08/12/2009 12:00 am
POV
Surviving Sudden Cardiac Arrest, by Dr. Holly Andersen
Dr. Holly Andersen
Editor’s Note: Dr. Holly Andersen is dual board certified in Internal Medicine and Cardiology, is a Fellow of the American College of Cardiology and the American College of Sports Medicine and is an assistant professor of medicine at the Weill Cornell Medical Center. Dr. Andersen has been selected as one of America’s "Best Doctors" every year by Castle Connolly since 2001, and in 2008 was named by the Consumers’ Research Council of America as one of "America’s Top Cardiologists."
An estimated 400,000 Americans die every year from sudden cardiac arrest (SCA). The recent tragic deaths of Michael Jackson and Billy Mays remind us all of how someone can be so alive and seemingly healthy one moment, and be gone the next. In fact, SCA is one of the leading causes of death in the United States. It occurs when the heart’s rhythm is disrupted, becomes chaotic, too fast, and can therefore no longer pump blood in an efficient manner to the brain and body (ventricular fibrillation). For every minute that passes without restoring the heart to a normal rhythm – "defibrillation" – survival decreases by 10%. Less than 7% of SCA victims survive – mostly because they are not defibrillated in time. After only a few minutes without defibrillation, most attempts at resuscitation are unsuccessful.
Sudden cardiac arrest does not just occur in old or diseased hearts – a young athlete dies every three days from this form of sudden death. In 490 BC, a young Greek messenger, Phidippides, ran 26.2 miles from Marathon to Athens to deliver the news of the Greek victory over the Persians, and then collapsed and died. This is the first recorded incident of sudden death in an athlete. It occurs in up to one in 100,000 athletes annually, predominantly striking males. In the United States, two-thirds of sudden deaths in athletes have occurred in basketball, like sports stars Hank Gathers and Pistol Pete Maravich; and football, including all-pro Minnesota Viking Korey Stringer.
Dramatic footage on YouTube shows the sudden deaths of several international soccer players including the beautiful 25-year-old Miklos Feher, who, in 2004 during a televised game, collapsed on the field. His teammates watch and cry, stunned and in disbelief – but no one runs out with a defibrillator to save his life. Other well-known athletes who have succumbed include Flo Hyman (Olympic volleyball star, 1986), Sergei Grinkov (Olympic figure skater, 1995) and Darryl Kile (all-star pitcher for the St.Louis Cardinals, 2002).
Over the age of 30, the most common underlying cause is coronary artery disease – or blockages in the arteries that supply the heart with blood. If this blockage, from atherosclerotic plaque, ruptures, it can completely block blood flow to a portion of the heart and not only cause a heart attack, but trigger ventricular fibrillation and subsequent sudden death. People who have survived a heart attack are also at an increased risk of sudden death; the decrease in heart function and the scar from the damage done both increase the risk of a life-threatening rhythm.
The most common condition causing SCA in athletes younger than 30 in the United States is "hypertrophic cardiomyopathy," which is almost always an inherited disorder. In this condition, the heart muscle is disordered and thickened. A congenital abnormality of a coronary artery (the heart’s artery) is the second most frequent cause of athletic field deaths in the United States. But SCA can also occur in a perfectly healthy young heart when a precisely timed blunt impact is delivered to the chest wall (most often from a ball or a bat), disrupting the heart’s electrical activity, a condition known as "commotio cordis."
Drugs, both prescription (antidepressants, antipsychotics, narcotics, stimulants and some antibiotics) and illicit (cocaine, methamphetamine) are also known to increase the risk of SCA. Interestingly, anger and acute stress can also contribute. Studies have linked earthquakes, war, the loss of the World Cup Soccer match and Monday mornings to increased rates of sudden cardiac death.
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Dr. Andersen, I had cardiac arrest on June 4, 2008 - but I was on an operating table. It happened about 30 minutes into ear surgery (stapedectomy). The blood pressure (always outstanding in me) soared, and the heartbeat slowed to zero. There was a concoction of at least six medicines in the anesthesia.
I underwent a battery of allergy tests at the U of M this past April, and the only thing I tested postivie for on the skin test was a minor allergic reaction to Labetelol. Fortunately, followup stress and heart-catherizations revealed no damage.
I went back for the ear surgery on July 15, 2009, and asked them to use local anesthesia (only 3 medications this time), and sedation. The surgery went well; hearing has improved slightly (hopefully more in a couple months).
