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If we only knew how to prevent Sudden Cardiac Arrest and death.

DrD11
0 Recommendations

Today we know how to rescue an individual,who sustains cardiac
arrest and death. Thanks to CPR,Defibrillators and ICD's,lot of
people are rescued.Still,this population constitutes only 5% of the
total number of persons estimated to sustain S.C.A. and S.C.D.
If we could screen and predict this coming tragedy,we could
prevent a whole lot more such disasters.
I wonder if anything is known in this issue.Something practical
available to the masses(And affordable).
Please do not relate to risk factors,as these are not practical
enough.

Explore topics in this discussion:

Exercise Surgery Sudden cardiac arrest Falls Syncope Anxiety Long QT syndrome Stent Arrhythmia Hydrocephalus Stroke Diabetes Hypertension Memory Brugada syndrome Heart attack Obesity

29 replies

janee

This type of prediction would be like knowing who survives SCA and has no brain damage, has moderate brain damage, and severe brain damage. And even if we did know cardiac risks ahead of time, who are we to make the decision as to whether to agressively use resuscitation. Take it to a medical ethesist.

janee

I am sorry if my first reply is filled with sarcasm. My husband was being followed very closely for a MVP with severe regurg. He had a heart cath just 1 1/2 months prior to his SCA. He also has hemachromatosis. He now has a significant brain injury. I say that I went to sleep with my husband and awakened with a stranger. He has maintained a high IQ but cognitively is very different. I am an RN, there was a paramedic and an MD in the restaurant when my husband went down. He had the best CPR possible between the three of us, the firemen were excellent and had him intubated a bagged within several minutes but heart not started until after 8 minutes. Now I have a stranger for a husband who looks like my husband and I am worn out trying to keep him out of trouble making poor decisions. Maybe the medical field has gotten too "godly" and should allow natural death to take place. As my husband says, "it doesn't hurt to die, I don't remember a thing." My kids and I remember everything!!!! A good outcome is considered a save. Perhaps a "save" needs to be redefined. What do you think, Doc. We families are left to live with the saves.

DrD11

The question: "If only we knew how to Prevent S.C.D",was never
intended to put a doubt in peoples sincerity and devotion, to each other.When tragedy occur,we all hurt,specially those directly involved.
Trying to avoid tragedies, has been the history of mankind.
When unsuccessfull,we raised our hand,and put it in the realm
of faith and luck.
In the case of Sudden Cardiac Arrest and Death,everybody did and does the best they could.This site of the S.C.D. association
is a testimony to it.
The invention of the Defibrillators and the development of I.C.D,
are Godsend . It does save lives,and we are all thankfull for it.
Risk factors,as part of any History and Physical,are of utmost importance in life.
Doctors visit,occurs all time.In the society of mankind,everybody
practice medicine:The Physician,the Nurse,the Paramedic,the
Bystander etc.Anytime you are giving care, you are a Caregiver.
A complete H&P is a must.
Like in any tragedy,we treat it with two steps approach"Search"
and "Rescue"(In Medicine it is called:"Diagnosis and Treatment")
Big strides were made in the "Rescue" part of S.C.D.
Today we are trying to have more achievements in "Search"
The development of Telemedicine,i.e. monitoring a person from
a distance, is Prevention.
Starting with the Apollo mission to the moon we could know,and
see his cardiac activity of the astronaut, on that planet,as it occured.
Today we still do not have the mean to see the heart at the time of any Physical Examination.We must see the heart at the same time we listen to it.
Today,Medicine is in crisis,Financial and Moral.(Written and published)
In the attempt to do better,a call was issue:"Prevention!"
What can I do about it?.This is the question.
Respectfully
DrD11

janee

As to prevention, we cannot look at the heart without also looking at the brain. It all works together. Should my husband have had a valve replacement and his SCA would have been prevented? I don't know nor do the doctors. His ferritin and iron saturation levels were good; he had just been phlebotomized. But perhaps his heart still contained too much FE. Who knows?
A young athlete heart stops--maybe just misfires. An AED is not next to the coach who is not next to the player--or people are human and hesitate at the site of the young person who just experienced SCA. Brain injury occurs rapidly. Should that young person be resuscitated with the big possibility of brain damage that will affect the rest of the lives of his family. I don't know. Perhaps we are trying too hard to play "god."
Perhaps our screwed up health care could better put it's dollars towards prevention of hydrocephalus, cancers, etc. to prevent all the suffering. I think the suffering that families and patients experience following brain injury can sometimes be much greater then death itself.

Leenie

Hi, I just wanted to say something here. I suffered SCA and I have a TBI. I thank God,the EMT's and all the Dr's everyday. And I also thank god everyday for Kessler Inst. in west Orange NJ for everything they have done for me. They have a wonderful CRP program. My husband and I are injoying his retirement very much. For what it worth!! Leenie

Lydjahh

My personality has changed since my SCA. I did very well on a battery of neuro-psych testing and my IQ is the same (127) as it was. I have become scatter-brained and passive and have great difficulty making simple decisions.
To answer Doc's query...physicians need to pull out all the tools in the arsenal and treat any abnormal heart rhythms aggressively. My cardiologist put me in the hospital and took me off all medications that might cause long QT syndrome. I was on my way to having my ICD and was wearing an event monitor when I arrested!

