Sudden Cardiac Arrest: When Your Heart Stops Beating

What is sudden cardiac arrest?

The leading cause of death in the United States is heart disease. This should not come as a surprise. The heart beats about 2 billion times during an average lifetime and pumps 100,000 gallons of blood. No other piece of machinery works as hard and lasts as long.

Sudden cardiac arrest, or cardiopulmonary arrest, is what happens when the heart stops beating suddenly and unexpectedly. If the heart is not restarted, then the person dies. Seemingly out of nowhere, the heart stops pumping blood and the person collapses. We like the machinery analogy: It’s like your car or washing machine breaking down without warning.

Our non-profit organization, Simon's Heart, focuses on the conditions that lead to sudden cardiac arrest and death in children. There is no national registry - and sadly, there is not much research being done.

Children leave the hospital as newborns and their hearts are not screened until they are symptomatic or middle-aged adults. That’s no way to treat such a vital and hardworking organ. Would you drive the same car for decades without getting an oil change or a checkup? Definitely not. Yet, many people go their entire life without ever having their heart monitored for problems.

We want to change that.

How is sudden cardiac arrest different from a heart attack or heart failure?

The first thing to understand is how the heart normally functions to pump blood to the body. Your body needs oxygen to work, and that oxygen is carried in the blood.

In a healthy person, the heart pumps thousands of times a day to send blood to all the organs of the body so that a person can do what they want to do. Normally, when the heart pumps blood, some of the blood goes to the heart itself. Usually, the heart has three main blood vessels, or arteries, that pump blood to the different parts of the heart.

OK, so what is a heart attack?

A heart attack is when one of those blood vessels suddenly becomes blocked. This causes a part of the heart muscle to be without any blood, and as a result without any oxygen. Over time, as the heart goes without oxygen, the muscle begins to die. Once it dies, it is not able to recover.

Usually, when someone is having a heart attack, the main symptom is chest pain. However, some people may only have minor chest discomfort, or no chest pain at all. Some individuals will only have shortness of breath, nausea, or other non-specific symptoms.

This is different than a cardiac arrest, when instead of one single blood vessel in the body having no blood flow, the entire body suddenly has no blood flow.

How is a heart attack different from a cardiac arrest?

People often confuse cardiopulmonary arrest and a heart attack. They’re related, but different.

Think about the water in your home. In one scenario, someone shuts off the water main and there is no water in the house. In another, the water in one faucet of the house slows down because there is a clog in the drain. In both scenarios, the plumbing isn’t working properly, but the causes, symptoms and treatments are different.

Sudden cardiac arrest is when your heart stops pumping. The “main” gets shut off instantly, and everything in the body stops working. The person collapses and dies Alternatively, during heart attack, a single artery is blocked and that artery’s blood flow either slows down or stops entirely. This blockage can damage or destroy some of the heart muscle over time. Unlike with cardiopulmonary arrest, the person will likely remain conscious during the heart attack.

And what is heart failure?

Heart failure is when the heart, for various reasons, is not able to pump enough blood to meet the demands of the body. For some people, a heart attack can damage the muscle of the heart and cause the pumping to weaken, leading to heart failure. Other people inherit genetic problems with the muscle of the heart that cause it to weaken, leading to decreased pumping and eventually heart failure.

The symptoms of heart failure usually include shortness of breath (especially with activity), weight gain, leg swelling, waking up at night out of breath, and shortness of breath while lying flat. If you or someone you know is having these symptoms, it may be worth speaking with a doctor to decide if any tests are needed to check the function of the heart.

How is heart failure different from a cardiac arrest or a heart attack?

Heart failure is different from a heart attack because there is not a problem with the blood flow to the heart itself.  Heart failure is different from cardiopulmonary arrest because the blood is still pumping in heart failure –  it is just not pumping enough. Or, to return to the plumbing analogy, heart failure is when the water pressure is low and the water is just trickling out of the faucet. There is still water, but it is not enough to take a shower or do what you need to do.

