A sudden cardiac arrest, or SCA, is sometimes referred to as a “massive heart attack,” but that moniker is not quite accurate. It’s true that SCA affects the heart, but it’s not a true heart attack. A heart attack occurs when blood flow to a part of the heart is stopped or slowed, generally due to a blockage in the coronary arteries, causing the death of heart muscle tissue.

Generally, there are signs and symptoms signaling a heart attack, and in most cases those hearts continue to beat after the event. But with SCA, people just collapse and discontinue breathing, and their hearts simply stop beating. A very serious heart attack can lead to SCA, but most SCAs are caused by problems in the rhythm of the heartbeats.

Most of the body’s electrical activity is handled by nerves, but the heart has its own unique electrical system. In the heart, electricity is generated in special pacemaker cells in the right atrium, or upper chamber, and is carried through designated pathways to the heart muscle cells. The cells then all contract at once to produce a heartbeat.

If there’s an interruption anywhere along that electrical pathway, the heartbeat can become faster, slower or erratic. The most common cause of SCA is ventricular fibrillation, a very fast or chaotic heart rhythm, or arrhythmia. While ventricular fibrillation is most common, any arrhythmia can cause the heart to stop beating.

Most people at risk for SCA have coronary artery disease (CAD), although some don’t know they have it. There are other preexisting heart conditions that can lead to SCA, including cardiomyopathy, or an enlarged heart, valvular heart disease and a congenital heart condition, a problem present since birth.

Some other factors that put you at risk for SCA include the risk factors for CAD. These include being a smoker; having diabetes, high blood pressure and/or high cholesterol; being overweight or obese; and living a sedentary lifestyle. Drinking more than two drinks a day is another CAD risk factor, as is having a family history of the disease.

Other risk factors for SCA include having had a previous SCA or a family history of SCA. If you’ve had a heart attack or a family history of heart disease, your risk for SCA increases. The risk also goes up with getting older, being male, using recreational drugs like cocaine and amphetamines, and having low levels of potassium or magnesium in your system.

Blunt force trauma, like what can occur in a car accident or after taking a direct blow to the chest, can also trigger SCA. This is called commotio cordis. Strenuous physical activity can trigger SCA, but in most cases, there is an underlying heart problem. This is often the case when athletes in top physical condition experience SCA.

About 95 percent of SCA sufferers die, often within minutes. Rapid treatment is critical, not only for survival but also to minimize damage to the brain from being without oxygenated blood. When the heart stops beating, blood flow to the rest of the body ceases.

The chances of a positive outcome increase dramatically if the person’s receives CPR and treatment with a defibrillator within minutes. Automated external defibrillators (AED) are available in many public places, including shopping malls, buses, parks and schools. You can even get an AED for your home, but talk to your doctor before you buy.

AEDs are devices that analyze the heart and if they detect a problem deliver an electrical shock to restore the heart’s normal rhythm. They are designed for use by laypeople and provide visual and voice prompts. They will only shock the heart when necessary to restore normal rhythm.

If you witness someone experiencing SCA, call 911 immediately, then check to see if the person is breathing. If they’re not, begin chest compressions. If an AED happens to be available, use it on the unconscious, unbreathing person. Follow the instructions and prompts provided with the AED. Use the AED once, then continue chest compressions until emergency personnel arrive.

SCAs happen without notice, so they can’t be diagnosed until after they occur. There are, however, tests to diagnose contributory disorders and steps to reduce the impact of some risk factors. Having routine appointments and physicals with your doctor and getting appropriate screenings when required can help alert you to potential risk factors.

If you survive an SCA or are at very high risk for SCA, your doctor may choose to place an implantable cardioverter defibrillator (ICD). An ICD goes under the skin in your chest wall, with wires that attach to the heart. The ICD works like a pacemaker. When it detects a dangerous arrhythmia, it sends a shock to the heart to restore the natural rhythm.

Your doctor may also prescribe medication, especially if you’ve had a heart attack or if you have heart failure or an arrhythmia. Types of medications include ACE inhibitors, beta blockers, calcium channel blockers and other anti-arrhythmia drugs. If you’ve got high cholesterol and coronary artery disease, your doctor may also prescribe a statin medication for lowering your cholesterol levels.

If you’re aware of a heart condition or other risk factors for SCA, you can help yourself by making lifestyle changes to reduce your risk of CAD and SCA. Lifestyle behaviors to put into practice include quitting smoking, maintaining a healthy weight, exercising regularly, eating a low-fat diet, and managing diabetes, high blood pressure and other chronic conditions.

For the best outcome in the case of SCA, treatment must be started within minutes of the event.

If someone you love is at high risk for SCA, do them a favor and learn the proper techniques for CPR. The American Heart Association and many hospitals and health organizations routinely offer classes you can sign up for.

