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Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to your body.

Sudden cardiac arrest differs from a heart attack, when blood flow to a part of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest.

If not treated immediately, sudden cardiac arrest can lead to death. With fast, appropriate medical care, survival is possible. Giving cardiopulmonary resuscitation (CPR), using a defibrillator — or even just giving compressions to the chest — can improve the chances of survival until emergency workers arrive.

Sudden cardiac arrest care at Mayo Clinic

Symptoms
Sudden cardiac arrest signs and symptoms are immediate and drastic and include:

Sudden collapse
No pulse
No breathing
Loss of consciousness
Sometimes other signs and symptoms occur before sudden cardiac arrest. These might include:

Chest discomfort
Shortness of breath
Weakness
Palpitations
But sudden cardiac arrest often occurs with no warning.

When to see a doctor
See your doctor promptly if you have episodes of:

Chest pain or discomfort
Heart palpitations
Rapid or irregular heartbeats
Unexplained wheezing
Shortness of breath
Fainting or near fainting
Lightheadedness or dizziness
If you're currently having these symptoms, call 911 or emergency medical help.

When the heart stops, the lack of oxygenated blood can cause death or permanent brain damage in minutes. Time is critical when you're helping an unconscious person who isn't breathing.

If you see someone who's unconscious and not breathing normally, do the following:

Perform CPR. Quickly check the breathing. If the person isn't breathing normally, begin CPR. Push hard and fast on the person's chest — at the rate of 100 to 120 compressions a minute. If you've been trained in CPR, check the person's airway and deliver rescue breaths after every 30 compressions.

If you haven't been trained, just continue chest compressions. Allow the chest to rise completely between compressions. Keep doing this until a portable defibrillator is available or emergency workers arrive.

Use a portable defibrillator, if one is available. It will give you step-by-step voice instructions. Continue chest compressions while the defibrillator is charging. Deliver one shock if advised by the device and then immediately resume CPR, starting with chest compressions, or give chest compressions only, for about two minutes.

Using the defibrillator, check the person's heart rhythm. If necessary, the defibrillator will give another shock. Repeat this cycle until the person recovers consciousness or emergency workers take over.

Portable automated external defibrillators (AEDs) are available in many places, including airports, casinos and shopping malls. You can also purchase one for your home. AEDs come with built-in instructions for their use. They're programmed to allow a shock only when appropriate.

Causes
A problem in your heart rhythm (arrhythmia) — the result of a problem with your heart's electrical system — is the usual cause of sudden cardiac arrest.

The heart's electrical system controls the rate and rhythm of your heartbeat. If something goes wrong, your heart can beat too fast, too slowly or irregularly (arrhythmia). Often these arrhythmias are brief and harmless, but some types can lead to sudden cardiac arrest.

The most common heart rhythm at the time of cardiac arrest is an arrhythmia in a lower chamber of your heart (ventricle). Rapid, erratic electrical impulses cause your ventricles to quiver uselessly instead of pumping blood (ventricle fibrillation).

Heart conditions that can lead to sudden cardiac arrest
Sudden cardiac arrest can happen in people who have no known heart diease. However, a life-threatening arrhythmia usually develops in a person with a pre-existing, possibly undiagnosed heart condition. Conditions include:

Coronary artery disease. Most cases of sudden cardiac arrest occur in people who have coronary artery disease, in which your arteries become clogged with cholesterol and other deposits, reducing blood flow to your heart.
Heart attack. If a heart attack occurs, often as a result of severe coronary artery disease, it can trigger ventricular fibrillation and sudden cardiac arrest. Also, a heart attack can leave scar tissue in your heart. Electrical short circuits around the scar tissue can lead to abnormalities in your heart rhythm.
Enlarged heart (cardiomyopathy). This occurs primarily when your heart's muscular walls stretch and enlarge or thicken. Then your heart's muscle is abnormal, a condition that often leads to arrhythmias.
Valvular heart disease. Leaking or narrowing of your heart valves can lead to stretching or thickening of your heart muscle. When the chambers become enlarged or weakened because of stress caused by a tight or leaking valve, there's an increased risk of developing arrhythmia.
Congenital heart disease. When sudden cardiac arrest occurs in children or adolescents, it can be due to a heart defect that was present at birth (congenital heart disease). Adults who've had corrective surgery for a congenital heart defect still have a higher risk of sudden cardiac arrest.
Electrical problems in the heart. In some people, the problem is in the heart's electrical system itself instead of a problem with the heart muscle or valves. These are called primary heart rhythm abnormalities and include conditions such as Brugada's syndrome and long QT syndrome.
Risk factors
Because sudden cardiac arrest is so often linked with coronary artery disease, the same factors that put you at risk of coronary artery disease can also put you at risk of sudden cardiac arrest. These include:

