Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Cardiac
arrest is the sudden loss of cardiac function, when the heart abruptly stops
beating. A person whose heart has stopped will lose consciousness and stop
normal breathing, and their pulse and blood pressure will be absent.
Unless resuscitative efforts are begun immediately, cardiac arrest leads to
death within a few minutes. This is often referred to by doctors as "sudden
death" or "sudden cardiac death (SCD)."
Ventricular fibrillation is the most common cause of cardiac arrest. Ventricular
fibrillation occurs when the normal, regular, electrical activation of heart
muscle contraction is replaced by chaotic electrical activity that causes the
heart to stop beating and pumping blood to the brain and other parts of the
body. Permanent brain damage and death can occur unless the flow of blood to the
brain is restored within five minutes. Heart attack is the most common cause of
ventricular fibrillation. Less common causes of cardiac arrest include
respiratory arrest (loss of breathing function), choking, trauma, electrocution,
and drowning.
A natural disaster hits, the power goes off and the lights go out. It's a
common scene that plays out during hurricane and tornado seasons, and it's very
similar in trying to explain sudden cardiac arrest. The heart sustains an insult,
the electricity is short circuited, the heart can't pump, and the body dies.
The heart is an electrical pump, where the electricity is generated in
special pacemaker cells in the upper chamber, or atrium, of the heart. This
electrical spark is carried through pathways in the heart so that all the muscle
cells contract at once and produce a heart beat. This pumps blood through the
heart valves and into all the organs of the body so that they can do their work.
This mechanism can break down in a variety of ways, but the final pathway in
sudden death is the same: the electrical system is irritated and fails to
produce electrical activity that causes the heart to beat. The heart muscle
can't supply blood to the body, particularly the brain, and the body dies.
Ventricular fibrillation (V Fib) is the most common reason
for sudden
death in patients. Without a coordinated electrical signal, the bottom chambers of the heart
(ventricles) stop beating and instead, jiggle like Jello. Ventricular
Fibrillation is treated with
electrical shock, but for it to be effective, the shock usually needs to happen
within less than four to six minutes, not only for it to be effective, but also to
minimize brain damage from lack of blood and oxygen supply.
Automatic external
defibrillators (AEDs) are commonly available in public places to allow almost anybody
to treat sudden death. Less commonly, the heart can just stop beating. The
absence of a heart beat is known as asystole (asystole: a=no + systole=beat).
What are the causes of sudden cardiac arrest?
Sudden death is most often caused by heart disease. When blood vessels
narrow, the heart muscle can become irritated because of lack of blood supply.
In heart attack (acute
myocardial infarction), a blood vessel becomes
completely blocked by a blood clot, and there is enough irritability of the
muscle to cause ventricular fibrillation. In fact, the reason many people with
chest pain are admitted to the hospital is to monitor their heart rate and
rhythm for signs that might lead to ventricular fibrillation. Sudden death may
also be the first presentation of heart disease.
Cardiomyopathy is a broad category of heart disease where the heart muscle
does not contract properly for whatever reason. Often it is ischemic, where part
of the heart muscle doesn't get an adequate blood supply for a prolonged period
of time and no longer can efficiently pump blood. People whose ejection
fractions (the amount of blood pumped out of the heart with each heart beat) is
less than 30% are at greater risk for sudden death (a normal ejection fraction
is above 50%). In some people, cardiomyopathy may develop in the absence of
ischemic heart disease.
Inflammation of the heart muscle, known as myocarditis (myo=muscle +
card=heart + itis= inflammation), can also cause rhythm disturbances. Diseases
like sarcoidosis, amyloidosis, and infections can cause inflammation of the
heart muscle.
Some people are born with electrical conducting systems that are faulty,
which place them at higher risk for rhythm disturbances. Some are due to the
wiring, or electrical conduction system, like Wolff-Parkinson-White syndrome,
while others are due to the structural basic structural problems within the
heart, like Marfan syndrome.
Pulmonary embolus, a blood clot to the lung, can also cause sudden death.
Clots form in the leg or arm and may break off and flow to the lung where they
decrease the lung's ability to get oxygen from the air to the body. Risk factors
for blood clots include surgery, prolonged immobilization (for example, hospitalization,
long car rides or plane trips), trauma, or certain diseases like cancer.
Blunt chest trauma, such is in a motor vehicle accident, may result in
ventricular fibrillation. (please see commotio cordis below)
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
An arrhythmia is an abnormal heart rhythm. With an arrhythmia, the heartbeats may be irregular or too slow (bradycardia), to rapid (tachycardia), or too early. When a single heartbeat occurs earlier than normal, it is called a prmature contraction.
