Everything you should know about early detection of cardiac arrest: Dr Shriram Nene answers

There has been a huge number of cases recently. Of very high profile in relatively young patients who have had a sudden cardiac arrest. Ace cardiologist answers all questions regarding heart health.

What are the most common causes and symptoms of cardiac arrest?

By far the patients that were discussed were 30- 40 – 50 years old, the number one case of cardiac arrest is underline coronary artery disease. If you look at younger patients in their 20s and younger it could be from irregular heartbeats. But worldwide caused by underlying coronary artery disease specifically, which then leads to heart attacks, which leads to disruption of the cardiac rhythms. 

So let’s talk about that. two things we should know:

The heart is a very complex organ; it has three subsystems within it. So it’s not a pump just pumping the blood to the rest of the body but on the surface of the heart are the coronary arteries which actually Pump blood to the heart muscles themselves. When these coronary arteries get blockages that when you get disruption inflow. 

Now in addition to the previous two functions of coronary arteries and the heart muscles, the heart is unique and it has its own conduction system which triggers pumping in an orderly fashion on the top of the atria, Ventricular, and then pumping blood to the rest of the body. What happens in cardiac arrest is the function of the heart stops suddenly leading to sudden collapse, pulselessness, lack of breathing, and lack of consciousness. There are many things which come up before that. 

Can it be prevented? If yes then how?

Yes, it can be potentially prevented. Remember that everything about the heart is supply and demand can the coronary arteries and follow you have provided adequate supply to the heart. To allow it to function Adequately and if you are in a sanitary lifestyle you may never know you have adequate coronary flow and this coronary can get blocked over the years with different things.  

Heart disease or coronary disease is about supply and demand if there is an adequate supply of coronary blood flow to allow your heart to function well and that’s measured by how robust your function is. So, we typically see a very high incidence of early heart diseases. before getting into that. Can we prevent the answer is Yes? 

In fact, in India, we can say early recognition, early prevention and early treatment are keys to preventing cardiac diseases. Let’s be clear about it once you are at the point of sudden collapse, no pulse, no breathing, and loss of consciousness the game is practically over. 

if you develop chest discomfort, shortness of breath weakness. or fast and fluttering heart rate or you have unexplained vision, fainting, or lightheadedness, you have to see a doctor so they can work you up. If you have risk factors for heart diseases or symptoms you need to do a proper cardiac workup. In diagnosing you early it is all about prevention, early diagnosis, and early treatment and that’s how a cardiac arrest can be prevented. 

How can you detect cardiac arrest at an earlier stage?

Cardiac arrest is the end-stage of the disease and if someone collapses what do you do to change that. There are several things as a first responder you can do. The first thing is calling for help 108 in India, 911 in the US. The second thing is we should be pushing CPR (Cardiopulmonary resuscitation) to everyone and that should be in school and corporate everywhere. It’s not difficult, you are just pushing hard and fast in someone’s chest in 100 or 120 compresses a min and if you are trained that you are doing rescue breathing in every 30th compression. That coupled with one another device called portal Automated external defibrillator could save many lives because you have 6 mins in cardiac arrest before the brain starts tying as well. SO in that 6 mins, you have to establish adequate flow and turn around the rhythm. Chest compression and CPR can help you to some degree. But the problem is that if you can’t convert it into a meaningful rhythm that can pump blood this patient will not be saved. 

What is sudden cardiac arrest (or SCD Sudden cardiac death)?

When the heart rhythm ceases and when you have sudden collapse, no pulse, no breathing, and loss of consciousness, there is a certain type of rhythm with true cardiac arrest which you can’t convert. But the ones you can typically do are ventricular fibrillation (VF), rapid ventricular tachycardia. The other rhythms are hard. So we should focus on prevention rather than treatment because many of these data suggest you cannot save lives. I think understanding the disease, Understanding the risk factor for coronary artery disease understating are symptoms and signs, and understanding when you need to go in is critical. 

We are seeing a lot of younger generation people dying because of heart attacks? Why do you think this is happening?

This is not new. Back in 2004, the Indian medical association published a paper on the fact that Indian males see heart diseases and heart attacks 10 years earlier than the western country and in particular, there are different types of fat transplantation vehicles. But in particular, they have a triglycerides-rich heart disease which is a little bit different than the west. Secondly, Indians tend not to be the biggest people so when you see a small blockage. the blockage of flow in their coronaries is proportionally higher. That’s even more true for women who typically have smaller arteries owing to their size. 

Interestingly enough that 80% of people get symptoms at once as chest pain, soreness In the arm with shortness of breath. Palpitation irregular heartbeats or sweating. 20% of people never have typical symptoms and the symptoms will be more like a reflex. They can be like musculoskeletal pain and so we shouldn’t be afraid of such things, in case you have a risk factor then you need to be careful. The various risk factors are is it a first-generation, or pass-through generation brother, a sister who has bad heart disease. Who has immature particular heart disease before 50? If they have that you have a 4 times higher risk than the normal person. If having heart disease. Second, if you have heart disease yourself, having it again is possible. 

There is an interesting thing about cholesterol. It used to be thought that cholesterol’s primary prevention was beneficial. Much of the data has changed and most of us will say now that it is not we can go after the primary. Meaning that we will go to keep an ultra-low cholesterol margin of 100 or less. But we should be aware of diet and exercise in order to lead a healthy lifestyle. 

Sure question about young people getting it. We knew about it years ago in India. The only difference is about a few things. One – with Social media and PR coming out and covering these things the awareness has gone up dramatically. This was happening in early 2000 but I think people knew it when a high-profile person got it. 

My answer to this is we should be diligent about it. 

Any special initiative you are taking to spread awareness.

There are several things we need to do first we need to join hands together. To bring awareness about heart disease. It is by far the number one killer of people around the world. So the issue is we have created a website and YouTube channel to entertain and educate at the same time and not make it us on a soapbox with a doctor preaching to you. Rather make it a social initiative where it’s a grassroots movement, Todo the right thing, and live a better life. 

The second thing is we are pioneering something and are trying to teach CPR to everyone. That should be early and often and at the same time. Raising awareness about heart disease, its risk factors, signs, symptoms, and how to treat it. That people can come for early treatment doesn’t mean that people can’t have a heart attack. But it does mean that the hope will be that they should come before the cardiac arrest. And seek attention. And putting the pendulum from acute care to prevention early recognition. 

The last thing is working with some of the companies to provide AED’s (Automated external defibrillator) in public locations. When I’m talking about public locations I am talking about shopping malls and places like that. But I am also looking at the train station, school, and society and that’s where we can make a difference in the Aam Admi lives. It also means that people know how to use them. That means there has to be a countrywide initiative to do that. We are also doing some other things. Which will change things which have happened. So stay tuned as Pathfinder comes out. You will see some remarkable things. 

And our initiator was always the same to make life better on the planet for everyone. Demonstrate and we’re still after the same to get great minds, great hearts together. And do something that matters. In the end, you have everything in the world but if you don’t have a healthy life it may not be worth leaving.