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Diagnosing a cardiac arrest, the ailment that took away Sheila Dikshit

Know ways to diagnose cardiac arrest, the condition that not only took the life of Sheila Dikshit but is a threat to million other lives all across the world. © Shutterstock

Former chief minister of Delhi, Sheila Dikshit passed away recently after suffering from cardiac arrest. Here is a bird's eye view of the condition to help you fight it better.

Written by Juhi Kumari |Published : July 22, 2019 1:10 PM IST

The longest serving Chief Minister of Delhi, Sheila Dikshit breathed her last on 20th July. She was admitted to the Fortis Escorts Heart Institute, Okhla, after she suffered a cardiac arrest. Though her case was critical, a multi-disciplinary team of doctors carried out advanced resuscitative measures, that temporarily stabilized her condition. But soon, Sheila Dikshit, who was 81-years-old, experienced another cardiac arrest that took her life at 3:55 pm on July 20. Notably, she underwent a heart surgery last year in France and was under treatment at Fortis Escorts Heart Institute for the last few years. Here, we tell you about the ways to diagnose cardiac arrest, the condition that not only took the life of Sheila Dikshit but is a threat to million other lives all across the world. Correct and early diagnosis are essential for successful treatment.

WHAT IS CARDIAC ARREST?

It is a heart condition in which the heart suddenly stops functioning leading to loss of breath and consciousness. The cause behind this problem is an electrical disturbance in your heart that stops blood flow to your body and brain. It is characterized by symptoms like sudden collapse, no pulse, loss of breathing, loss of consciousness. Before cardiac arrest, sometimes people may experience signs like chest discomfort, shortness of breath, weakness, or/and palpitations.

Notably, there is a difference between a heart attack and cardiac arrest. The former occurs due to the complete blockage of one of the main arteries supplying blood to the heart. This happens when plaques accumulated in the artery burst suddenly and form clot leading to the death of heart muscles slowly. If you are suffering from any of the heart conditions like coronary artery disease, heart attack, cardiomyopathy, valvular disease, congenital cardiac disease, or electrical problems in the heart, your chances of experiencing a cardiac arrest amp up. There are certain other factors including family history, smoking, obesity, diabetes, a sedentary lifestyle, high cholesterol level, high blood pressure etc. that can put you at an increased risk of developing this life-threatening condition. If not treated urgently, reduced blood flow to your brain during a cardiac arrest can damage your brain permanently leading to your death.

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DIAGNOSTICS

Cardiac arrest requires instant diagnosis and treatment. On an urgent basis, doctors perform electrocardiogram. If you are lucky enough to survive the arrest, your doctor may perform some other tests to know the exact cause behind your cardiac arrest so that they can prevent future episodes. We guide you through those tests.

Electrocardiogram

It is a non-invasive, painless test during which, doctors attach sensors (electrodes) to your chest and your limbs in order to detect the electrical activity of your heart. These sensors show results quickly. Your heart beats are triggered by electrical impulses, which are generated from your pacemaker cells. An ECG actually records the timing and strength of these signals show in the form of waves or graph.

Blood tests

There are four types of blood tests, that are performed to find out the exact reason behind a cardiac arrest. They include cardiac enzyme test, electrolyte test, drug test, and a hormone test. In the cardiac enzyme test, doctors look for certain enzymes that usually leak into your blood if your heart has been damaged by a heart attack. Presence of those enzymes confirm your condition. In the electrolyte test, doctors take your blood sample to test it for the levels of electrolytes like potassium, calcium and magnesium. Notably, these electrolytes help create electrical impulses. So, any kind of imbalance in their levels can increase your risk of suffering from arrhythmia (a condition in which either your heart beats too fast or too slow) and sudden cardiac arrest. During drug test, your doctor basically looks for the evidence of drugs in your blood. Certain prescription and over-the-counter drugs can potentially cause arrhythmia. A hormone test is performed to detect hyperthyroidism, a condition that may trigger and cause cardiac arrest.

Chest X-ray

It is a non-invasive test during which doctors position you between a machine that produces X-rays and a plate that creates the image digitally. An X-ray creates a black and white image of your chest that allows your doctor to look at the shape and size of your heart and its blood vessels. This is done to find out whether or not you are experiencing a heart failure.

Echocardiogram

It is a test during which you will lie on a table while your doctor will attach electrodes to your body to detect your heart's electrical currents. Also, a gel will be applied to the transducer to improve the conduction of sound waves. Now, moving the transducer over your chest will produce images of sound wave echoes created from your heart. If your heart is damaged, the sound will be irregular.

Ejection fraction testing

This test is basically to know your heart's pumping capacity. The term ejection fraction means the percentage of your blood pumped out of a filled ventricle with each heartbeat. Notably, a normal ejection fraction is expressed as 50 to 70 per cent. An ejection fraction of less than 40 per cent means an increased risk of developing a sudden cardiac arrest. There are various ways to do this test including echocardiogram, MRI, a nuclear medicine scan, CT scan or a cardiac catheterization.

Nuclear scan

During this test, doctors inject small amounts of radioactive material like thallium, into your bloodstream. Special cameras detect the radioactive material as it flows through your heart and lungs. This is done to identify blood flow problems that your heart might be facing.

LINE OF TREATMENT

As mentioned earlier, cardiac arrest requires immediate treatment. The first and basic treatment option is to perform a cardiopulmonary resuscitation (CPR). It is a procedure that involves chest compression with artificial ventillation. This is done to manually preserve the function of the brain till proper medical help is accessed. This can keep oxygenated blood flowing to the brain and other vital organs for at least some time.

After this, doctors give various anti-arrhythmic drugs to the cardiac arrest patient for emergency. Once the condition is stable and better, doctors try to know the exact cause behind the condition. Based on that, they suggest treatment options. These options may include implantable cardioverter-defibrillator (doctors implant a battery-powered unit on your left collarbone to detect any irregularity in your heart rhythm and pace it accordingly), coronary angioplasty (doctors remove blockage to your coronary arteries), coronary bypass surgery (to improve blood flow) etc.

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