- It is the stoppage of the mechanical activity of the heart that results in lack of circulating blood in the body tissues.
- Absence of circulating blood to the vital organs leads to death (due to lack of oxygen).
- Rapid and shallow breathing
- Reduced mental alertness.
- Arterial hypotension
- Ventricular fibrillation
- Absence of heart, carotid and femoral sounds
- Apnoea and cyanosis
- Collapse and death may happen without prior warning.
- Seizure may occur before collapse.
- ECG (to detect heart abnormalities such as prolonged QT interval)
- Blood tests for electrolytic balance (such as potassium and sodium levels).
- Chest X-ray (to determine size and shape of the heart)
- Echocardiogram (used to locate myocardial and valvular abnormalities)
- Nuclear scan (uses radioisotope elements such as thallium to locate the areas of CVS where the blood flow is impended)
- Angiogram or coronary catheterization (that make the arteries visible on X-ray revealing areas of blockage).
- Ejection fraction testing
- Electrophysiological testing and mapping (to locate the source of arrhythmias)
- Angina Pectoris
- Aortic aneurysm
- Drug overdose
- Aortic Stenosis
- Tetralogy of Fallot
- Torsade de Pointes
- Ventricular Tachycardia
- Dilated Cardiomyopathy
- Pulmonary embolism
- Myocardial Infarction
- Ventricular Fibrillation
- Wolff-Parkinson-White Syndrome
- Stroke or subarachnoid hemorrhage
- Treatment and monitor of underlying diseases such hypertension, pulmonary embolism and others.
- Consideration of fixing implantable cardioverter defibrillator (ICD) to reduce chances of dying from a second sudden cardiac arrest.
- Avoiding smoking
- Proper weight control
- Prompt initiation of cardiopulmonary resuscitation, CPR (best outcome if this is started within the first 4 minutes after cardiac arrest). [When a person collapses there is normally enough oxygen to last for a period of 10 minutes. The goal of CPR is to supply blood to the brain and the heart within this period]. Cardiac massage (one breath interposed between 4-5 cardiac compressions or continuous compressions for adults without respiratory failure or in cases of drowning as recently recommended.
- Clear the airways by aspiration of vomitus and other secretions. (It may be necessary to use fingers to do so when no other option is available).
- Mouth-to-Mouth ventilation
- Mouth-to-Nose insufflation
- Bag-Valve-Mask (BVM) or Ambu bag or Manual Rescitator ventilation.
- Defibrillation by use of either standard External Automatic Defibrillator (EAD) at 200 - 360J or the biphasic EAD at 150-200J. This is given together with CPR.
- IV adrenaline: 1mg bolus, repeated at 3-5 minute interval OR
- IV vasopressin 40 I.U OR
- Amiodarone 300mg in 20-30mLin normal saline.