What is a Cardiac Arrest? Is a Cardiac Arrest the same as a Heart Attack?
No. A cardiac arrest occurs when the heart stops beating normally. More specifically when there is a sudden onset of an abnormal heart beat (usually “Ventricular tachycardia” or “ventricular fibrillation”) which results in the failure of the heart being able to pump blood to the brain and other vital organs. Without CPR and defibrillation these abnormal heart rhythms usually rapidly lead to death.
“Heart attack” or “myocardial infarction” usually occurs due to blockage of an artery supplying the heart muscle. Symptoms include chest pain and breathlessness. The greater the damage, the weaker the heart, the higher the chance of “heart failure”and worse the prognosis. Sometimes acute myocardial infarction or very poor cardiac function can also lead to abnormal heart rhythm and cardiac arrest.
Over the age of 35 the vast majority of cardiac arrests occur due to coronary artery disease and myocardial infarction. Otherwise a cardiac arrest can also occur due to other structural abnormalities of the heart (such as hypertrophic cardiomyopathy, severe valve diseases, and right ventricular dysplasia) or primary electrical disorders of the heart (such as long QT syndrome). Many of these disorders have a genetic basis and are passed on from family members.
I play team sport once a week, is this enough and/or is there a benefit in doing more exercise?
While there is a clear overall benefit in performing exercise, a number of studies have shown there is an increased risk of heart attack and sudden cardiac death in athletes who do not perform regular exercise. The more regularly you exercise the less chance (up to 90% less) of sudden heart problems.
Can only CPR trained people use a Defibrillator?
No. Automatic external defibrillators are designed to be used by the general public however having CPR training is an important skill in improving the chance of successful resuscitation.
What’s an AED? Is it the same as a defibrillator?
Yes. AED stands for Automatic External Defibrillator. These devices instruct the operator on pad placement, diagnose the patient’s heart rhythm and prompt the operator to deliver an electric shock to the heart to restore normal rhythm. Defibrillators used by ambulance officers and doctors in hospital are similar devices but generally don’t automatically prompt the operator.
Can giving a shock from a Defibrillator cause any harm?
No. Once the defibrillator pads are applied and the defibrillator switched on, the device will only deliver a shock if the patient has an abnormal cardiac rhythm that requires defibrillation.
What if I use a Defibrillator on someone who isn’t having a cardiac arrest?
The device will not allow you to deliver a shock if it is not required.
Can I use a Defibrillator on the field if it is raining?
Yes. AED components are sealed and designed to use in various outdoor conditions. Wipe the chest dry to improve defibrillator pad contact.
I'm thinking I should see a Doctor before the season starts - what should I ask them and/or is there a list of questions that I can download?
Definitely. Report any symptoms you may be experiencing such as chest pain, blackouts, palpitations or unexplained breathlessness or fatigue when exercising. You should both be aware of your cardiac risk factors (blood pressure, cholesterol levels, blood sugar levels and family history of heart problems). If you have symptoms or concerning cardiac risk factors your doctor may arrange further investigation before you commence training.
Should I see a Doctor before I start any form of exercise?
If you are a mature age athlete or have a family history of heart problems or risk factors for heart disease it is a good idea to have a medical review before exercising and competing.
In some parts of the world (especially in Europe and the UK) and for some professional sporting organisations such as FIFA and the IOC, cardiac screening (history, examination and Electrocardiogram) is required especially in elite level sporting activities.
How regular should I visit my Doctor to get a health check?
There are no firm guidelines dictating how often you need to have a medical review. If you are a mature age athlete (over 35) and have had a general health check and there are no concerning symptoms or risk factors it would be reasonable to have a medical review every 2 to 3 years. The older you are and the greater the number of cardiac risk factors, the more careful you need to be. Review before every season would be reasonable. If you have a history of heart disease you should have cardiac specialist assessment before training and competing. There are some conditions where competiton is not recommended because of an increased risk of heart attack and sudden cardiac death.
I saw my Doctor preseason and after several tests and an ECG (all normal), I was told that there was still a chance that something could go wrong with my heart. Why bother?
It is true that medical assessment can not predict or prevent all problems however
- If a significant cardiac condition is identified it may be life saving on the football field.
- Identifying cardiac risks and correcting them will reduce your chance of heart attack, death or other cardiovascular problems such as stroke in the long term
- A significant proportion of athletes who have died or had heart attacks experienced symptoms before their event. Discussion with your doctor about cardiac symptoms and your heart health in general will help reduce the likelihood of problems on and off the field.
How long should CPR be continued if the person is not responding?
CPR should be continued until the patient shows signs of response or until professional help arrives. Patients have survived after more than an hour of CPR.
Shouldn’t I check for a pulse before assuming someone has had a cardiac arrest?
If a patient/athlete has a pulse they will have some sign of life (breathing spontaneously, moving, or making some sounds). It can be difficult to confidently assess the absence of a pulse which is why it is not routinely advised in CPR guidelines. Prompt commencement of CPR improves survival. With every 1 minute delay in return to normal cardiac rhythm there is an approximate 10% reduction in the chance of survival. An AED will not deliver a shock to someone if they have a pulse.
Is there an App that I can have on my 'phone that could help in the event of an incident?
Yes, you can download this app onto your iPhone http://www.fundacionmapfre.org/fundacion/en/campaign/campaign-juega-seguro/presentation-juega-seguro-give-them-heart/
Can I download a list of actions in the event of a heart issue that I should always carry with me?
I thought that if someone was unconscious you should lie them on their side, so they don’t swallow their tongue. Why isn’t that done in a cardiac arrest situation?
If a patient has vomited or you are worried about obstruction of the airway, it is important to try and clear this. Otherwise while a patient is not breathing and is unresponsive it is essential to commence effective CPR as quickly as possible. This is performed with the patient lying on their back. If possible you should provide 2 breaths per 30 chest compressions and have someone assist in applying AED pads to the patient’s chest. The faster you can restore normal cardiac rhythm the greater the chance of survival.
How common is sudden cardiac arrest in girls and women playing sport?
Sudden cardiac death or arrest in athletes is rare with reports ranging from 1 in 50,000 to 80,000 per year. The proportion of sudden cardiac death associated with sport is a small proportion of the overall number of sudden cardiac deaths in the community , however there is evidence that the physiological changes seen in intense exercise can lead to acute cardiac problems especially in older athletes.
For reasons not well understood the incidence of sudden cardiac death is much higher in men than in women, however it can still occur in females.