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate.
Deep vein thrombosis (DVT) is a blood clot in a vein located deep in the muscles of the legs, thighs, pelvis (lower torso), or arms. The most common symptoms of a deep vein thrombosis are swelling and pain in the leg that has the blood clot. A DVT is difficult to diagnose without specific tests in which the deep vein system can be examined.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
Heat stroke (heatstroke or sun stroke) is a form of hyperthermia. Heat stroke is a true medical emergency that can be fatal if not promptly and properly treated. Symptoms of heat stroke include: high body temperature, absence of sweating, with hot red or flushed dry skin, rapid pulse, difficulty breathing, strange behavior, hallucinations, confusion, agitation, disorientation, seizure, and coma. A victim of heat stroke must receive immediate treatment to avoid permanent organ damage.
Marfan syndrome is hereditary condition affecting connective tissue. A person with Marfan syndrome may exhibit the following symptoms and characteristics: dislocation of one or both lenses of the eye; a protruding or indented breastbone; scoliosis; flat feet; aortic dilatation; dural ectasia; stretch marks; hernia; and lung collapse. Though there is no cure for Marfan syndrome, there are treatments that can minimize and sometimes prevent some complications.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Aortic valve stenosis is an abnormal narrowing of the aortic valve of the heart. The causes of aortic stenosis are wear and tear of the valve in the elderly, congenital, or scarring or scarring of the aortic valve from rheumatic fever. Symptoms include angina, fainting, and shortness of breath. Treatment is dependant upon the severity of the condition.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Amyloidosis is a group of diseases resulting from abnormal deposition of certain proteins (amyloids) in various bodily areas. The amyloid proteins may either be deposited in one particular area of the body (localized amyloidosis) or they may be deposited throughout the body (systemic amyloidosis). There are three types of systemic amyloidosis: primary (AL), secondary (AA), and familial (ATTR). Primary amyloidosis is not associated with any other diseases and is considered a disease entity of its own. Secondary amyloidosis occurs as a result of another illness. Familial Mediterranean Fever is a form of familial (inherited) amyloidosis. Amyloidosis treatment involves treating the underlying illness and correcting organ failure.
Hypothermia is having a body core temperature of less than 35 C or 95 F. Most causes of hypothermia are preventable. Risk factors for hypothermia include age, mental status, medical conditions, and medications. Symptoms of hypothermia generally depend upon the severity of the condition. Treatment depends upon the severity of hypothermia. If not treated early, hypothermia can lead to cardiac arrest, coma, or death.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Wolff-Parkinson-White syndrome is a condition in which abnormal electrical pathways in the heart cause arrhythmias. Symptoms of Wolff-Parkinson-White syndrome include tachycardia, dizziness, palpitations, fainting, and shortness of breath. Wolff-Parkinson-White syndrome is a common cause of paroxysmal supraventricular tachycardia. Wolff-Parkinson-White syndrome is caused by mutations in the PRKAG2 gene.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Heart disease, particularly coronary artery disease is the leading cause of heart attacks. Women are more likely to die from a heart attack than men. High cholesterol, high blood pressure, obesity, and high triglycerides are contributors to heart disease. Some of the common symptoms of a heart attack in women include chest pain, shortness of breath, nausea, feeling faint or woozy, and more. Heart disease can be prevented by lifestyle changes and controlling high blood pressure, cholesterol, weight, and diseases such as diabetes.
Drowning is a common cause of death and disability worldwide. In the US, it is the third most common cause of accidental death. Brain damage, pneumonia, ARDS, hypothermia, and spine fractures are complications of drowning. At times, there are discussions of wet vs. dry, or salt vs. fresh water drownings. Children and young adults are at most risk for drowning accidents. Medical emergencies in the water may lead to drowning (such as seizures, hypoglycemia, sudden cardiac death, or heart attack). Treatment of a drowning victim depends up on the severity of the injury. Prevention is the key to prevent drowning.
Hypertrophic cardiomyopathy (HCM) affects many people today. Many people with HCM have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which progress and worsen as heart function worsens.
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
An echocardiogram (often called "echo") is a graphic outline of the heart's movement. During this test, high-frequency sound waves, called ultrasound, provide pictures of the heart's valves and chambers. This allows the technician, called a sonographer, to evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.
Why Do I Need an Echo?
Your doctor may perform an echocardiogram to:
Assess the overall function of your heart.
Determine the presence of many types of heart disease .
Follow the progress of heart valve disease over time.
Evaluate the effectiveness of medical or surgical treatments.
What Are the Types of Echocardiograms?
There are several types of echocardiograms and your doctor will he...
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