DEAR MAYO CLINIC: I've heard about several people who have experienced sudden cardiac arrest. What is cardiac arrest? And how is it different from a heart attack? What do you do for someone who has this condition?

ANSWER: Cardiac arrest, or sudden cardiac arrest as it is more formally known, is a medical emergency. Think of it as a problem with the heart's electrical activity. This synchronized electrical activity allows the heart to fill and pump blood normally. Sudden cardiac arrest can happen unexpectedly and quickly, and the heart stops working. It's not the same as a heart attack, but it is just as critical that treatment occurs rapidly.

Cardiac arrest is when the heart cannot fulfill its duties, such as pumping oxygenated blood around the body to reach critical areas such as the brain and the rest of the body. It is sometimes called “sudden” because it seems to happen without warning. A person suddenly loses all heart activity, stops breathing and becomes unconscious. Without immediate treatment, sudden cardiac arrest can lead to death.

What causes cardiac arrest?

There are two types of ways a person has a cardiac arrest. The first is when no electrical activity stimulates the top or bottom of the heart muscle to squeeze. The second is when the heart's electrical activity is no longer synchronized and efficient but is chaotic and unable to pump blood. This is called ventricular fibrillation. Rapid, erratic heart signals cause the lower heart chambers to quiver uselessly instead of pumping blood. Certain heart conditions can make you more likely to have this heartbeat problem. Sudden cardiac arrest also can happen in people with no known heart disease.

What is the difference between cardiac arrest and heart attack?

When someone has a heart attack, it's more of a plumbing problem. The major arteries that supply the heart with blood and oxygen get plugged up with a clot, causing a block in flow. The heart tissues are not getting oxygenated blood, so those tissues could die. Over time, this can lead to electrical problems like ventricular fibrillation and sudden cardiac arrest. In some instances, scar tissue after a heart attack can cause changes to one's heartbeat. When someone has a sudden cardiac arrest or sudden cardiac death, it could be a manifestation of a heart attack. But sudden cardiac arrest doesn't mean you necessarily have heart blockages.

Who is at risk of cardiac arrest?

The same heart conditions that increase the risk of heart disease can raise the risk of sudden cardiac arrest, including:

• Coronary artery disease.
  When cholesterol builds up in the arteries that supply blood to the heart — hardening and narrowing the path — it's known as coronary artery disease. The most common symptom is chest discomfort.
• Cardiomyopathy.
  Cardiomyopathy means there is something wrong with the heart muscle itself. This condition can be genetic. A common form is called hypertrophic obstructive cardiomyopathy. The heart muscle is not normal and is thicker.
• Heart valve disease.
  In heart valve disease, one or more of the valves in your heart doesn't work properly. Leaking or narrowing of the heart valves can lead to stretching or thickening of the heart muscle. When the chambers become enlarged or weakened because of stress caused by a tight or leaking valve, there's an increased risk of developing a heart rhythm problem (electrical disturbance).
• Congenital heart defect.
  Sudden cardiac arrest in children or adolescents often is due to an electrical or structural heart problem that they're born with. Adults with a prior surgical repair for a congenital heart defect have an increased risk of sudden cardiac arrest.
• Long QT syndrome (LQTS) and other heart electrical signaling diseases.
  Conditions such as long QT syndrome, Brugada syndrome and arrhythmogenic cardiomyopathy can cause a risk of developing ventricular fibrillation. If the heart rhythm isn't quickly restored, sudden death can occur. Young people with LQTS are especially at risk of sudden death.

What do I do if I see someone in cardiac arrest?

Survival is possible for a person in cardiac arrest, but time is crucial. It is important to restore the rhythm as fast as possible with CPR and an automated external defibrillator (AED). Always call 911, but you can assist until help arrives.

A cardiac arrest could happen wherever and whenever in life — in a mall, at school or work. If someone passes out, you want to ensure they are breathing, have a pulse, and their heart is pumping. If their heart is not pumping, then start emergent CPR. Push hard and fast on the person's chest — about 100 to 120 pushes a minute.

Often you will see AED machines hanging in hallways at a school, the office, in a restaurant or a stadium. Many people are familiar with them from TV, where patients are shocked by the device back into a normal rhythm.

Many people are nervous to use an AED because they are not medical professionals, but the device is meant for bystanders. The machine guides the user. It will recognize that the patient is not in a good rhythm. It will tell you to shock the heart.

The goal is to stabilize the patient by getting them back to a normal rhythm. This will restore blood flow to critical parts of the body, especially the heart and brain. — Dr. Christopher DeSimone, Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: What is cardiac arrest? appeared first on Mayo Clinic News Network.

