First Aid in case of Heart Attack

Promptly attending to an individual experiencing a heart attack at workplace is crucial to preventing additional damage. Dr. Parneesh Arora, Director, Interventional Cardiology, Max Hospital, Patparganj, talks about the mandatory do’s and don’ts before the patient is given medical treatment.

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Here's a detailed description of each cause of Cardiac Arrest, categorized systematically with mechanisms, risk factors, and preventive measures.

1. Coronary Artery Disease (CAD)

Category: Ischemic Heart Disease

Mechanism: Plaque buildup in coronary arteries reduces blood flow to the heart, leading to myocardial ischemia and triggering life-threatening arrhythmias like ventricular fibrillation (VF).

Risk Factors: High cholesterol, smoking, hypertension, diabetes, obesity, sedentary lifestyle, family history.

Prevention: Healthy diet, exercise, cholesterol control, medications (statins, aspirin), and angioplasty/stenting if needed.

2. Myocardial Infarction (Heart Attack)

Category: Ischemic Heart Disease

Mechanism: A blood clot blocks a coronary artery, leading to muscle death (infarction) and electrical instability, causing VF or ventricular tachycardia (VT).

Risk Factors: CAD, smoking, stress, high blood pressure, diabetes.

Prevention: Aspirin, beta-blockers, revascularization procedures (PCI, CABG).

3. Heart Failure

Category: Structural Heart Disease

Mechanism: Weakened heart muscle fails to pump blood efficiently, leading to arrhythmias and sudden cardiac arrest.

Risk Factors: CAD, hypertension, obesity, diabetes, cardiomyopathy.

Prevention: Medications (ACE inhibitors, beta-blockers), lifestyle changes, implantable cardioverter-defibrillator (ICD) in severe cases.

4. Cardiomyopathy (Dilated, Hypertrophic, Restrictive)

Category: Structural Heart Disease

Mechanism: Weak or stiff heart muscle leads to abnormal electrical conduction, increasing the risk of arrhythmias like VT or VF.

Risk Factors: Genetics, hypertension, alcohol abuse, viral infections.

Prevention: Lifestyle changes, genetic screening, medications, ICD if needed.

5. Valvular Heart Disease (e.g., Aortic Stenosis, Mitral Regurgitation)

Category: Structural Heart Disease

Mechanism: Defective valves strain the heart, causing heart failure and arrhythmias. Aortic stenosis can lead to sudden cardiac arrest.

Risk Factors: Aging, rheumatic fever, bicuspid aortic valve (BAV).

Prevention: Regular monitoring, valve repair/replacement.

6. Bicuspid Aortic Valve (BAV)

Category: Congenital Heart Defect

Mechanism: Two aortic valve leaflets instead of three cause abnormal blood flow, leading to aortic stenosis or regurgitation, increasing arrhythmia risk.

Risk Factors: Genetic predisposition, connective tissue disorders.

Prevention: Regular echocardiograms, controlling blood pressure.

7. Congenital Heart Disease (CHD)

Category: Structural Heart Disease

Mechanism: Anatomical defects alter normal heart function, leading to arrhythmias or heart failure.

Risk Factors: Genetic disorders, maternal infections during pregnancy.

Prevention: Early surgical correction, lifelong monitoring.

8. Long QT Syndrome (LQTS)

Category: Electrical Heart Disorder

Mechanism: Prolonged cardiac repolarization increases the risk of Torsades de Pointes, leading to sudden cardiac arrest.

Risk Factors: Genetic mutations, medications (certain antibiotics, antiarrhythmics).

Prevention: Beta-blockers, avoiding QT-prolonging drugs, ICD placement in severe cases.

9. Brugada Syndrome

Category: Electrical Heart Disorder

Mechanism: Sodium channel dysfunction disrupts electrical impulses, leading to sudden VF and cardiac arrest.

Risk Factors: Genetic mutation (SCN5A gene), fever, certain medications.

Prevention: Avoid triggers, ICD implantation.

10. Wolff-Parkinson-White (WPW) Syndrome

Category: Electrical Heart Disorder

Mechanism: An abnormal accessory pathway bypasses the AV node, causing rapid arrhythmias that may lead to VF.

Risk Factors: Congenital abnormal electrical pathway.

Prevention: Catheter ablation, antiarrhythmic medications.

11. Ventricular Tachycardia (VT) / Ventricular Fibrillation (VF)

Category: Arrhythmia

Mechanism: Uncoordinated ventricular contractions lead to loss of cardiac output.

Risk Factors: CAD, cardiomyopathy, electrolyte imbalances.

Prevention: ICD, antiarrhythmic medications.

12. Atrial Fibrillation (AF) with Rapid Ventricular Response (RVR)

Category: Arrhythmia

Mechanism: Fast, irregular atrial activity leads to ventricular dysfunction and possible cardiac arrest.

Risk Factors: Hypertension, valvular disease.

Prevention: Rate/rhythm control, anticoagulation therapy.

13. Pulmonary Embolism (PE)

Category: Vascular Cause

Mechanism: A blocked pulmonary artery leads to right heart failure and sudden cardiac arrest.

Risk Factors: Deep vein thrombosis (DVT), immobility.

Prevention: Blood thinners, early mobilization.

14. Aortic Dissection

Category: Vascular Cause

Mechanism: Rupture in the aortic wall causes severe hemorrhage and cardiac tamponade.

Risk Factors: Hypertension, BAV, Marfan syndrome.

Prevention: Blood pressure control, surgical repair.

15. Cardiac Tamponade

Category: Mechanical Cause

Mechanism: Fluid accumulation around the heart compresses it, stopping blood flow.

Risk Factors: Trauma, cancer, pericarditis.

Prevention: Early detection, pericardiocentesis.

16. Severe Electrolyte Imbalances (K+, Mg2+, Ca2+)

Category: Metabolic Cause

Mechanism: Disrupted ion balance alters cardiac conduction, causing arrhythmias.

Risk Factors: Kidney disease, diuretics.

Prevention: Regular monitoring, electrolyte correction.

17. Hypoxia (Low Oxygen)

Category: Respiratory Cause

Mechanism: Oxygen deprivation leads to myocardial dysfunction.

Risk Factors: COPD, suffocation, sleep apnea.

Prevention: Oxygen therapy, airway management.

18. Acidosis (Metabolic or Respiratory)

Category: Metabolic Cause

Mechanism: pH imbalance depresses cardiac function, causing asystole.

Risk Factors: Diabetic ketoacidosis, kidney failure.

Prevention: Treat underlying cause (bicarbonate, dialysis).

19. Hypothermia (<30°C)

Category: Environmental Cause

Mechanism: Slowed metabolism leads to bradycardia and asystole.

Risk Factors: Cold exposure, drowning.

Prevention: Gradual rewarming.

20. Hyperthermia (Heat Stroke)

Category: Environmental Cause

Mechanism: Heat stress leads to dehydration and cardiac arrhythmias.

Risk Factors: High temperatures, dehydration.

Prevention: Hydration, cooling measures.

21. Drug Overdose (e.g., Cocaine, Opioids)

Category: Toxicological Cause

Mechanism: Direct cardiac toxicity or severe bradycardia.

Risk Factors: Substance abuse, polypharmacy.

Prevention: Avoidance, naloxone (opioid overdose).

This detailed breakdown should provide a comprehensive understanding of cardiac arrest causes.

[ramchanderbhimra]

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[AyurvedicDoctor-yq]

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