A circulatory arrest or cardiovascular failure can have various causes. Rapid intervention is essential for a good prognosis in cardiac arrest.
What is cardiac arrest?
The patient is in acute mortal danger and brain death is imminent. Early treatment by means of a heart muscle massage can, in the best case, restore a pulse. See AbbreviationFinder for abbreviations related to Circulatory Arrest.
In medicine, the failure of the cardiovascular system in an affected person is referred to as circulatory arrest. If such a cardiovascular failure occurs, it is often defined as clinical death.
Cardiac arrest can take many forms. So-called ventricular fibrillation can be present in the event of a circulatory arrest ; the various heart muscle cells do not work in a coordinated manner, so that the heart cannot contract.
Cardiovascular failure is also possible when the heart beats too fast to fill with enough blood between heartbeats. In addition, a circulatory arrest can be characterized by the fact that although electrical nerve impulses can be measured in the heart, these cannot lead to the heart working.
Signs that can point to a circulatory arrest with a high degree of certainty are, for example, respiratory arrest, gasping or a missing pulse from the main arteries.
Sudden cardiac death is the most common cause of cardiac arrest in people in industrialized nations. Such a sudden cardiac death as a reason for cardiovascular failure can occur, for example, as a result of a heart attack.
In rarer cases, a cardiac arrest can also be caused by so-called non-cardiac causes (i.e. causes that are not related to the heart): Such causes of cardiovascular failure include, for example, respiratory arrest or pulmonary edema (i.e. originating in the respiratory tract Causes).
Various disorders affecting the brain can also lead to cardiac arrest; a stroke or traumatic brain injury, for example, can lead to circulatory arrest. Last but not least, other incidents can also lead to cardiovascular failure; such as electrical accidents or suffered shocks.
Symptoms, Ailments & Signs
A circulatory arrest is announced by paleness, cold sweat and drowsiness. Shortly before cardiac arrest, those affected are often nervous and anxious. If a heart attack or cardiac arrhythmia is the cause, the typical symptoms of the respective cause appear. This can lead to palpitations, a feeling of tightness in the chest, dizziness, stiff neck and a multitude of other signs which, taken individually, do not necessarily indicate an imminent cardiovascular arrest, but in combination they are a clear warning sign.
The actual collapse manifests itself in the affected person becoming unconscious and no longer able to speak. Typically, breathing sounds can no longer be heard at the mouth and nose. At the same time, blood pressure drops and the heart stops beating. At this stage, a zero line can already be detected in the ECG.
The patient is in acute mortal danger and brain death is imminent. Early treatment by means of a heart muscle massage can, in the best case, restore a pulse. However, cardiac arrest has serious after-effects such as confusion, physical and mental exhaustion and panic attacks. It is not uncommon for another to occur after a cardiac arrest has been overcome, usually with more severe symptoms.
Diagnosis & History
Cardiac arrest can be diagnosed with a fairly high level of certainty if the person concerned has symptoms such as cessation of breathing or a lack of pulse that affects the large arteries. Symptoms that may indicate a circulatory arrest, but may also be the result of other diseases, include loss of consciousness, seizures or dilated, rigid pupils.
The course of cardiovascular failure in an individual case depends to a large extent on how quickly appropriate measures are taken. Basically, cardiovascular failure is reversible; this means that an affected person can be resuscitated. Whether such resuscitation is successful and what consequential damage (such as brain damage due to lack of oxygen) can occur can depend in particular on the immediate measures that are taken, such as artificial respiration or cardiac massage by laypersons until an emergency doctor arrives.
Cardiovascular failure can be fatal if medical intervention is not carried out in a timely manner.
Various complications can occur as a result of cardiac arrest. In the acute phase, hyperventilation occurs first, and this is often followed by heart problems, cramps and swallowing air. The tongue is rarely swallowed by the gasping, but this can then result in suffocation. Cardiac arrest can also lead to falls and accidents.
This can result in fractures, bruises or very serious injuries, which are usually associated with further complications. If the treatment of cardiovascular failure is too late, the lack of oxygen can cause irreversible organ damage. The brain is first affected, which suffers severe damage after just a few minutes without an oxygen supply and ultimately suffers brain death.
If treated incorrectly or too late, cardiac arrest can lead to death. In addition, drugs used with adrenaline, lidocaine or amiodarone can cause side effects and interactions. Cardiac arrest often leads to cardiac insufficiency in the long term. Those affected must then wear a pacemaker and take medication for the rest of their lives. In addition to the physical consequences, this can also lead to psychological complaints and a general decrease in quality of life.
When should you go to the doctor?
