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Heart attack and Cardiac arrest

A heart attack is a dangerous condition, and the greatest danger is that of the occurrence of cardiac arrest, i.e., sudden stoppage of heart action. If this happens, there is no heart beat and, therefore, no pulse.

Why is cardiac arrest so dangerous?
All supply of blood to the body organs is cut off. No organ can live without oxygen for any length of time, and the first to die is the brain. Within four minutes of such a happening the brain tissue starts dying. Even if the heart starts beating again later on, damage to the brain has been more or less done, depending upon the time the heart had remained at a standstill. In a few minutes, the vital centers fail and the respiration also stops, making the job of resuscitation even more difficult and uncertain.

Then what do you advise?
Under these circumstances, if something has to be done, there are only 3 ½ minutes available in which to revive the heart. In such a short time no doctor can possibly reach the patient. whosoever is on the spot is the only one who can save him provided he knows exactly what is to be done.

How do I recognize that a cardiac arrest has taken place before I can take any action.
This reminds me of an incident a few years ago. A patient in his mid-forties had a hectic day, and in the evening came, along with his son, to consult me for his angina. I had barely started with the examination, when I noticed that he had suddenly stopped talking and his head had drooped. We managed just in time to hold him from falling down from the stool on which he was sitting. His face had become ashen grey. Neither the pulse could be felt nor the heart beat could be heard. A thump or two on his chest did not revive him. We quickly laid him on the floor. By now he had become blue and had a convulsion like epilepsy. External cardiac massage was started immediately. In a couple of minutes the pulse returned, his face twitched, he gave a cry and opened his eyes. His facial colour also returned to normal. He was confused for a few minutes then started talking normally. He was lucky that the cardiac arrest did not take place while on the way but occurred in my clinic. However, he was not so lucky two years later.

I taught his son the method of giving external cardiac massage, and told him to practise the same and to teach everyone at home, so that in case of a future contingency it would be useful. But it seems the boy did not understand the seriousness of what had happened.

About two years later an electric short circuit occurred in the patient’s house resulting in a fire. With restless energy the patient started putting off the fire, and as a result of the high degree of exertion and excitement, just dropped dead- another cardiac arrest. The members of the family were unprepared for such a happening. Instead of attempting immediate resuscitation they ran to the telephone to call me or any doctor who could come. When two of us arrived it was too late. He was beyond cure. This case illustrates what happens when a cardiac arrest takes place.

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