Sudden Cardiac Arrest

What is sudden cardiac arrest (SCA)?

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly stops beating. When that happens, blood stops flowing to the brain and other vital organs. If it is not treated, SCA usually causes death within minutes. But quick treatment with a defibrillator may be lifesaving.

A heart attack is different from an SCA. A heart attack happens when blood flow to the heart is blocked. During a heart attack, the heart usually doesn't suddenly stop beating. With an SCA, the heart stops beating.

Sometimes an SCA can happen after or during recovery from a heart attack.

Your heart has an electrical system that controls the rate and rhythm of your heartbeat. An SCA can happen when the heart's electrical system is not working right and causes irregular heartbeats. Irregular heartbeats are called arrhythmias. There are different types. They may cause the heart to beat too fast, too slow, or with an irregular rhythm. Some can cause the heart to stop pumping blood to the body; this is the type that causes SCA.

Certain diseases and conditions can cause the electrical problems that lead to SCA. They include:

• Ventricular fibrillation, a type of arrhythmia where the ventricles (the heart's lower chambers) don't beat normally. Instead, they beat very fast and very irregularly. They can't pump blood to the body. This causes most SCAs.
• Coronary artery disease (CAD), also called ischemic heart disease. CAD happens when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. It is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. The plaque blocks some or all of the blood flow to the heart.
• Some types of physical stress can cause your heart's electrical system to fail, such as
  • Intense physical activity in which your body releases the hormone adrenaline. This hormone can trigger SCA in people who have heart problems.
  • Very low blood levels of potassium or magnesium. These minerals play an important role in your heart's electrical system.
  • Major blood loss
  • Severe lack of oxygen
• Certain inherited disorders which can cause arrhythmias or problems with the structure of your heart
• Structural changes in the heart, such as an enlarged heart due to high blood pressure or advanced heart disease. Heart infections can also cause changes to the structure of the heart.

You are at higher risk for SCA if you:

• Have coronary artery disease (CAD). Most people with SCA have CAD. But CAD usually doesn't cause symptoms, so they may not know that they have it.
• Are older; your risk increases with age
• Are a man; it is more common in men than women
• Are Black or African American, especially if you have other conditions such as diabetes, high blood pressure, heart failure, or chronic kidney disease
• Have a personal history of heartbeats that aren't regular (arrhythmia)
• Have a personal or family history of SCA or inherited disorders that can cause arrhythmia
• Have a problem with drug or alcohol use
• Have had a heart attack
• Have heart failure

Usually, the first sign of SCA is loss of consciousness (fainting). This happens when the heart stops beating.

Some people may have a racing heartbeat or feel dizzy or light-headed just before they faint. And sometimes people have chest pain, shortness of breath, nausea, or vomiting in the hour before they have an SCA.

SCA happens without warning and requires emergency treatment. Health care providers rarely diagnose SCA with medical tests as it's happening. Instead, it is usually diagnosed after it happens. Providers do this by ruling out other causes of a person's sudden collapse.

If you are at high risk for SCA, your provider may refer you to a cardiologist, a doctor who specializes in heart diseases. The cardiologist may ask you to get various heart health tests to see how well you heart is working. He or she will work with you to decide whether you need treatment to prevent SCA.

SCA is an emergency. A person having SCA needs to be treated with a defibrillator right away. A defibrillator is a device sends an electric shock to the heart. The electric shock can restore a normal rhythm to a heart that's stopped beating. To work well, it needs to be done within minutes of the SCA.

Most police officers, emergency medical technicians, and other first responders are trained and equipped to use a defibrillator. Call 9-1-1 right away if someone has signs or symptoms of SCA. The sooner you call for help, the sooner lifesaving treatment can begin.

Many public places such as schools, businesses, and airports have automated external defibrillators (AEDs). AEDs are special defibrillators that untrained people can use if they think that someone has had SCA. AEDS are programmed to give an electric shock if they detect a dangerous arrhythmia. This prevents giving a shock to someone who may have fainted but isn't having SCA.

