Definition

Cardiorespiratory arrest, also known as sudden cardiac arrest, is the abrupt cessation of heart function, breathing, and consciousness. This condition is typically caused by disturbances in the heart's electrical system, disrupting its pumping activity and halting blood flow throughout the body. When the heart stops pumping blood, the brain suffers from oxygen deprivation due to the sudden cessation of blood supply. This leads the affected person to collapse and stop breathing.

Cardiorespiratory arrest is distinct from a heart attack. It occurs when the normal rhythm of the heart's pumping is disrupted by rapid and abnormal electrical impulses. Meanwhile, a heart attack happens when there is a blockage in the blood vessels that supply blood and oxygen to the heart, thereby disrupting blood flow. However, sometimes a heart attack can trigger electrical disturbances that cause cardiorespiratory arrest.

Cardiorespiratory arrest is classified as a medical emergency. If not promptly treated, this condition can lead to death. Survival depends on swift and appropriate medical intervention.

Causes

Under normal circumstances, the heart's electrical system sends impulses that regulate each heartbeat. During cardiorespiratory arrest, rapid and abnormal impulses can suddenly interfere with normal heartbeat regulation. Disruptions in this process can cause the heart to stop beating. When the heart ceases to beat, blood flow throughout the body is disrupted.

Common causes of cardiorespiratory arrest include abnormal heart rhythms (arrhythmias), with ventricular arrhythmias being the most common cause. Fast and erratic electrical impulses cause your ventricles to quiver rather than pump blood (ventricular fibrillation).

Several factors can contribute to cardiorespiratory arrest, including:

Heart-related causes:

• Coronary artery disease, where heart blood vessels become obstructed by fatty deposits and other deposits, reducing blood flow to the heart
• Heart attack, often a result of severe coronary artery disease, which can trigger cardiorespiratory arrest
• Enlargement of the heart, a condition where the heart muscle walls stretch, enlarge, or thicken, often leading to rhythm disturbances
• Heart valve disease, such as valve leakage or narrowing, which can cause stretching or thickening of the heart muscle and increase the risk of arrhythmias
• Congenital heart disease, if cardiorespiratory arrest occurs in children or adolescents, may be due to congenital heart disease
• Electrical problems in the heart can trigger cardiorespiratory arrest

Respiratory system causes:

• Airway obstruction
• Pulmonary embolism
• Weakness of respiratory muscles

Other causes:

• Use of certain medications or illegal drugs
• Severe trauma with significant blood loss
• Abnormal potassium or magnesium levels
• Oxygen deficiency
• Intense exercise, which can trigger a heart attack in individuals with pre-existing heart disease

Risk factor

Several factors increase the risk of cardiorespiratory arrest, including:

• History of heart attack or previous cardiorespiratory arrest
• Personal or family history of heart disease, such as:
• Coronary artery disease
• Heart rhythm disturbances
• Congenital heart defects
• Heart failure
• Cardiomyopathy
• Age over 45 for men, or over 55 for women
• Male gender
• High blood pressure
• High blood cholesterol levels
• Obesity
• Diabetes
• Chronic kidney disease
• Smoking
• Inactive lifestyle
• Use of illegal drugs
• Nutritional imbalances, such as low potassium or magnesium levels

Symptoms

Cardiorespiratory arrest typically occurs suddenly and unexpectedly. Common symptoms include:

• Sudden loss of consciousness or fainting
• Absence of a pulse
• Not breathing
• Sometimes preceded by other symptoms such as:
• Chest discomfort
• Shortness of breath
• Weakness throughout the body
• Rapid heartbeat
• Dizziness
• Abdominal pain

Diagnosis

Cardiorespiratory arrest is a sudden medical emergency that requires quick diagnosis. It is typically identified by symptoms such as sudden loss of consciousness or fainting, along with the absence of pulse and breath..

Several diagnostic tests can help determine the risk of cardiorespiratory arrest and investigate its causes, although these are typically performed after managing the emergency situation. These tests include:

• Cardiac catheterization, a procedure to assess heart function by inserting a type of cable into the heart's blood vessels
• Echocardiogram, an examination that uses sound waves to show heart movement
• Stress echocardiogram, an examination evaluating heart movement during monitored activity
• Electrocardiogram (EKG), a test to record heart electrical activity
• Electrophysiology study, a detailed evaluation of electrical activity in your heart
• Magnetic Resonance Imaging (MRI), a scan that uses magnets and radio waves to produce images of the heart
• Multigated Acquisition Scan (MUGA), an examination that tests heart function using radioactive material

Management

Cardiorespiratory arrest is a medical emergency so immediate management can save the person's life in the first few minutes. If someone shows signs of cardiorespiratory arrest, you should contact or seek assistance from emergency medical services, and if possible, ask others to call emergency services.

Cardiopulmonary Resuscitation (CPR) Check whether the unconscious person is breathing by observing chest movements. If the person is unconscious, not breathing, and has no palpable pulse, immediate cardiopulmonary resuscitation (CPR) should be performed manually. Place both hands on top of the other in the center of the person's chest and press firmly about 100-120 times per minute, allowing the chest to rise fully between compressions. CPR can temporarily restore blood and oxygen flow to the organs and brain and should be continued until emergency medical assistance arrives or an Automated External Defibrillator (AED) is available.

If an Automated External Defibrillator (AED) is available at the scene, it can be used to deliver an electric shock to the heart. The electric shock delivered is automatically controlled for people with dangerous heart rhythm disturbances. This device will not deliver an electric shock unless an abnormal heart rhythm is detected in the person.

Advanced Treatment CPR is one form of emergency management for cardiorespiratory arrest. If you survive cardiorespiratory arrest, your doctor may start with one or more of the following treatments to reduce the risk of further attacks:

• Medications that can lower high blood pressure and cholesterol
• Surgery to repair damaged blood vessels or heart valves, which can also cut or remove blockages inside blood vessels
• Exercise to improve fitness and heart health
• Dietary changes to help you lower cholesterol

Complications

If not promptly and correctly treated, cardiorespiratory arrest can lead to death. Due to oxygen deprivation to the brain during cardiorespiratory arrest, you may experience long-term effects on your brain, such as:

• Personality changes
• Memory problems
• Fatigue
• Dizziness or balance disturbances
• Aphasia/dysphasia (speech and language problems)
• Myoclonus (involuntary movements)
• Permanent brain injury

Prevention

The prevention of cardiorespiratory arrest involves reducing risks through routine check-ups, screening for heart disease, and adopting a healthy heart lifestyle, such as:

• Paying attention to your diet, consuming plenty of vegetables, fruits, grains, and lean protein
• Losing weight to achieve an ideal body weight
• Managing stress
• Being physically active, doing 150 minutes of exercise per week as allowed by your doctor, and avoiding prolonged sitting
• Quitting smoking

When to see a doctor?

 Immediately visit the Emergency Department if you experience any of the following signs and symptoms:

• Chest pain or discomfort
• Palpitations
• Rapid or irregular heartbeat
• Unexplained wheezing
• Shortness of breath
• Fainting or near-fainting
• Severe headache or dizziness

If you see someone unconscious and not breathing normally, do the following:

• Call emergency medical assistance. If you have direct access to a telephone, call before starting CPR
• Perform CPR. Quickly check the person's breathing; if it is not normal, begin CPR. Press firmly and rapidly on the person's chest at a rate of 100 to 120 times per minute. If you have been trained in CPR, check the person's airway and provide rescue breaths after every 30 compressions. If you are not trained, continue chest compressions only. Allow the chest to rise fully between compressions. Continue this until an AED is available or emergency help arrives.

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