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Cardiac Emergencies - An Overview

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Cardiac emergencies are common and life-threatening. Seeking prompt medical treatment without delay can save lives. Read the article to know more.

Medically reviewed by

Dr. Isaac Gana

Published At November 3, 2022
Reviewed AtApril 11, 2023

Introduction:

Cardiac emergencies are heart-related emergencies that lead to death without immediate medical treatment. Awareness of the common symptoms of cardiac emergencies is necessary to seek immediate treatment. The chances of survival improve with prompt medical care. Emergencies of the heart include:

  1. Heart attack.

  2. Cardiac arrest.

  3. Unstable angina (worsening chest pain due to decreased blood flow to the heart).

  4. Heart failure.

What Is a Heart Attack?

A heart attack (myocardial infarction) is a medical emergency in which blood flow to the heart is cut-off. Heart attacks occur due to constriction and blockage of blood vessels that supply oxygenated blood to the heart. This lack of oxygen supply damages the heart muscles and leads to a heart attack.

What Are the Causes of a Heart Attack?

The causes of heart attacks include the following:

  1. Coronary heart disease - The heart's major blood vessels get clogged with clots or fat and can result in a heart attack. The risk for coronary heart disease increases due to smoking, a high-fat diet, diabetes, high cholesterol levels, obesity, and high blood pressure.

  2. Drug misuse.

  3. Lack of oxygen in the blood or hypoxia.

What Are the Warning Signs of a Heart Attack?

Not all heart attacks are intense and sudden. They exhibit a wide range of symptoms varying between individuals. The most common warning signs to look for include the following:

  • Chest discomfort that does not go away, pressure or tightness in the chest.

  • Chest pain radiating to the left arm.

  • Intense central chest pain.

  • Radiating pain (to both arms, jaws, back, or stomach).

  • Breathlessness or shortness of breath.

  • Cold sweats.

  • Dizziness or fainting.

  • Increased heart rate.

  • Faint heartbeat.

What Is a Cardiac Arrest?

Cardiac arrest is a sudden and abrupt loss of heart function. Faulty electrical and mechanical activity of the heart muscles causes irregular heartbeats. If left untreated, the heart stops pumping blood efficiently. This decreases blood flow to different body parts, including the brain. Cardiac arrest is different from a heart attack, though heart attacks can cause cardiac arrests. It is a life-threatening condition and can cause permanent brain damage and death without immediate medical treatment.

What Are the Symptoms of Cardiac Arrest?

Often, there are no warnings before a sudden cardiac arrest. The most common warning signs to look for include the following:

  • Unconsciousness.

  • Loss of pulse.

  • Breathlessness.

  • Sudden collapse.

  • No breathing.

  • Chest discomfort.

  • Increased heart rate.

  • Irregular (fluttering) heartbeat.

What Is Unstable Angina?

Unstable angina (chest pain) is also known as an acute coronary syndrome. It presents as worsening or persistent pain in the chest or chest discomfort, often during rest. The coronary arteries supply blood to the heart. These arteries, when blocked by fatty buildups or clots, the blood flow to the heart is reduced or cut off. Unstable angina requires emergency care. It puts the person at risk of life-threatening cardiac arrests and heart attacks. Immediate medical attention to unstable angina can help prevent progression to other heart emergencies and save lives.

What Are the Symptoms of Unstable Angina?

Unstable angina must be suspected if the chest discomfort or pain:

  • Occurs during rest or sleep.

  • It is unexpected (during little physical activity).

  • It is persistent.

  • Worsens with time.

  • Does not go with rest or medicine.

What Is a Heart Failure?

Coronary artery diseases, heart attacks, heart valve diseases, high blood pressure, and alcohol and drug abuse can cause heart failure (congestive heart failure). Heart failure can be chronic (long-standing) or acute (sudden onset). It is a heart condition where the heart cannot pump blood efficiently to other body parts. As a result, the heart’s wall becomes thick or thin to normalize blood flow. In addition, the pressure in the heart increases over time, leading to fluid retention in the legs (lower parts of the body). Shortness of breath is also commonly seen in heart failure patients as the blood backs up to the lungs, causing fluid buildup. The signs and symptoms of chronic heart failure can be improved with proper treatment and lifestyle changes. But acute heart failure with sudden severe symptoms is life-threatening and requires immediate medical attention.

What Are the Warning Signs of Heart Failure?

The various signs and symptoms of heart failure include the following:

  • Shortness of breath (at rest or exercise).

  • Swelling in the lower part of the body (legs, ankles, and feet).

  • Fatigue.

  • Weakness.

  • Difficulty performing physical activities (inability to exercise).

  • Irregular or rapid heartbeat.

  • Persistent wheezing or cough.

  • Abdomen swelling.

  • Fluid buildup in the body.

  • Lack of appetite.

  • Nausea.

  • Loss of responsiveness.

  • Decreased alertness or difficulty concentrating.

  • Pain in the chest (if a heart attack has caused heart failure).

When Should We Seek Emergency Care for Heart Failures?

Emergency medical care is essential in case of:

  • Pain in the chest.

  • Unconsciousness (fainting).

  • Sudden and severe breathlessness or shortness of breath.

  • Sudden and severe cough (with foamy, white, or pink mucous).

  • Fluttering heart (rapid irregular heartbeat).

  • Severe fatigue and weakness.

How Can We Handle Cardiac Emergencies?

