You will need CPR
Any person who is in a cardiac arrest needs a shock to the heart to survive (more on that later.) However, CPR can keep a person alive until that can happen. Needless to say, this is life or death. Without CPR, a person in cardiac arrest will die within minutes.
If you witness someone pass out, try to rouse them, and if you can’t, check their pulse. “If there is no pulse, start cardiopulmonary resuscitation (CPR or chest compressions) immediately and call 911,” says Konstantinos Dean Boudoulas, MD, an interventional cardiologist at The Ohio State University Wexner Medical Center in Columbus.
CPR manually gets the blood moving through the body and is a person’s best shot at survival. (Here’s how to do CPR so you know what to do if someone experiences a life-threatening emergency.)
Ninety percent of people who suffer out-of-hospital cardiac arrests die, but CPR, if performed in the first few minutes, can triple a person’s odds of survival, according to the American Heart Association. Cardiac arrest can also occur in the hospital. (Survival rates are rising for people who have a cardiac arrest while in the hospital, but unfortunately if it happens at night or on a weekend, you’re less likely to survive, according to a 2018 study the Journal of the American College of Cardiology.)
You need your heart shocked STAT
Automated external defibrillators (AEDs) are everywhere today—schools, airports, hotels, restaurants, gyms, you name it. They are designed to be used by anyone, and they do save lives.
Defibrillators can instantly analyze heart rhythms to determine if they are “shockable,” which means reversible. Defibrillation should be started as soon after CPR as possible. Further treatment may be needed after an abnormal rhythm is reversed to keep it from coming back.
If this doesn’t work, some people can be placed on an automated CPR machine and transferred to a hospital where they are immediately placed on a heart-lung bypass machine for support. This is known as extracorporeal cardiopulmonary resuscitation (ECPR), and it allows interventional cardiologists to look for reversible causes of the arrest.
“It’s a game changer,” explains Dr. Boudoulas.
You need a diagnosis
Asystole is a cardiac arrest-causing rhythm where there is no electrical activity visible on the electrocardiogram (ECG) monitor, explains Dr. Boudoulas. Pulseless electrical activity (PEA) occurs when the ECG shows a heart rhythm that should produce a pulse but does not.
“Essentially, sudden cardiac death results from arrhythmia indirectly or directly,” he says. “Heart disease can cause a heart attack, which can lead to arrhythmia.”
The bottom line
If your heart stops beating, survival depends on the cause of the arrest as well as the timeliness of treatment. Each year, there are 365,000 SCAs in the United States—and about 90 percent are fatal.
Knowing CPR and acting quickly to use call an ambulance and use an AED (if one is available) provides the best chance of survival in the face of cardiac arrest.