I’m not feeling too well……..My Chest………I….can’t …..
What if you came across someone clenching their chest with a very uncomfotable look on their face as if they are having a heart attack?
Is it a heart attack or a cardiac arrest or just plain heartburn from stomach acidity?
This is a situation that confuses most people including doctors at the first instance.
I will take you through the scenario of a heart attack and acidity in a later post.
For now let us have a look at Cardiac arrest.
What is a cardiac arrest and what causes it?
A cardiac arrest to put it in simple words just means that your heart has just given up adjusting to whatever torment it has been going through.
This is not to be mistaken for a heart attack, which happens commonly. A heart attack is usually caused by a block in an artery, supplying a part or many parts of your heart, either by a blood clot or the artery itself narrowing inside because of long standing pile up of cholesterol or fat. When this block happens you have some time to relieve that block and get the blood flowing to that part again. Most people feel this as a sharp pain in the chest among other symptoms but some people do not feel any pain and instead feel breathlessness or numbness in their arm etc. If the block is not relieved in time that part of the heart dies and things move to the next stage which is when an arrest can take place because your heart does not beat in the same synchronous or rhythmic manner that it used to. Sometimes if the part of the heart that dies is an area with some major nerves that stimulate the heart, the whole electrical system to the heart gets affected and the heart beats very chaotically leading to a complete shutdown.
How do various parts of my body get nutrition and how is the waste removed from them? What keeps it beating without my knowledge?
The heart and any organ in the body have a plumbing division and an electrical wiring division.
The plumbing division supplies the heart with fresh blood and removes waste blood. This is what they call the circulatory system in medical school.
Fresh Blood flows from the heart to various organs in the body through the Arteries (Large pipes) branching into smaller Arterioles(Smaller pipes) further branching into smaller Capillaries(Taps) finally into the target organ which uses up the nutrition and then gives back waste into a set of outward flowing capillaries (Sinks) which join together to form bigger outflow pipes called Veinuoules which then join together from various parts of the area to form Veins( Large waste pipes) , and this empties back into another section of the heart for reprocessing and filtration by the lungs to be returned back to the heart as fresh blood and this cycle keeps repeating.
The electrical wiring division brings in the electricity to any organ through nerves. The nerves are all connected to the main electrical distribution box which is the brain and the spinal cord.
This is what they call the nervous system in medical school.
Just like the plumbing division there are large nerves (electrical wires) branching into smaller ones that electrify the whole organ. An extremely amazing rhythmic discharge of electricity through these wires one after another like a set of dominoes makes the heart beat in a very particular manner which makes all the pumping described above work like clockwork. All while you are completely unaware of the whole process going on while running, sleeping, eating, fighting, crying, etc.
What happens when the electrical wiring in my heart gets messed up?
When the heart is not able to pump in the normal rhythm or when the electricity supplied to the various parts of the heart start to become haphazard you start getting irregular heart beats. Normal heart beat range is 60-100 beats every minute. Now this haphazard heart rhythm can range from a skipped heart beat every few seconds to a very slow heart beat below 50 to a very fast heart beat over 250 to absolutely no beat at all. When your heart is not effectively beating at all it is called a CARDIAC ARREST.
If the heart does not beat as it is supposed to it will not pump any blood to any part of the body and the moment blood does not reach the brain the person faints and falls down.
We now only have minutes to save the person because neither the heart nor the brain can survive more than a few minutes without blood.
What to do I do now?
1- Call the emergency ambulance/paramedic service in your country or area
2-Assess the responsiveness of the person by trying to talk to him/her or by rocking.
2- Look for a pulse to confirm if the person has a heart beat. You can check this either at the wrist (Radial Pulse) or the neck (Carotid Pulse).Its better to check the carotid pulse if the person is unconscious or the person might find you creepy.
3- In case you don’t find a beat chances are he/she is in a cardiac arrest and immediately start CPR(Cardio Pulmonary Resuscitation ) , the popular chest pumping action you always see on T.V. Please ensure you don’t overuse force while doing this or else you could make things worse by breaking the person’s rib cage.
4- If by any chance there is an automatic defibrillator in the vicinity , please follow the instructions on it and use it.
Your aim since the heart is not pumping by itself is to mechanically keep the heart pumping till emergency services arrive.
Be aware of the surroundings and make sure both you and the person you are attending to is out of any further danger like explosions, fire, mechanical accidents etc.
The most important thing is to stay calm although that is probably the hardest part when you face a situation like this.
