Causes Of Cardiac Arrest

Cardiac arrest is a critical medical emergency characterized by the sudden cessation of heart function, leading to a loss of effective blood circulation. Understanding the causes of cardiac arrest is essential for prevention, timely intervention, and improving patient outcomes. This article synthesizes findings from multiple research studies to provide a comprehensive overview of the causes of cardiac arrest.

Cardiac Causes of Cardiac Arrest

Acute Myocardial Infarction and Coronary Artery Disease

Acute myocardial infarction (AMI) and coronary artery disease (CAD) are the most common cardiac causes of cardiac arrest. These conditions lead to the obstruction of blood flow to the heart muscle, resulting in ischemia and potentially fatal arrhythmias such as ventricular fibrillation . Coronary artery disease remains the predominant cause of out-of-hospital cardiac arrest (OHCA).

Structural Heart Abnormalities

Structural heart abnormalities, including cardiomyopathies and coronary atherosclerosis, are significant contributors to cardiac arrest. Conditions such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy can predispose individuals to sudden cardiac arrest . In some cases, unusual structural causes like a freely mobile left atrial mass can also lead to recurrent cardiac arrest.

Genetic and Electrical Disorders

Genetic factors play a crucial role in unexplained cardiac arrest, particularly in the absence of coronary artery disease and overt structural heart disease. Inherited ion channel abnormalities, such as Long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia, are common genetic causes . These conditions disrupt the heart's electrical activity, leading to arrhythmias and sudden cardiac arrest.

Non-Cardiac Causes of Cardiac Arrest

Pulmonary Causes

Pulmonary conditions, including pulmonary embolism and severe respiratory disorders, are significant non-cardiac causes of cardiac arrest. Pulmonary embolism, in particular, can obstruct blood flow in the lungs, leading to hypoxia and cardiac arrest . Pulmonary causes account for approximately 15% of in-hospital cardiac arrests.

Metabolic and Toxic Causes

Metabolic imbalances, such as hyperkalemia and severe electrolyte disorders, can precipitate cardiac arrest. Additionally, toxic agents, including drug toxicity and adverse drug reactions, are notable non-cardiac causes. Drug toxicity is a leading cause of OHCA in younger populations.

Other Non-Cardiac Causes

Other non-cardiac causes include aortic dissection, exsanguination, cerebral disorders, sepsis, and accidental hypothermia. These conditions can lead to severe physiological disturbances, ultimately resulting in cardiac arrest .

Psychological and Environmental Factors

Anxiety and Mental Stress

Anxiety and mental stress have been linked to sudden cardiac arrest. Mental stress can precipitate cardiac arrest by affecting cardiac ion channels and leading to arrhythmias such as ventricular fibrillation. Anxiety may predispose individuals to cardiac arrest by contributing to other risk factors like cardiovascular disease and diabetes mellitus.

Exercise and Physical Activity

Cardiac arrests disproportionately occur during physical activity, particularly exercise. This is likely due to the increased cardiac demand and potential for triggering underlying cardiac conditions during exertion.

Conclusion

Cardiac arrest is a multifactorial event with both cardiac and non-cardiac causes. Acute myocardial infarction, coronary artery disease, structural heart abnormalities, and genetic disorders are primary cardiac causes. Non-cardiac causes include pulmonary conditions, metabolic imbalances, toxic agents, and other severe physiological disturbances. Psychological factors like anxiety and mental stress, as well as physical activity, also play a role. Understanding these diverse causes is crucial for developing effective prevention and intervention strategies to improve patient outcomes.

Causes of cardiac arrest

Summary

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