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We Can Help Victims Of Sudden Cardiac Death Live To Tell About It

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By RAO MUSUNURU

Special to the Tribune

Published: June 9, 2008

It is not that infrequent anymore that a patient's past medical history in my cardiology practice would include "sudden death" along with gallbladder surgery, hysterectomy, hypertension, diabetes, etc. That is because many people, under the right circumstances, can survive sudden cardiac death and live to tell their story.

It is estimated that each year more than 3 million people worldwide die from sudden cardiac death. In the United States, sudden cardiac death is responsible for more than 350,000 deaths per year, killing more people than stroke, lung cancer, breast cancer or AIDS.

Early June is designated national CPR and AED awareness week in an effort to encourage the public to get CPR (cardiopulmonary resuscitation) training and learn how to use an AED (automated external defibrillator) to reduce death and disability from sudden cardiac arrest.

Many times, the reason for ventricular fibrillation, causing sudden cardiac death, is the electrical irritability resulting from sudden loss of blood supply to a portion of the heart muscle.

This is due to a sudden, unexpected rupture of a cholesterol plaque that has been building in the wall of the artery (coronary) supplying blood to the heart muscle. Sometimes, the irritability is because of a scar in the heart muscle from an old (which can be silent) heart attack, which also makes the heart weak, causing congestive heart failure.

About every minute, one American dies from a coronary event. Fifty percent of the men and 60 percent of the women who die suddenly of coronary heart disease have no previous symptoms of this pre-existing disease.

When a person sustains an unexpected sudden cardiac death from ventricular fibrillation, the only chance of survival is through prompt delivery of electric shock to the heart (defibrillation) by an incidental bystander, wherever and whenever the incident happens. It involves the availability of a functioning AED and the willingness of the bystander to use it.

The AED shocks the heart back to even rhythm. The AEDs nowadays are so simple and foolproof that even children can use them without previous training.

For every minute delay in the rescue after cardiac arrest or sudden cardiac death, the chance of survival goes down 10 percent. After about seven minutes there is a great risk of brain death because of the lack of oxygen from lack of blood supply to the brain - even if the heart restarts.
Cardiopulmonary resuscitation buys time while arrangements are being made for defibrillation. AEDs in police cars will make a difference in survival, even if they get to the scene a minute or two before the ambulance.

Seventy percent of out-of-hospital cardiac arrests occur in the home. Working with the American Heart Association, I led a statewide movement of communities becoming "heart ready" by the mass training of people in CPR and having functioning AEDs readily available.

The Florida Legislature, to its credit (special thanks to the Pasco/Hernando delegation, especially Rep. Tom Anderson of Dunedin), have passed many pieces of legislation over the past several years to promote placement and functioning of AEDs in public places and senior centers, etc. Thankfully, the sheriffs and county commissioners of Pasco and Hernando counties have greatly supported this cause.

I would like to compare AEDs to fire extinguishers (even though the devices are expensive, but cost effective). Anywhere there is a routine conglomeration of people, like large buildings, both public and private, and clubhouses, conference halls, malls, gyms, golf courses, stadiums, airports, churches, etc., there should be an AED in working condition permanently available and displayed prominently.

Hopefully, it will never need to be used, but when it is needed, it will make a difference between life and death.

Of course, none of this underscores the importance of prevention. By controlling or preventing risk factors for heart disease like obesity, hypertension, smoking, high cholesterol, diabetes, inactivity, depression, etc., one can minimize the risk of sudden cardiac death - just like we take precautions to prevent the start of a fire in spite of the availability of fire extinguishers, firetrucks and fire stations.

Is there a sudden death in your future? If there is, you can defy destiny by taking proper precautions and preparations. You can save your own life through proper prevention, and you may be able to save somebody else's (family member, friend, neighbor or even a lucky stranger) through prompt intervention.

Learn more about CPR and AEDs. Save a life without ever getting a medical degree.

The writer, a cardiologist, practices at Regional Medical Center Bayonet Point in Hudson. He is a member of the advisory council for the National Heart, Lung and Blood Institute and the National Leadership Committee of the Clinical Cardiology Council of t

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