Sudden Cardiac Arrest: Can Risk Be Identified and Reduced?

We`ve all heard stories that have left us in shock. A seemingly healthy man in his 40s who collapsed during his morning workout. A 50-year-old woman who died while dancing at a family function. A 38-year-old professional who was found slumped over his work desk, without a pulse. One moment they seemed perfectly fine, and the next, they were gone. 

The common assumption is that all three suffered a heart attack. But how does someone who appeared perfectly healthy suddenly lose their life? While heart attacks are widely recognized, another equally serious condition remains far less understood by the public. In some such cases, the actual cause may be sudden cardiac arrest, a medical emergency that can strike without warning, often in people who may appear healthy and do not know they carry an underlying risk. 

Sudden cardiac arrest occurs when the heart develops a life-threatening abnormal rhythm, causing it to stop pumping blood effectively. Unlike a heart attack, which is primarily a problem of reduced blood flow to the heart muscle, sudden cardiac arrest is an electrical problem that can lead to death within minutes if not treated immediately. While a heart attack is one of the most common triggers, it is not the only cause. 

Since sudden cardiac arrest can strike without warning, it is important to know who is at risk. A first-degree relative or multiple relatives with sudden unexplained death at a young age should prompt evaluation. Some may have inherited or structural heart abnormalities that increase the risk of life-threatening rhythm issues. Another high-risk group includes people who have previously suffered a heart attack. Even years after treatment with a stent or bypass surgery, damage to the heart muscle can leave the heart weak and reduce its pumping function. Although these people may feel completely well, they remain among those at the highest risk of sudden cardiac arrest. 

One of the greatest challenges with sudden cardiac arrest is that there may be little or no warning. In some cases, the first symptom is the cardiac arrest itself. This is why regular heart checks are important in people with warning symptoms (unexplained fainting, palpitations, chest pain during exertion), weakened heart function, known heart disease, or a family history of sudden cardiac death. 

The encouraging news is that risk can often be recognized and reduced in high-risk individuals. Through appropriate evaluation and risk assessment, doctors can identify those who are at an increased risk of dangerous heart rhythm issues. For these patients, we may recommend an Implantable Cardioverter Defibrillator (ICD), a small device placed inside the body that continuously monitors the heart`s rhythm. If a dangerous rhythm develops, the ICD can deliver a life-saving shock within seconds and restore the heart`s normal rhythm. 

This is what we call primary prevention. Rather than waiting for a cardiac arrest to occur, we identify those at highest risk and intervene early. People with low pumping function after a heart attack, certain inherited heart conditions, and selected high-risk individuals identified through evaluation may benefit from ICD assessment and preventive e treatment. 

For patients who survive a cardiac arrest because of timely CPR, an automated external defibrillator (AED), or prompt emergency medical care, an ICD is often considered as part of secondary prevention. The device helps protect against future life-threatening heart rhythm issues and reduces the risk of another episode. 

This makes public awareness important. During a cardiac arrest, every minute counts. If someone suddenly collapses, is not breathing normally or is only gasping, call for an ambulance first. Then begin chest compressions or use an AED if one is available. Chest compressions can help maintain blood flow until medical help arrives. This is why CPR training should become a life skill, ideally beginning in school. Wider availability of AEDs in public places can also make a critical difference. 

When it comes to sudden cardiac arrest, early risk identification and prevention are always better than waiting for an emergency. Not everyone gets a warning. If you fall into any of the above-mentioned categories, speak to a cardiologist about your risk. Managing blood pressure, diabetes, cholesterol levels, maintaining a healthy weight, avoiding smoking, and staying physically active can also help reduce heart risk. Identifying risk early and taking action at the right time can save lives.

Dr. Karthigesan AM

Senior Consultant Cardiologist & Electrophysiologist,

Apollo Hospitals, Chennai