Patti DiPanfilo

It’s February, and you know what that means – it’s American Heart Month. It’s that annual opportunity to review what we know about heart disease. And it’s our chance to be sure we’re doing everything we can to prevent or manage it in our lives.

After all, heart disease is the leading killer of both men and women in the US. About 655,000 Americans die from heart disease each year – that’s 1 in every 4 deaths.

What’s more, almost half of all Americans are at risk for developing the condition. The good news is that heart disease is preventable in most people.

Heart disease encompasses a wide array of conditions affecting the heart and blood vessels. These conditions include arrhythmias, cardiomyopathy, congenital heart defects, heart infections, and the main form of heart disease, coronary artery disease (CAD).

Heart disease is often grouped with stroke and related conditions under the more global term cardiovascular disease (CVD). CVD involves a number of diseases of the heart and circulatory system. Other conditions that fall under CVD include heart attack, heart failure, and heart valve disorders.

While stroke, heart attack and the other CVD disorders are serious conditions, we’ll concentrate our discussion today on heart disease and primarily on CAD, its most prevalent form.

CAD is a disorder of your coronary arteries, the blood vessels that supply your heart muscle with fresh, oxygenated blood. With CAD, the coronary arteries become blocked with a fatty material called plaque, which prevents oxygen and nutrients from getting to your heart. This can lead to a heart attack and to the death of heart muscle tissue.

One common symptom of CAD is a type of chest pain called angina, which may feel like a tightness, heaviness or pressure in your chest. Other symptoms include shortness of breath, sweating, dizziness, weakness, nausea, and rapid heartbeat. It may also feel like your heart is pounding hard and fluttering or skipping beats. These feelings are called palpitations.

Symptoms of heart disease can differ in women. They may feel classic angina in the form of chest pain or pressure, but more often feel chest tightness, squeezing, burning, and general discomfort. Women are also more likely than men to experience discomfort in the arms, neck, jaw, throat, or back.

There are certain risk factors for CAD. These factors increase your chances for developing the condition. They can also make it more likely existing heart disease will get worse. Some of these risk factors, such as age, gender, and having a family history of heart disease, cannot be changed.

Age is a big factor. Your risk increases if you’re a women over age 55 or a man over 45. The same is true if your father or brother had heart disease before age 55, or your mother or sister had it before age 65. These are all things you can’t do anything about.

There are other risk factors, however, that you can control. These include having high blood pressure and/or high cholesterol, having diabetes or prediabetes, smoking, being overweight or obese, being physically inactive, eating an unhealthy diet, and drinking a lot of alcohol. These are the risk factors you should be putting your energy into changing.

The best way to determine your risk for CAD or another type of heart disease is by partnering with your doctor. He or she will evaluate your blood pressure, cholesterol level, blood glucose to check for diabetes, weight, personal and family medical history, and lifestyle.

Your doctor can then recommend steps to lower your risk for heart disease or treat the condition if you already have it.

If you are at risk for heart disease or have already been diagnosed with it, there are some actions you can take to reduce the chance of getting heart disease or keep it from getting worse. Your doctor may recommend simple lifestyle changes and/or drug treatments.

Among the steps you can take to lower your heart disease risk or slow its progression is to control your high cholesterol and high blood pressure. This can often be done by adjusting your diet and getting more exercise, but it may require medication. Be sure to have your cholesterol and blood pressure checked regularly.

Lifestyle changes are pretty much common sense. They including eating a heart-healthy diet that is rich in high-fiber foods and low in saturated and trans fats; becoming more active; getting and staying at a healthy weight; quitting smoking; drinking alcohol in moderation, and managing stress, which can have a negative effect on your heart.

If you’re at high risk for heart disease or already have it, your doctor may recommend that you take an aspirin every day to reduce your chances of having a heart attack. But don’t take aspirin on your own without talking to your doctor first. It isn’t the best course of action for all people.

Now that you’ve been reminded about the basics of heart disease and CAD, you can better take care of your heart health – during American Heart Month and the rest of the year as well.

Time to turn sugar highs into sugar lows.

It’s fitting that the day after the sugar high of Halloween marks the start of National Diabetes Month.

No doubt the folks who came up with the idea for a low-sugar awareness month figured this to be a good time to start keeping it real before the pumpkin pie, chocolate peppermint brownies and sugar cookies start to derail our diets. And well they should.

According to the U.S. Department of Health and Human Services, diabetes is one of the leading causes of disability and death in the United States. One in 10 Americans have diabetes — that’s more than 30 million people. And another 84 million adults in the United States are at high risk of developing type 2 diabetes.

In Florida, it is estimated that more than 2.4 million people have diabetes and more than 5.8 million have prediabetes. Diabetes is the seventh leading cause of death in Florida, according to the Florida Department of Health.