Cardiac arrest, or sudden cardiac arrest as it is more formally known, is a medical emergency. It happens when an event, usually an electrical disturbance, quickly and unexpectedly causes your heart to stop working. It's not the same as a heart attack and is called sudden because it seems to happen without warning.

Dr. Christopher DeSimone, a Mayo cardiac electrophysiologist specializing in abnormal cardiac rhythm, answers questions about cardiac arrest, the differences between cardiac arrest and heart attack, and why time is critical when treating someone with cardiac arrest. 

Journalists: MP3 audio files of featuring Dr. DeSimone are available in the downloads at the end of this post.

QUESTION:  What happens during cardiac arrest?

Cardiac arrest is when the heart cannot fulfill its duties and pump blood, especially oxygenated blood, around the body to get to critical areas, such as the brain. Now, when there's an arrest, there are two things we go over. One could be the heart stops electrically, so the heart is not going to pump. The other one is the heart goes into an abnormal or lethal rhythm, which we call ventricular fibrillation. That's a more chaotic rhythm of the heart. So electrically this heart's in a bad rhythm, and the ventricles are quivering and not pumping out. Ultimately, both things put you into cardiac arrest, sudden cardiac arrest or sudden cardiac death. The heart cannot fulfill its duties of pumping blood to the lungs and the rest of the body, so that all the nutrients and oxygen can get to the tissues of the heart, brain or what have you.

QUESTION:  Why is immediate care, like CPR and AED, so critical?

Survival is possible with immediate, appropriate medical care. Call 911, if able, first. 

Once you know that someone's suffered or suspect that they've suffered a cardiac arrest or sudden cardiac arrest, it is important to restore the rhythm as fast as you can. 

A cardiac arrest could happen wherever we are in life — in the malls, schools and at work. And if someone passes out, you want to make sure that they're breathing, their heart has a pulse and their heart is pumping. If their heart's not pumping, then what people need to do is emergent CPR. 

And every time we walk by things in the hallway, whatever buildings we're in, there are all these things called AED, or automated external defibrillators. That's one of those things that people see on TV where they're shocking the patient back into a normal rhythm.

Because if that device notes that the patient does not have a good rhythm and they're in this ventricular fibrillation, the machine will tell you to shock the heart, and the machine will shock. You're trying to electrically restart the heart so that it goes back into its normal rhythm, and you could have normal pumping function.

QUESTION: Why is time so crucial for dealing with cardiac arrest?

Time is critical because the heart's not pumping blood to the rest of the body — not to the lungs, not to the brain. The oxygen is not getting to the tissues as it usually does when the heart's pumping normally. Everyone knows that time is heart muscle, time is myocardium. When someone's having a heart attack, think about the whole body having a heart attack. The brain is not getting blood, the liver is not getting blood, and the kidney is not getting blood. The heart itself isn't getting oxygenated blood, so all those tissues could die off. 

QUESTION:  What is the typical treatment for a person having cardiac arrest?

As soon as you can establish a rhythm or if you're still doing CPR and have given medications and doing advanced cardiac life support, part of that is to put a tube down the patient's throat, intubation, and sedate them so that they're under anesthesia. 

Sometimes they'll even cool the patient. The patient will not be breathing on their own. A machine will be breathing for the patient. And sometimes what we do is we also cool the patient down.

We're trying to let the tissues that might not have gotten oxygen for minutes — hopefully not hours — recuperate some of their function and make the body spend the least energy as we can. It's common for that to happen so that we can stabilize the patient.

QUESTION:  What is the difference between cardiac arrest and heart attack?

When someone has a heart attack, it's more of a plumbing problem. The major arteries going to the heart get plugged up with a clot. When that happens, there's a blockage in the plumbing, and then the heart at that area might get weak because it can't pump because it doesn't get blood flow to itself. And things could happen — like the patient goes into an electrical problem, like sudden cardiac arrest. The plumbing leads to an electrical problem, that's common. 

But the heart attack is blocking the plumbing, so blood does not get to the heart. When someone has a sudden cardiac arrest or sudden cardiac death, it could be a manifestation of a heart attack. But sudden cardiac arrest doesn't mean you necessarily need to have heart blockages. 

Related topics:

• Heart attack symptoms: Know what’s a medical emergency
• Automated external defibrillators: Do you need an AED?

The post What is cardiac arrest? A Mayo Clinic heart expert explains appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network."Read the script."