Paul_Pakusch

I was talking with my wife in the kitchen when she suddenly collapsed from SCA. A wonderful 911 operator talked me through CPR until firemen arrived. Her heart was stopped for at least 8 minutes. They got it going again on the second shock. It was very grim. After an amazing cooling therapy and a lot of recovery, she seems completely normal today, except for the ICD she needs. It blows my mind that she beat the odds to be where she is today.

I don't believe it's our place to play God and decide whether to help a SCA victim or not; or a victim of anything, for that matter. No matter what the injury or illness, I believe it is the responsibility of each and every one of us to do whatever we can to help each other. Some will survive intact, some will not. It's not for us to make that determination during the moment of crisis.

DrD11

My reply:

Amen.

As you wrote:"It's not for us to make that determination during the moment of crisis."I, absolutly, agree.
The question is:"Can we do something before the moment of crisis?".More than what we are doing now.

Debra71508

On July 15, 2008 - just a little over 2 weeks ago my 53 year old husband suffered his second SCA while we were walking in the woods with our dogs. He fell down right in front of my eyes & because this had just happened (on 2/21/08 - another story) I knew it was a SCA. I called 911 from his cellphone at 9:10. I did rapid, hands only chest compressions as currently suggested by the American Heart Association, and the EMTs arrived at 9:20 according to their records. 10 minutes. At one point I knew without any doubt that he had nothing going for him but me & I just kept at it. He was defibbed & as it turned out the LAD stent that had been placed on 2/21/08 had a new blockage due to scar tissue.

He is home today with no brain damage. New medicated stent & an ICD. I am a twitching, jumpy, nervous wreck but he's doing great.

There is no way to know in advance who will suffer what after SCA. After the first SCA, when it looked like there was going to be some serious brain injury, after I cursed and wept, I promised myself that I would accept him in what ever condition God (or whoever) decided to send him back to me. I don't know if I would have been able to keep that promise and I am grateful not to have been tested.

janee

I appreciate and am pleased that there are so many good outcomes. I guess my husband didn't get so lucky and obviously I am still very angry but don't know who to take it out on!! Cooling was not used on my husband and may have made the difference. Also he continued to go into v-fib during the entire night after his SCA. He has gone from being a very kind, caring, concerned man to one who is extremely ego -centric. My Dad died just a year afterwards and my husband was unable to give me any empathy. It is just tuff and I know that there are others like me out there. I am truly sorry for those families and pleased so many of you have good outcomes. As an RN, I hope to never have to help someone in SCA again unless it is in a hospital and controlled setting. I am sure that I would give it my all tho. Good luck to you all.

MoJo

Since cardiovascular disease can lead to SCA, there is a good screening tool for that disease and it is a coronary artery scan, otherwise known as a heart scan. The scan is non-invasive and measures a person's coronary calcium score--the higher the score, the more likely you are to have a "cardiovascular event", which could be a heart attack, stroke or SCA. For more information see www.shapesociety.org. Costs of scans vary, but in the Baltimore area, they are under $100 at leading hospitals. Not covered by insurance, but well worth the cost to see if you are at risk.

DrD11

Calcium Scan,is a good test to have.This test answers the question if a plaque is calcified.
It also identifies the existance of the plaque.
Since big part of the plaques are not-calcified,this test does not detect it.(MRI of the heart will detect it).
The "Soft" plaques rupture more easily than the "Hard"Plaques,cauing coronary occlusion.
Let us not forget that Cardiac Arrythmias are the
"Bigger killer" in S.C.A.

drjose

Hi,

I am not a medical doctor so don't get confused. PhDs also used the DR. before the name and many times I get questions about health that I am qualified to answer.

However, as a SCA survivor, I have found that prevention should include the way we eat, work, streess, exercises, etc.

I se every day that we do not know how to eat well and our children are going in the same direction, we do not exercise well and our children are doing the same. We need to lead by example.

Go to your favorite supermarket and see the families and their shopping carts. My wife says that the secret is to learn to buy food.

Prevention can be done in many ways and I am doing my part by teachig others how to have a better daily life.

Have fun,

Jose

Camping in a Scout reservation as staff of the National Youth Leadership Training Brownsea XXVIII. Back to the woods two months after my SCA, and kept doing it every month. (Yes, we have Internet, cell phone signal, and a brand new AED donated to the camp by St. Vincent's Hospital.)

DrD11

Hello
You are correct in emphsizing Lifestyle modification.
Doctors are notorious to have little knowledge about nutrition.Therefore,nutrition,is a neglected subject.The public is not less negligent,in not paying attention, to what they eat and why.
Willing to have a "Quick fix",we eat fast,fast food.
When our arteries get clogged,we speed into surgery and then suffer some consequences.
Then we complain:"Why me".
"Stop whinning and do something",somebody said it recently.Prevent,prevent prevent.This is what medicine is now start to turn to.Unfortunately it turn too slow.Someone got to do something about it!

