Sudden Cardiac Death (cont.)
Can sudden cardiac arrest be prevented?
Death is best treated by prevention. Most sudden death is associated with
heart disease, so the at-risk population remains males older than 40 years of
age who smoke, have high blood pressure, and diabetes (the risk factors for heart attack).
Other risks include syncope
(fainting or loss of consciousness) and known heart disease.
Syncope, or loss of consciousness, is a significant risk factor for sudden
death. While some reasons for passing out are benign, there is always a concern
that the reason was an abnormal heart rhythm that subsequently spontaneously
corrected. The fear is that the next episode will be a sudden cardiac arrest.
Depending on the healthcare provider's suspicion based on the patient's history,
physical examination, laboratory tests, and EKG, the healthcare practitioner may recommend
inpatient or outpatient heart monitoring to try to find a clue as to whether the
passing out was due to a deadly heart rhythm. Unfortunately, the potentially
suspect rhythm may not recur and depending on the situation, prolonged
outpatient monitoring lasting weeks and months may be necessary. Use of
electrophysiologic testing may help identify high risk patients (the electrical
pathways are mapped using techniques similar to heart catheterization).
In people who present to their doctor with chest pain, aside from making the
diagnosis, monitoring both the heart rate and rhythm are emphasized. The purpose
of watching people with chest pain in a hospital setting is to prevent sudden
cardiac arrest.
Using implantable defibrillators in high risk patients, especially those with
markedly decreased ejection fractions can reduce the incidence of sudden cardiac
arrest. These devices are placed under the skin in the chest wall and have wires
that are attached to the heart itself. When they detect ventricular
fibrillation, a shock is automatically delivered to the heart, restoring a heart
beat and averting sudden death.
Next: What is the prognosis sudden cardiac arrest? »
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