"The goal of using CPR is to move blood through the heart and lungs, and the brain," says Henderson. "You are pushing down on the breastbone, or sternum, compressing the heart between the sternum and the spine, which pushes the blood out."

If there's no response, call 911, or have someone do it for you. Then, start hands-only compressions.  Place one hand down and the other hand on top.

"Push straight down 2 inches. Then, allow the chest to return to the neutral position. Do it over and over. At a rate of about 100 to 120 compressions a minute."

 Don't stop — not even to breath for the victim.

"It's more important to give consistent compressions to move blood that is still partially oxygenated until we get advanced care on the scene," says Henderson.

Continue providing compressions until someone else who knows CPR can take over for you. 

The post Mayo Clinic Minute: Learn hands-only CPR appeared first on Mayo Clinic News Network.

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The universal sign for choking is hands clutched to the throat. If the person doesn't give the signal, look for these indications:

• Inability to talk
• Difficulty breathing or noisy breathing
• Inability to cough forcefully
• Skin, lips and nails turning blue or dusky
• Loss of consciousness

If choking is occurring, the Red Cross recommends a "five-and-five" approach to delivering first aid:

• Give 5 back blows. First, deliver five back blows between the person's shoulder blades with the heel of your hand.
• Give 5 abdominal thrusts. Perform five abdominal thrusts (also known as the Heimlich maneuver).
• Alternate between 5 blows and 5 thrusts until the blockage is dislodged.

The American Heart Association doesn't teach the back blow technique, only the abdominal thrust procedures. It's OK not to use back blows, if you haven't learned the technique. Both approaches are acceptable.

To perform abdominal thrusts (Heimlich maneuver) on someone else:

• Stand behind the person. Wrap your arms around the waist. Tip the person forward slightly.
• Make a fist with one hand. Position it slightly above the person's navel.

• Grasp the fist with the other hand. Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up.
• Perform a total of 5 abdominal thrusts, if needed. If the blockage still isn't dislodged, repeat the five-and-five cycle.

If you're the only rescuer, perform back blows and abdominal thrusts before calling 911 or your local emergency number for help. If another person is available, have that person call for help while you perform first aid.

Watch: Saving Lives With Gus: Heimlich Maneuver

If the person becomes unconscious, perform standard CPR with chest compressions and rescue breaths.

Watch: Mayo Clinic Minute: Learn Hands-only CPR

To perform abdominal thrusts (Heimlich maneuver) on yourself:

First, if you're alone and choking, call 911 or your local emergency number immediately. Then, although you'll be unable to effectively deliver back blows to yourself, you can still perform abdominal thrusts to dislodge the item.

• Place a fist slightly above your navel.
• Grasp your fist with the other hand and bend over a hard surface — a countertop or chair will do.
• Shove your fist inward and upward.

To clear the airway of a pregnant woman or obese person:

• Position your hands a little bit higher than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs.
• Proceed as with the Heimlich maneuver, pressing hard into the chest, with a quick thrust.
• Repeat until the food or other blockage is dislodged or the person becomes unconscious.

To clear the airway of an unconscious person:

• Lower the person on his or her back onto the floor.
• Clear the airway. If a blockage is visible at the back of the throat or high in the throat, reach a finger into the mouth and sweep out the cause of the blockage. Be careful not to push the food or object deeper into the airway, which can happen easily in young children.
• Begin cardiopulmonary resuscitation (CPR) if the object remains lodged and the person doesn't respond after you take the above measures. The chest compressions used in CPR may dislodge the object. Remember to recheck the mouth periodically.

To clear the airway of a choking infant younger than age 1:

• Assume a seated position and hold the infant facedown on your forearm, which is resting on your thigh.
• Thump the infant gently but firmly five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object.
• Hold the infant faceup on your forearm with the head lower than the trunk if the above doesn't work. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions.
• Repeat the back blows and chest thrusts if breathing doesn't resume. Call for emergency medical help.
• Begin infant CPR if one of these techniques opens the airway but the infant doesn't resume breathing.

If the child is older than age 1, give abdominal thrusts only.

To prepare yourself for these situations, learn the Heimlich maneuver and CPR in a certified first-aid training course. 

The Mayo Clinic Book of Home Remedies provides answers you need to take care of common health problems on your own. This reference covers 120 of today’s common health problems in an easy-to-follow, A-to-Z format. Learn what you can do for yourself and when to seek medical attention.

The post Home Remedies: When someone is choking appeared first on Mayo Clinic News Network.