If you see someone who you think has had SCA, you should give cardiopulmonary resuscitation (CPR) until defibrillation can be done.

People who are at risk for SCA may want to consider having an AED at home. Ask your cardiologist to help you decide whether having an AED in your home might help you.

If you survive SCA, you'll likely be admitted to a hospital for ongoing care and treatment. In the hospital, your medical team will closely watch your heart. They may give you medicines to try to reduce the risk of another SCA.

They will also try to find out what caused your SCA. If you're diagnosed with coronary artery disease, you may have an angioplasty or coronary artery bypass surgery. These procedures help restore blood flow through narrowed or blocked coronary arteries.

Often, people who have had SCA get a device called an implantable cardioverter defibrillator (ICD). This small device is surgically placed under the skin in your chest or abdomen. An ICD uses electric pulses or shocks to help control dangerous arrhythmias.

You may be able to lower your risk of SCA by following a heart-healthy lifestyle. If you have coronary artery disease or another heart disease, treating that disease can also lower your risk of SCA. If you have had an SCA, getting an implantable cardioverter defibrillator (ICD) can lower your chance of having another SCA.

NIH: National Heart, Lung, and Blood Institute

Aplastic Anemia

What is aplastic anemia?

Aplastic anemia is a rare but serious blood disorder. If you have it, your bone marrow doesn't make enough new blood cells. It happens when there is damage to stem cells inside your bone marrow. There are different types of aplastic anemia, including Fanconi anemia.

The causes of aplastic anemia can include:

• Autoimmune disorders, which are the most common cause
• Certain inherited gene changes, such as the one that can cause Fanconi anemia
• Toxic substances, such as pesticides, arsenic, and benzene
• Radiation therapy and chemotherapy for cancer
• Certain medicines
• Viral infections such as hepatitis, Epstein-Barr virus, or HIV
• Pregnancy

In many people, the cause is unknown. This is called idiopathic aplastic anemia.

Aplastic anemia can develop suddenly or slowly. It can be mild or severe. The symptoms of aplastic anemia can include:

• Fatigue
• Weakness
• Dizziness
• Shortness of breath
• Easy bruising or bleeding

Aplastic anemia can cause other problems, including frequent infections and bleeding. It raises your risk of developing a serious blood disorder.

If not treated, aplastic anemia can also lead to heart problems such as an arrhythmia (a problem with the rate or rhythm of your heartbeat), an enlarged heart, or heart failure.

To find out if you have aplastic anemia, your doctor will:

• Take your medical and your family medical histories
• Do a physical exam
• Order tests, such as tests to check if you have low numbers of cells in your bone marrow and blood

If you have aplastic anemia, your doctor will create a treatment plan for you. The plan will be based on how severe the anemia is and what is causing it. Treatments can include:

• Blood transfusions
• Blood and marrow stem cell transplants
• Medicines to suppress your immune system

Because of the risk of blood disorders, your doctor will monitor your condition and screen you for blood disorders regularly.

NIH: National Heart, Lung, and Blood Institute

Blood Pressure Medicines

What is high blood pressure?

High blood pressure, also called hypertension, is when blood puts too much pressure against the walls of your arteries. Almost half of American adults have high blood pressure, usually with no symptoms. But it can cause serious problems such as stroke, heart failure, heart attack, and kidney disease.

Healthy lifestyle changes can help reduce high blood pressure:

• Losing weight
• Being physically active
• Managing stress
• Reducing sodium in your diet
• Avoiding alcohol, tobacco, and illegal drugs
• Getting enough sleep

Sometimes lifestyle changes alone cannot control or lower your high blood pressure. In that case, your health care provider may prescribe blood pressure medicines.

