Ventricular standstill is an uncommon heart condition. The name is characteristic of the problem; it refers to a heart that is not moving. A few different abnormal heart rhythms may lead to this condition. 

What Is Ventricular Standstill? 

The ventricles are the bottom chambers of the heart. The left ventricle is in charge of pumping blood to the body. When this ventricle is not moving then the heart is not pumping blood to the rest of the body. 

Ventricular standstill occurs during a cardiac arrest. It is a medical emergency. Ventricular standstill is sometimes referred to as ventricular asystole. Asystole typically refers to the absence of a heart beat and is a heart rhythm. Ventricular standstill would result from this rhythm. Other rhythms, like ventricular fibrillation, can also result in ventricular standstill. 

How Common Is Ventricular Standstill?

Ventricular standstill is very uncommon. Even among all people suffering a cardiac arrest, ventricular standstill only occurs some of the time. When a person is not able to be resuscitated successfully, observing ventricular standstill on an ultrasound of the chest will confirm that they have died. 

Signs and Symptoms

Ventricular standstill refers to no movement of the heart. Regardless of the rhythm causing this problem, if the heart is not moving, the person will lose consciousness as is common in other forms of cardiac arrest. This will occur suddenly and without warning.  

Causes and Risk Factors

Ventricular standstill is most common in people who are older and have structural heart disease, such as weakening or scar of the heart muscle. Structural heart disease may be congenital, something you are born with, or the result of illness, trauma, high blood pressure, or a heart attack. 

Some specific cases of structural heart disease include:

  • Myocardial infarction, or a heart attack, occurs when a blood vessel that gives blood to the heart becomes blocked. This occurs due to plaque buildup in the vessel. If the heart does not receive enough blood itself it may develop an unstable rhythm leading to cardiac arrest and standstill. 
  • Mitral valve regurgitation or stenosis: Regurgitation is the backflow of blood that occurs when the valve fails to seal correctly. Stenosis occurs when the leaflets of a valve thicken, stiffen, or, in some circumstances, fuse, preventing some blood from passing through.
  • Aortic stenosis occurs when the valve between the heart and the aorta, the primary artery that transports blood from the heart to the rest of the body, fails to open completely.
  • Coarctation of the aorta is minor to severe narrowing that occurs in a section of the aorta, the body's major artery.
  • Ventricular septal defects are holes in the wall that divide the two lower chambers of the heart. It can disrupt blood flow and, if very big, make the heart and lungs work too hard.

How Is It Diagnosed? 

Ventricular standstill will be diagnosed when it is noticed that the heart of a patient suffering from a cardiac arrest is not moving. This is typically done by using an ultrasound. A doctor can evaluate for signs of structural heart disease in several ways. Measuring blood pressure is an important risk for structural heart disease. Tests such as cardiac ultrasound, or echocardiogram, stress testing, or cardiac MRI can be used to evaluate the heart.  

Treatment Options

Ventricular standstill is an ominous finding during a cardiac arrest. This typically means that the person's heart is not responding to attempts to revive them. Continued resuscitation measures such as CPR, medications, and electric shocks may be required to save the person.