The numbers are expected to get worse as the population continues to age, with 54.9 million Americans diagnosed in 2030, according to a study by the Institute for Alternative Futures, analyzed by PsyD  Programs. That’s an increase of 38 percent from current rates.

The study estimates that 5,393,800 Floridians will have diabetes in 11 years. That’s 19.8 percent of the state’s population and puts Florida as the second-highest state in the nation for diabetes cases. The top state is expected to be West Virginia, with 20.5 percent. The three states with the lowest percentages are Utah, Alaska and Colorado, each with slightly more than 10 percent.

When broken down by metro area, Miami leads the nation with 18.8 percent of the population projected to be diabetic in 2030. The lowest metro is Minneapolis, with 11.7 percent.

“Diabetes is a very serious disease affecting millions of Americans, but it can be managed with a healthy lifestyle,” says Florida Surgeon General and Secretary Dr. Celeste Philip. “This year, I encourage you to know your risk factors for diabetes and act as a support system for those in your life who may be affected by the disease.”

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). Women with diabetes have more difficulty conceiving and may have poor pregnancy outcomes, so it is especially important for women to be aware of their risk factors for developing diabetes, including having a family history of diabetes as well as age, weight, and physical activity level.

The good news, especially for those with prediabetes, is that it can be prevented. A healthy diet, regular exercise and medical monitoring can go a long way toward ensuring that diabetes never gains a foothold.

That’s important because adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes. Over time, high blood sugar from diabetes can damage blood vessels and the nerves that control your heart.

This year, the National Institute of Diabetes and Digestive and Kidney Diseases is emphasizing that tie-in to cardiovascular health.  Here are their tips to take control of your health:

• Stop smoking or using other tobacco products.
• Manage your A1C, blood pressure, and cholesterol levels.
• Develop or maintain healthy lifestyle habits – be more physically active and learn ways to manage stress.
• Take medicines as prescribed by your doctor.

Yes, that also includes throwing out that bag of candy corn you bought on clearance.  For more information about diabetes and what you can do to prevent, control it or support a loved one, click here.

 

It happens every now and then. My heartbeat runs amok. It’s likely due to too much caffeine or one of my medications, but I’ll get palpitations. The feeling is truly weird. My heart’s been checked out and everything’s OK, but there are a lot of non-heart-related reasons your heart can skip a beat.

Of course, if you get palpitations, you’ve got to get your heart checked out, especially if you have other symptoms such as shortness of breath, dizziness, chest pain or pressure, or trouble breathing. Palpitations could signal an arrhythmia, a problem with your heart’s electrical system that controls the rhythm of its beating.

The good news is less than half of those with palpitations actually have arrhythmias. In most cases, palpitations are harmless and go away without any treatment needed. In some cases, the cause of the irregular heartbeats is never determined, but there are a few factors that have been found to trigger the flutters or the skipped, hard or speedy beats.

In addition to caffeine, nicotine, alcohol and street drugs such as cocaine, marijuana and amphetamines can stir the pot. So can certain medications, including asthma inhalers, decongestants and drugs to treat an underactive thyroid. Some over-the-counter cold medicines that contain pseudoephedrine can do it, too. For palpitations, there are problem supplements and herbal preparations as well, such as ma huang.

Certain things going on inside the body can affect the heartbeat, also. The body needs the appropriate levels of electrolytes, such as potassium, magnesium and calcium, for optimal function. When these levels are out of balance, it can affect the smooth coordination of the heart’s electrical system and cause changes in the heartbeat.

We all know how awful stress can be for you. Well, add another black mark, because stress, fear and anxiety can increase the adrenalin level in your body and cause a rapid heartbeat. A good workout or other vigorous activity can get it going as well. No surprises there.

I know we blame hormones for just about everything, but the hormonal changes that occur during pregnancy, menopause and perimenopause can sometimes create palpitations or increase their frequency. Stupid hormones! I know we need them, but they can sure mess up a lot of functions when they’re out of whack.

If your palpitations are related to an arrhythmia, another heart issue or other medical problem, such as an overactive thyroid or anemia, obviously you need to be treated for that underlying condition. But what do you do when the cause is not so clear-cut? Many experts tell you that you should keep a log of what you’re doing when they occur and any other symptoms you may be having at the same time.

If you do this for a while, you might be able to identify substances or situations that trigger your palpitations, and then you can take steps to avoid those triggers in the future. If too much caffeine is the culprit, cut back. If stress is the problem, try some stress-reducing techniques like relaxation exercises. Lifestyle changes can often take care of the problem, but if not, your doctor might prescribe a medication as a last resort.

Palpitations can freak you out, but as long as your heart gets the A-OK from your doctor, they’re pretty harmless. Don’t be foolish, though. If you get them and it’s unusual for you, or you have any of those other symptoms with them, GET YOUR HEART CHECKED OUT. Palpitations are weird, but they can also be a warning!