These distinctions are important for accurately completing medical history forms for yourself and family. Doctors consider the health of your parents and grandparents when treating you, so the more you know, the better you’ll be.

What are the symptoms of cardiac arrest?

The first sign is obvious: the individual is not breathing. He might have collapsed for no apparent reason. She may not have woken up from sleep. In both scenarios, they may be lying still or shaking in what looks like a seizure. If someone collapses and is shaking, and there is no history of epilepsy or head trauma, assume it is cardiopulmonary arrest.

What causes sudden cardiac arrest in adults?

There are various causes of cardiopulmonary arrest in adults. Some of the most common causes are: low oxygen levels, severe electrolyte abnormalities, a blood clot in the lung (pulmonary embolism), a blood clot in the heart (heart attack), certain drugs, or certain irregular heart rhythms.

When a person suffers a sudden cardiac arrest, if they are lucky enough to survive, the doctors caring for them will attempt to figure out why this event occurred and prevent it from happening again.

What are the risk factors for sudden cardiac arrest?

There are many factors that contribute to a person’s risk of sudden cardiac death. In kids, these risk factors are often genetic abnormalities that can increase the risk of developing dangerous heart rhythms that can be fatal. These genetic conditions often run in families, which is why it is so important to know your family history.

In addition to genetic risk factors, some individuals acquire additional risk factors as they age. These can include heart disease, kidney disease, lung disease, and high blood pressur to name a few. In additional to certain medical conditions, there are other factors that can increase a person’s risk, such as illegal drug use.

Can you survive sudden cardiac arrest?

Yes. Survival rates in general are low, but with preparation and training, we can greatly increase a person’s chance of survival. And fortunately, preparation does not need to be difficult or expensive.

To survive cardiopulmonary arrest, the victim needs to receive hands-only cardiopulmonary resuscitation (CPR) and potentially be defibrillated with an automated external defibrillator (AED).

CPR keeps the blood flowing throughout the body and the AED shocks the heart back into its normal rhythm. CPR should begin immediately and the AED should be applied within three minutes. For every minute lost, the chance of survival drops by 10%.

Cardiac screening, also known as cardiovascular or heart screening

How can you prevent a sudden cardiac arrest?

Preventing a cardiac arrest is a very challenging thing to do. One of the best ways is to identify individuals at risk as early as possible. In order to do this, organizations like Simon’s Heart screen the hearts of thousands of children.

If an individual is identified as having a high-risk condition that could lead to a cardiac arrest, that child is referred to a cardiologist, who will come up with the best treatment plan for preventing a problem before it occurs.

How do you treat a sudden cardiac arrest?

The first thing to do is feel around the neck for a pulse. The carotid artery (blood vessel that brings blood from the heart to the brain) runs along the side of the neck. If you press over the area with your fingers, you will feel a pulsation if someone is alive.

To practice feeling a carotid pulse, feel along one side of your neck until you notice the pulsation. The pulse is almost always in the same location. If the individual does not have a pulse, then they have suffered a cardiac arrest. You should immediately call 911 and start performing CPR. If the person does have a pulse, it’s not cardiopulmonary arrest. If you think there is an emergency, always call 911.

If you think someone has suffered a sudden cardiac arrest, follow the Chain of Survival:

  1. Call 911
  2. Get an AED
  3. Administer CPR

The goal of treating someone who suffers a cardiac arrest is to restore blood flow to the organs of the body. When a person suffers a cardiopulmonary arrest, their heart stops pumping blood to the body so the organs do not get the oxygen that they need to function. If the blood flow is able to be restored with CPR or an AED, then it is possible for the individual to survive the event.

AED cardiac arrest

Automated external defibrillators (AEDs)

Automated external defibrillators are one of the most effective treatments we have for cardiopulmonary arrest that is due to certain types of dangerous heart rhythms.

AEDs are devices that can be attached to the chest wall of an individual who has suffered a cardiopulmonary arrest. The device functions by monitoring the person’s heart rhythm and determining if it is one of the irregular heart rhythms that can be shocked back to normal to save someone’s life.

