached to heart with small wires.ICDCardiac resynchronization therapy.(CRT)This is a type of pacemaker-like device which sends timed electrical signals to heart chambers allow them to pump synchronous and efficient manner.CRT DEVICEHeart pumps (left ventricular assist devices)These mechanical devices are implanted into the abdomen and attached to weakened heart to help it to pump better.HEART PUMP