James, because of such a situation, I mediated through an angiogram last month after a "wide complex" event on a Life Wave monitor. I kept saying my heart was all right, but who believes us. I was skewed to a point, because all of my cousins (males) died of spontaneious cardiac arrest in their 40s; however, I did not smoke, and led a healthier lifestyle, plus swimming most of my life since Polio. What no one thought about, in IM/Cardiology, was the Polio, and the fact that I’m on a volume ventilator (not invasive); hence they did not call the specialist who oversees that all for me - in spite of me handing everyone his information and they agreed it would be done!
The test where they electrically stopped my heart - i was given 2 drugs that should not be given for anyone with a neuromuscular disease/condition (NMD) - affecting the muscles (diaphragm in my case), by the anesthesist in spite of them being on my RED armband, and a Medic-Alert bracelet. I crashed without the cardiologist’s drug!!!
I’m now on a campaign to alert the world to neuromuscular breathing conditions, such as Polio survivors, post-polio syndrome, ALS, Muscular Dystrophy, CP, et al (and many of the autoimmune diseases). If doctors would only realize that the world’s top experts are at their beck and call (that is why they are EXPERTS), so they don’t have to harm patients by trying to practice solely alone, and know who those experts are - or at least contact NIH! It’s free! Many doctors care, and they care very much. In many cases, with anesthesia reactions, there may be an underlying NMD there.
That is what Project Blue Whale is all about! ;-))
Thank goodness you are all right, but … it’s hell being "brought back," isn’t it!!!!
My poor momma of 89 yrs of age dies of C.A. She had Cardiac Heart Failure and fluid in the lungs; the doctor told me her heart was very swollen.
My mother died on 07/09/09 in her sleep as I was told by the nursing home staff.
At least she is no longer suffering but I miss her so very much :,(
Tina, you may never fill the void that the true essence of your Mom in your life because the absolute origins of each of your beginnings was part of the other, so don’t try. If I may offer something that may give you relief, try to write to her… you are probably already talking to your Mom. Sometimes, not always, writing to someone you "lost" in any way helps the vacuous impart of their absence from your life. "Visiting" her, in real life at the place of her burial if there was one, or in your heart, and/or mind though deep mediation. In case of the latter, once you are able to gain a depth of meditative existence, "someone" will be there for you, if in fact it may be your own subconscious; it’s never failed me at such times, nor in times of severe physical pain. (Healing sounds CDs help this, as well as "anything" Enya.)
My greatest loss is still one of my best friends - indeed, a sister, my self, in the truest sense. And, when the time came, she wanted me, or to die alone - I was not there, but "on the way," b/c her husband did not contact me in time (a totally different topic - how women view their husband’s reactions to their wives female sisterhoods).
Lastly, Tina Marie, five years from now you will only remember episodes of this time, in fact, you will realize that you had to "skim" over the top of your daily existence, so do not try to examine, nor judge yourself, now. Do what your Mom would tell you to do, and as a mother of adults I am certain it would be to take care of yourself, first, then examine the aspects of your Mom’s personality that you admired, and build on any thread of those in yourself. IMHO, there is such a "thing" as genetic ‘memory;’ hence, perhaps our ESP abilities.
We are all her to help you - be with you, if needed - if we can. Such is not limited, in my opinion, to this site, but to one another as humans. Hugs and more hugs - please go buy yourself a fresh flower, today! Your Mom would love that!
I have coronary artery disease, which we discovered after I had a heart attack. Fortunately I walked into the Vail Colorado emergency room at the right time and the ER followed a mandated protocol for 60 year old women that included checking to see if the reason why I wasn’t feeling well was due to a heart attack. (I thought I had the West Nile Virus.) I had atypical symptoms and it wasn’t until 30 minutes after taking my blood for a test, that they determined I was having a heart attack (much to everyone’s surprise, including me).
I was so lucky to have enough sense to go to the ER when the pain in my arms wouldn’t stop while I was on vacation in Vail Colorado. And I thank each morning, all the women who proceeded me, who had the same atypical symptoms and died before the medical establishment figured out (even though it is taught that women came out of the breast bone of men), women typically don’t have chest pain when they are experiencing a heart attack.
Please take note: if you have pain in any part of your body that won’t go away and you feel absolutely rotten, including having an up-set stomach and throwing up, you might want to consider having yourself immediately checked out for a heart attack, especially if you are over 60 years old.
Safety at work or play is important!
Accidents can occur and unfortunately do occasionallyhappen.
Just fourminutes in a medical emergency can mean the difference between life and death.
In the United States,approximately
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I help communities be heart smart and safe.
Call Tina at 518 7555168 or www.automatedexternaldefibrillatorsaed.com
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