Unfortunately, not all cardiac arrests can be helped by an AED, but many can, and an AED that is appropriately used can be the difference between life and death. Fortunately, AEDs are located in many public areas including airports, malls, and schools.

Cardiopulmonary resuscitation (CPR)

CPR is a skill that every adult should have. In addition to calling 911, and understanding how to use an AED properly, being able to perform CPR is one of the most important steps to take in order to save the life of someone who suffers a cardiac arrest.

The goal of CPR is to perform chest compressions that help the heart to resume pumping blood to the organs of the body. Being trained in the correct way to perform CPR dramatically increases your chance of saving someone’s life. There are many organizations that teach CPR skills to all age groups. Alternatively, if you attend a local Simon’s Heart screening you can learn the basics of performing high quality CPR.

For anyone who survives a cardiopulmonary arrest, there is always a concern that it could happen again. For the majority of individuals who survive one related to a dangerous heart rhythm, there is the possibility of surgically implanting a defibrillator (ICD).

There are several types of ICDs that can be used in order to prevent an episode of cardiopulmonary arrest. ICDs work by monitoring the heart rhythm, identifying any dangerous heart rhythms, and if needed, delivering a shock or other therapy to get the person out of the dangerous rhythm.

What causes cardiac arrest in children?

There are two types of heart conditions that lead to sudden cardiac arrest in children: structural and electrical.

A structural defect, like cardiomyopathy (enlarged heart), prevents the heart from working properly – it’s too big or the parts are in the wrong place.

An electrical defect, like Long QT Syndrome, interrupts the heart’s rhythm, resulting in a dangerous arrhythmia, or abnormal hearth rhythm. These conditions are usually hereditary, but can be acquired in some instances.

There are also certain infections that attack the heart and lead to either structural or electrical problems. Some medications can affect the heartbeat and cause harm. Finally, substances like caffeine and recreational drugs can make the heart race, resulting in an arrhythmia.

Sudden cardiac arrest in children

What do the symptoms look like for children?

Cardiopulmonary arrest does not always have warning signs. When it occurs the symptoms are similar to what it would be for an adult. The person child will be unresponsive, may be shaking with seizure like activity, and will have no pulse. When warning signs do occur, they can include:

  1. Fainting or seizures during or immediately after exercise
  2. Unexplained shortness of breath
  3. Dizziness
  4. Extreme fatigue
  5. Racing heart (feels like it is beating out of your chest)
  6. Sudden and unexplained death of a family member under the age of 50 (e.g. drowning, auto accident, SIDS)

If a child is having these symptoms they should see a doctor to figure out the cause.

How common is cardiac arrest in children?

The American Academy of Pediatrics estimates that 2,000 children die every year from cardiopulmonary arrest. It is the leading cause of death of student athletes. However, the exact number is not well established, and is likely even higher.

In 2013, the Center for Disease Control and National Institute of Health launched a pilot program to gather data on sudden death of minors in ten states. Until we have the right data, we cannot know the answer to this question – after all, if a child dies in a pool, or a teenager in an unexplained car accident, their heart may have been the ultimate culprit.

How Simon’s Heart is helping our youth?

Simon’s Heart provides free youth heart screenings in the Greater Philadelphia area. If you live in other parts of the country, you'll also find all the information you need to find a heart screening organization near you.

You should also be prepared to help if cardiopulmonary arrest strikes. With two hands and an easy-to-use machine, you can save someone’s life. Learn about the Chain of Survival.

How can you help save our kids by supporting our cause?

There are many ways to support Simon’s Heart. Whether through donations, volunteering, or facilitating a screening at your local high school, we are always looking for additional partners and champions to bring attention to our cause.

Please Donate Today to Help Our Cause (click here to access our donation form). We are a non-profit organization dedicated to preventing sudden cardiac arrest in infants and children. We need all the support we can get.

With your help and support, we can continue to work toward our goal of preventing every possible sudden cardiac death.

Sudden cardiac arrest prevention