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Every day more than a thousand people in the United States experience sudden cardiac arrest and it kills several hundred thousand people every year. On the next Mayo Clinic Radio, Saturday, June 14, at 9 am CT, Roger White, M.D., will join us to discuss what happens to your heart during cardiac arrest. What should you do to help until an ambulance arrives? Where can you learn CPR? How do you use an automatic external defibrillator? We'll find out the answers to these questions and more on the next program. Join us!

Myth or Fact:  Perform CPR before you use an AED when you suspect someone is having a cardiac arrest.

To hear the program LIVE on Saturday, click here.
Follow #MayoClinicRadio and tweet your questions.
Mayo Clinic Radio is available on iHeart Radio.

Listen to this week’s Medical News Headlines: News Segment 2 June 15, 2014 (right click MP3)  

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

For future topics, click on Upcoming Programs.
To listen to archived shows, click on Episodes.
If there is a topic you would like us to address, drop us a note.  Click here to create a guest account.

The post MAYO CLINIC RADIO appeared first on Mayo Clinic News Network.

Every day more than a thousand people in the United States experience sudden cardiac arrest and it kills several hundred thousand people every year. On the next Mayo Clinic Radio, Saturday, June 14, at 9 am CT, Roger White, M.D., will join us to discuss what happens to your heart during cardiac arrest.  What should you do to help until an ambulance arrives?  Where can you learn CPR?  How do you use an automatic external defibrillator? We'll find out the answers to these questions and more on the next program.  Join us!

Myth or Fact:  Perform CPR before you use an AED when you suspect someone is having a cardiac arrest.

For the transcript of the #SummerHealth Twitter chat, click here.

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeart Radio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

The post Mayo Clinic Radio: Cardiac Arrest appeared first on Mayo Clinic News Network.

It was two years ago when 54-year-old Howard Snitzer crumpled to the ground, suffering a massive heart attack, and more than 20 first responders came to his aid. Today he's enoying the slopes and a second chance at life.

Some say it was divine intervention and others say it was everyone being in the right place at the right time. Here's the original feature length report about a CPR miracle. [TRT 4:25]

Video and script are available in the downloads below. Reporter pkgs. can be edited into vo/sots and incorporated into your local reporting.
https://www.youtube.com/watch?v=wkXZLfd8f2E

The post Surviving a Heart Attack and 96 Minutes of CPR appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. - June 8, 2012.  Just the idea of performing CPR can intimidate the average person, whether it’s the thought of saving a life or or just trying to remember all of the steps.  Well, maybe it's not that difficult.  A move to simplify cardiopulmonary resuscitation practices is one of many advances that should be highlighted for the public during CPR Awareness Month, according to Mayo Clinic resuscitation expert Roger White, M.D.

Dr. White says other recent advances include the increasing use by professional responders of capnography, technology that gauges the effectiveness of CPR; widespread availability of automated external defibrillators in public places and emergency vehicles; and increasing use of therapeutic body cooling to protect recovering cardiac arrest patients from brain damage.

Soundbites with Dr. White are available in the downloads above.

Expert title for broadcast cg: Dr. Roger White, Mayo Clinic CPR Expert

Read entire news release

To request an interview with Dr. White please contact Sharon Theimer:
507-284-5005 (days)
507-284-2511 (evenings)
newsbureau@mayo.edu.

Just the idea of performing CPR can intimidate the average person, whether it’s the thought of what’s at stake or simply trying to remember all of the steps. A move to simplify cardiopulmonary resuscitation practices for the public is one of many advances important to highlight during CPR Awareness Month, says Mayo Clinic resuscitation expert Roger White, M.D.

Now, rather than taking time to check airways or trying to recall how many breaths to give, the guidance for what a bystander untrained in CPR should do if someone collapses boils down to this: If the person doesn’t respond to your command to awake, dial 911 to summon help, then immediately start continuous chest compressions. Press on the center of the chest as hard and as fast as you can — pushing about 2 inches down — and do it without stopping until help arrives to relieve you, says Dr. White, a Mayo Clinic anesthesiologist and a member of the American Heart Association scientific advisory committee that released the hands-only CPR call to action.

The move to make CPR more efficient and easier for the public to perform is one of several advances in resuscitation, Dr. White says. Others include use of technology called capnography to gauge the effectiveness of CPR, wide availability of defibrillators in public places and emergency vehicles, and growing use of therapeutic hypothermia to try to protect recovering cardiac arrest patients from brain damage.

###

About Mayo Clinic:

Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.org, www.mayoclinic.org and newsnetwork.mayoclinic.org.

Media Contact: Sharon Theimer, Mayo Clinic Public Affairs at 507-284-5005 or newsbureau@mayo.edu

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