Tammy1

I suffered a Sudden Cardiac Arrest October 23, 2007. There has been no diagnosis, no long Q-T syndrome, nothing. I have had syncope for years and then the SCA. I have been researching and studying for the last 8 months. I looked at WPW that has some of my symptoms but then I found a syndrome called Brugada Syndrome that is right on target with all of my symptoms. I think would be of interest for some to look into.
I have contacted him and he has agreed to look at my file. I am having a electro-physiology test soon to be sent to him as well. Hopefully we have an answer soon.
Hope this helps.

Debra71508

Drjose:

So you have a Ph.d., so does my husband and from MIT - like it matters in the least given all this? YEAH smart dude but he can be an eggplant in 4 or 5 minutes? So can we all?

FACT: My darling husband's risk factors (we know them all and well from family to pre-SCA test of every sort) did NEVER, EVER place him in a high or near high risk group. To this day when you "plug" in my husdand's pre-SCA known risk factors (family hx, smoking, diet, weight, chol levels, exercise patterns) he still falls into "low" risk levels.

YET he had SCA TWICE THIS DAMN YEAR!!!! - 2 times - TWO - (I am still totally freaked about this) in 2008.

February 21 and July 15 and only NOW after the last attack am I begining to get the diff between SCA and "heart attack." The only common factor was that I happened - by sheer dumb luck - I to be there both times and called 911 and did what I could to keep him alive via my lousy but apparently adequate CRP skills as learned from a late 1960's Girl Scout's (God Bless them - i.e., do not be afriad and don't freak out & please be useful & the new Heart Association public service anounncements about Hands Only CPR.)

Hands Only CPR is more - far more- resonable than you'd think when you look at the research behind it.


Both times it was enough but the Grace of GOD - not me, I know since I don't even believe in God -although these events are challenging my prior ideas about it.

drjose

Hi,

I went to MIT to get my MS. I am a survivor of the Blizzard of '78. haha.

I also believe that I was saved by the grace of God. I don't know anyone surviving a SCA with 45 minutes of CPR and 5 AED shocks. Maybe I should be in the Guinness Book of Records. :-)

The power of prayers was vital for my recovery. My wife prayed so hard and the prayers' chains were in churches in Jacksonville, Florida, Miami, Atlanta, and other countries.

I thank God every day for this second opportunity to share these thoughts and live better.

Jose

Mary1

Hi Debra,
Your comments caught my attention because you sound so much like my husband from when I had my SCA in July 2006. He never had any prior CPR training, yet he saved my life with the help of the 911 operator (whom we've both met since then!)... Anyway, while I was in the hospital and my family was told I would most likely die or be in a vegetative state, he was furious with himself for not being able to do enough. Even today, with a full recovery, he still won't believe he was the primary factor in the chain of survival that kept me alive.
I had a 2nd SCA last December. Luckily I also had an ICD. But it brought back many bad memories, especially for Paul. I am going to show him your letter. I think you could really benefit from talking to someone who felt as helpless as I'm sure you did.
Take care.
Mary

DrD11

Hello Mary1.
Your comment hit the point that I am trying to make.
You wrote:"...He was the primary factor in the chain of survival that kept me alive,"
In todays "Chain of survival",we still do not have the
ability of the bystander,who happen to come across a
person"Down",to function as E.M.T.
When one says call 911,it means that defibrillation
will occure when this proifessional arrives with this
tool.Everybody knows the value of "Time lost" "The 10 Golden Minutes".
I wish for everyone who gives care to be able to function as a full fledged Care Giver.
This idea of mine was already published.(see my
Profile in this publication),
P.S.I am not Debra.Just a Guy.

Debra71508

Mary!

How is Paul doing now? Still twitching? I can't sleep through the night, most nights, yet. I'd love to talk to someone who's been there. My husband (Chris) claims this has been harder on me emotionally than it's been on him. I am not sure he's wrong. I've been having a very hard time with pretty dark thoughts and random anxiety. I'm not normally jumpy or crabby but I've been both lately & I hate it.

As for diet, "let me say this about that" as our former President liked to say: I love to cook fresh, wholesome foods from scratch. It's creative, relaxing and rewarding since you get to eat the results of your efforts. Christopher has had something like 3 servings of french fries in the 10 years we've been together. I've seen him eat fastfood probably once a year. Diet, in his case as with so many others, had nothing to do with it. Although everyone would benefit from a thoughtful well balanced diet, I sometimes think we seek SCA protection from risk in places that are only partly (and sometimes never) related to risk.

You know since all this I have gotten a bunch of my friends to take CPR class & I've sent out the Am. Heart Assoc. video on chest compression only CPR. As a link in that "chain of survival" that you mentioned, Mary, I hope we all help make more links in the survival chains of others. I've got to turn my gratitude outward, right?

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