At times, it may be challenging to differentiate a simple chest pain from an emergency. In case of doubt, call for immediate medical care to prevent delay in treatment. If the heart stops functioning during a cardiac emergency, it can result in permanent brain and organ damage within a few minutes. In worst-case scenarios, the lack of oxygen supply to the body can lead to death. If a heart-related emergency is suspected, quick action is mandatory. It is advisable to call for emergency care as soon as possible to improve survival. Every minute delay in medical treatment reduces the chance of survival and recovery. The four steps that enhance the chance of survival in a cardiac emergency are:

  1. Immediately seek emergency care.

  2. Cardiopulmonary resuscitation (CPR) can save lives till medical help arrives (use only when trained).

  3. Using a defibrillator.

  4. Advanced emergency medical treatment in a hospital setup.

Can We Prevent Cardiac Emergencies?

If a person has known heart disease, it is possible to prevent life-threatening emergencies by following a few important steps:

  • Take the prescribed heart medications regularly.

  • Keep up with follow-up appointments with the cardiologist (heart doctor).

  • Reduce and manage your risk factors:

  • Healthy lifestyle changes like quitting smoking, maintaining a healthy weight, eating healthy foods, and staying active physically.

  • If you have other conditions like diabetes or high blood pressure, keep them under control and take appropriate medications regularly.

Conclusion:

Heart-related emergencies can present with a wide range of symptoms. We must be aware of common emergency warning signs like radiating chest pain, abnormal heart rate, fluttering heart, difficulty breathing, or unconsciousness. Time is a crucial factor that can affect a patient's chances of survival. The quicker the medical treatment is initiated, the better the survival. It is mandatory to seek immediate medical care if a cardiac emergency is suspected, as it is life-threatening.

Frequently Asked Questions

1.

Which Cardiac Emergency Occurs Most Frequently?

Acute myocardial infarction, also known as heart attack, is the most common cardiac emergency. It occurs when the blood supply to the heart ceases abruptly, leading to tissue damage. A blockage in the coronary arteries causes acute myocardial infarction.

2.

What Are the Various Steps of CPR?

The seven steps of CPR (cardiopulmonary resuscitation) include
- Step 1: Call the emergency contact number 911 for assistance.
- Step 2: Access the emergency scene.
- Step 3: Open the airway of the victim.
- Step 4: Check for breathing.
- Step 5: Perform 30 chest compressions.
- Step 6: Deliver 2 rescue breaths.
- Step 7: Repeat until an automated external defibrillator or an ambulance arrives.

3.

How Is Cardiac Emergency Managed?

A cardiac emergency is managed by seeking immediate emergency care. Also, starting cardiopulmonary resuscitation (CPR) as soon as the advanced help arrives can be life-saving for a person. This is followed by using a defibrillator and giving patients advanced emergency medical treatment by admitting them to the healthcare center.

4.

What Are the Medications for Cardiac Emergency?

The medications for cardiac emergency include:
- Aspirin.
- Nitroglycerin.
- Beta-blockers.
- Statins.
- ACE inhibitors.
- Morphine.
- Blood thinning medicines.
- Thrombolytic or fibrinolytic clot busters.

5.

Where Do Most Cardiac Emergencies Take Place?

 
Research suggests that almost 70 % of cardiac emergencies occur outside the hospital in residences or homes. In addition, approximately 18 % occur in public settings and about 11 % in hospitals. The survival rate of out-of-hospital cardiac emergencies may increase if CPR (cardiopulmonary resuscitation) is performed on time.

6.

What Is Meant By High-Quality CPR?

High-quality cardiopulmonary resuscitation (CPR) is the one that meets the performance and standard metrics set by International resuscitation guidelines. High-quality CPR involves chest compressions of sufficient depth, performed swiftly to revive the patient. It generates high blood flow to a person's vital organs and brain and delays cell death.

7.

What Drug Is Used During CPR?

The drug of choice during CPR (cardiopulmonary resuscitation) is Adrenaline (Epinephrine). The drug is administered to the patient every three to five minutes during cardiac arrest. In addition, vasopressin can be administered as a substitute for the second or third dose of adrenaline.

8.

When Is CPR Performed?

CPR or cardiopulmonary resuscitation is performed in cardiac emergencies, such as when a person stops breathing or a heart attack occurs. It is usually performed on an unresponsive or unconscious person. Cardiopulmonary resuscitation is successful only when performed on time and as soon as possible.

9.

How Many Chest Compressions Are Recommended per Minute for CPR?

The chest compressions recommended at a rate of 100 to 120 per minute for CPR (cardiopulmonary resuscitation) is
- 30 compressions to 2 breaths for adults.
- 15 compressions to 2 breaths for children

10.

Is Nose Blocked During CPR?

The nose can be pinched and blocked during CPR to give two rescue breaths to the person. This blows air into the patient’s mouth and inflates the lungs.

11.

Why Can CPR Not Be Performed on a Bed?

CPR (cardiopulmonary resuscitation) cannot be performed on a bed because shallow chest compressions are ineffective in reviving the patient. Therefore, to achieve the maximum chest compression depth, make a person lie on a hard and flat surface during CPR.

12.

What Are the three Reasons to Stop Giving CPR?

The three reasons to stop CPR are
- If the patient starts responding, opens their eyes, or starts breathing.
- A person performing CPR gets exhausted.
- Obvious death.
- Advanced support arrives.

13.

How Many Rounds of CPR Are Recommended Before AED (Automated emergency Device)?

Five cycles of 30 chest compression to 2 breaths must be performed before AED because it allows the automated emergency device to analyze the rhythm. Then, the CPR should be continued until the AED shows rhythm restored or till the AED arrives.
Dr. Isaac Gana
Dr. Isaac Gana

Cardiology

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heart attackcardiac arrest
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