If a person becomes unconscious, an ambulance must be called. A sudden drop in blood pressure and sweating can be the first signs of impending cardiac arrest. If you notice these symptoms, you shouldn’t wait any longer to get a medical check-up. Cramps or dilated pupils also require examination and treatment. At the latest when gasping, neurological disorders or cardiac arrhythmias are noticed, this must be clarified. People who have already suffered from cardiovascular failure or respiratory arrest are among the risk groups.
Likewise, people with a history of pulmonary edema or another condition that could cause circulatory arrest. If the cardiovascular failure occurs in connection with a stroke or a craniocerebral trauma, emergency services must also be called in. Further therapy takes place in a general clinic or in a specialist center for cardiovascular diseases. Possible contact persons are the general practitioner, a cardiologist or an internist. Children and adolescents should be taken to the pediatrician when the symptoms mentioned occur, who can make a diagnosis and prepare further therapy.
Treatment & Therapy
Cardiac arrest is always considered a medical emergency. An important immediate measure in cardiovascular failure is immediate cardiopulmonary resuscitation to save the life of an affected person. In the event of a circulatory arrest, first-aid measures such as cardiac massage can be successful in the short term; In addition, however, rapid, further medical measures are often necessary, such as defibrillation or the administration of medication.
Defibrillation describes a treatment method in which an affected person receives electric shocks to animate the heart’s activity. Defibrillation can be used, for example, in cardiovascular failure caused by ventricular fibrillation or ventricular flutter – i.e. in various forms of cardiac cardiovascular failure.
Administering medication in the event of cardiovascular failure may be necessary, for example, if cardiovascular failure is caused by an accelerated heartbeat, an impaired pacemaker or other reasons that do not originate from the heart. In the latter cases, defibrillation is usually an ineffective measure for the medical treatment of cardiovascular failure.
Outlook & Forecast
Cardiac arrest is a medical emergency. The person concerned is in acute danger of death and must be treated immediately by an emergency doctor. If the necessary resuscitation measures are initiated immediately, there is a relatively high chance of recovery. The chances of survival are also based on the cause of the cardiac arrest and the constitution of the patient. According to the German resuscitation register, around 10 to 15 percent of those affected survive a cardiac arrest. The association also states that immediate resuscitation measures can double to triple the patient’s chances of survival. In the long term, around 75 percent of all survivors are able to work again after cardiac arrest.
In the first few months, side effects such as exhaustion and circulatory problems occur, which can significantly reduce well-being and quality of life. Extensive medical supervision is necessary in any case. The prognosis can be improved by strictly adhering to the medical guidelines regarding diet, exercise and the like. Then, if necessary, even a full recovery is possible. The prognosis after a circulatory arrest depends on various factors, but is in principle relatively good if the person affected survives the actual circulatory arrest.
Preventing the various possible causes of cardiac arrest is usually the most important step in preventing cardiac arrest. Cardiac arrhythmias, heart attacks and strokes, for example, are the causes of circulatory arrest that are favored above all by obesity and high blood pressure. The latter factors can be prevented, for example, through regular exercise, a balanced diet and a conscious use of nicotine and alcohol.
In the case of a cardiac arrest, those affected usually have no special options for aftercare. In most cases, cardiac arrest also leads to death if it is not recognized in time. Therefore, a doctor should be consulted at the first sign or symptom of this condition to avoid this complication.
An ambulance should be called immediately or a hospital should be visited directly so that the person concerned can receive emergency care. Further follow-up measures are usually not available to the patient. Since cardiac arrest leads to the death of the patient in many cases, the parents, family or other relatives are dependent on psychological support and advice.
Loving conversations and intensive care of those affected have a very positive effect on the further course of these complaints. It can also prevent depression or other mental upsets. If the cardiac arrest is treated, the person concerned should rest their heart after the treatment and not engage in any stressful or physical activities, as this would put unnecessary strain on the heart.
You can do that yourself
Cardiac arrest is a life-threatening situation where every second counts. The relatives or first aiders should first alert the emergency doctor immediately. Before medical help arrives, first aid measures must be taken. Very important: do not lie down the affected person, but position the upper body upwards so that the heart is relieved. In addition, tight clothing should be loosened so that the patient can breathe. Then the resuscitation measures must be started immediately. If available, a defibrillator can be used. Otherwise, a cardiac massage or mouth-mouth/nose resuscitation should be performed.
If the person is conscious, it is important to calm them down and avoid stress and excitement until the emergency doctor arrives. The patient will then have to spend a few days in the hospital. Rest and bed rest are primarily indicated.
As soon as the cause of the cardiac arrest is known, the therapeutic measures can be started. In general, light exercise such as physiotherapy or yoga, dietary measures and avoiding stress are recommended. In short: a healthy and conscious lifestyle. Additional support from family members can help to keep up with the new lifestyle habits and avoid another cardiac arrest.