The most commonly used blood pressure medicines work in different ways to lower blood pressure:

• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) keep your blood vessels from narrowing as much and allows blood to move through them with less pressure.
• Beta blockers help your heart beat slower and with less force. This means that your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you also have certain other conditions.
• Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows the blood vessels to relax.
• Diuretics remove extra water and sodium (salt) from your body. This lowers the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.

Often, two or more medicines work better than one. If these medicines do not lower your blood pressure enough, your provider may suggest that you take another type of blood pressure medicine.

While taking the medicines, it is still important to keep up with your healthy lifestyle changes. Doing both helps keep blood pressure lower than lifestyle changes or medicines alone.

NIH: National Heart, Lung, and Blood Institute

Body Weight

What is body weight?

Body weight is the total mass of your body. Keeping track of your weight is one way to check for changes in your health, but it can't tell you the whole story. That's because your weight includes muscle, bone, fat, and water. Also, everyday factors can play a role in your weight, such as your:

• Diet
• Activity level
• Stress level
• Sleep habits
• Family history and genetics
• Age

A healthy weight is more than just a number on the scale. It's about feeling good, having energy, and lowering your risk of disease. Your health care provider can help you determine a healthy body weight based on several factors. These include your:

• Body Mass Index (BMI). BMI is a measure of how much you weigh compared to how tall you are. The higher your BMI, the higher your risk for certain diseases. BMI does not distinguish between fat, muscle, and bone mass. It also may overestimate body fat in athletes or those with a muscular build, or underestimate body fat in older persons or others who have lost muscle.
• Waist circumference. If most of your body fat is around your abdomen (belly) rather than your hips, you may be at a higher risk for heart disease and type 2 diabetes.
• Health history. Your health care provider will likely consider your risk factors for diseases and health conditions, such as having high cholesterol, in determining your healthy body weight.

Having a healthy body weight may lower your chance of developing certain health problems. Carrying too much or too little weight can affect your health. Ranges of body weight include:

• Underweight. Your weight is lower than it should be for your health.
• Normal. Your weight is within a healthy range.
• Overweight. Your weight is greater than it should be for your health.
• Obese. Your body fat is greater than it should be for your health.

Body weight needs can be different at different ages. For children, weight and growth are tracked over time based on their age. For older adults, keeping muscle and strength is key, and sudden weight loss should always be checked by your provider.

Talk to your provider if you're losing or gaining weight without trying. A sudden, unexpected change in weight can be a sign of a medical problem.

Causes for sudden weight loss can include:

• Thyroid problems
• Cancer
• Infectious diseases
• Digestive diseases
• Certain medicines

Causes for sudden weight gain can include:

• Certain medicines
• Thyroid problems
• Heart failure
• Kidney disease
• Liver disease

Maintaining a healthy body weight can improve energy, sleep, and overall wellbeing. Talk to your provider about what a healthy weight would be for you. If they recommend that you gain or lose weight, they might refer you to a dietician for support. A dietician is a professional who has special training to help you learn the best way to eat.

• Good nutrition and exercise can help in losing weight. Even a small change in weight can lower your risk of developing certain diseases.
• Eating extra calories within a well-balanced diet and treating any underlying medical problems can help you gain weight.

Focus on your health, not just the number on the scale. With daily healthy habits and self-compassion, you can support lasting improvements in your overall wellbeing.

NIH: National Heart, Lung, and Blood Institute

Cardiac Rehabilitation

Cardiac rehabilitation (rehab) is a medically supervised program to help people who have:

• A heart attack
• Angioplasty or coronary artery bypass grafting for coronary heart disease
• A heart valve repair or replacement
• A heart transplant or a lung transplant
• Angina
• Heart failure

The goal is to help you return to an active life, and to reduce the risk of further heart problems. A team of specialists will create a plan for you that includes exercise training, education on heart healthy living, and counseling to reduce stress. You will learn how to reduce your risk factors, such as high blood pressure, high blood cholesterol, depression, and diabetes. Being overweight, having obesity, smoking, and not exercising are other risk factors.

NIH: National Heart, Lung, and Blood Institute