A family history of coronary artery disease
Smoking
High blood pressure
High blood cholesterol
Obesity
Diabetes
A sedentary lifestyle
Other factors that might increase your risk of sudden cardiac arrest include:

A previous episode of cardiac arrest or a family history of cardiac arrest
A previous heart attack
A personal or family history of other forms of heart disease, such as heart rhythm disorders, congenital heart defects, heart failure and cardiomyopathy
Age — the incidence of sudden cardiac arrest increases with age
Being male
Using illegal drugs, such as cocaine or amphetamines
Nutritional imbalance, such as low potassium or magnesium levels
Obstructive sleep apnea
Chronic kidney disease

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Bradycardia is a slower than normal heart rate. The hearts of adults at rest usually beat between 60 and 100 times a minute. If you have bradycardia (brad-e-KAHR-dee-uh), your heart beats fewer than 60 times a minute.

Bradycardia can be a serious problem if the heart doesn't pump enough oxygen-rich blood to the body. For some people, however, bradycardia doesn't cause symptoms or complications.

An implanted pacemaker can correct bradycardia and help your heart maintain an appropriate rate.



Symptoms
If you have bradycardia, your brain and other organs might not get enough oxygen, possibly causing these symptoms:

Near-fainting or fainting (syncope)
Dizziness or lightheadedness
Fatigue
Shortness of breath
Chest pains
Confusion or memory problems
Easily tiring during physical activity
When a slow heart rate is normal
A resting heart rate slower than 60 beats a minute is normal for some people, particularly healthy young adults and trained athletes. For them, bradycardia isn't considered a health problem.

When to see a doctor
A number of conditions can cause signs and symptoms of bradycardia. It's important to get a prompt, accurate diagnosis and appropriate care. See your doctor if you or your child has symptoms of bradycardia.

If you faint, have difficulty breathing or have chest pain lasting more than a few minutes, get emergency care or call 911 or your local emergency number. Seek emergency care for anyone with these symptoms.

Bradycardia can be caused by:

Heart tissue damage related to aging
Damage to heart tissues from heart disease or heart attack
Heart disorder present at birth (congenital heart defect)
Infection of heart tissue (myocarditis)
A complication of heart surgery
Underactive thyroid gland (hypothyroidism)
Imbalance of chemicals in the blood, such as potassium or calcium
Repeated disruption of breathing during sleep (obstructive sleep apnea)
Inflammatory disease, such as rheumatic fever or lupus
Medications, including some drugs for other heart rhythm disorders, high blood pressure and psychosis
Electrical circuitry of the heart
Your heart comprises four chambers — two upper (atria) and two lower (ventricles). A natural pacemaker (the sinus node), situated in the right atrium, normally controls your heart rhythm by producing electrical impulses that initiate each heartbeat.

These electrical impulses travel across the atria, causing them to contract and pump blood into the ventricles. Then these impulses arrive at a cluster of cells called the atrioventricular (AV) node.

The AV node transmits the signal to a collection of cells called the bundle of His. These cells transmit the signal down a left branch serving the left ventricle and a right branch serving the right ventricle, which causes the ventricles to contract and pump blood — the right ventricle sending oxygen-poor blood to the lungs and the left ventricle sending oxygen-rich blood to the body.

Bradycardia occurs when electrical signals slow down or are blocked.

Sinus node problems
Bradycardia often starts in the sinus node. A slow heart rate might occur because the sinus node:

Discharges electrical impulses slower than is normal
Pauses or fails to discharge at a regular rate
Discharges an electrical impulse that's blocked before causing the atria to contract
In some people, the sinus node problems result in alternating slow and fast heart rates (bradycardia-tachycardia syndrome).

Heart block (atrioventricular block)
Bradycardia can also occur because electrical signals transmitted through the atria aren't transmitted to the ventricles (heart block, or atrioventricular block).

Heart blocks are classified based on the degree to which signals from the atria reach your heart's main pumping chambers (ventricles).

First-degree heart block. In the mildest form, all electrical signals from the atria reach the ventricles, but the signal is slowed. First-degree heart block rarely causes symptoms and usually needs no treatment if there's no other abnormality in electrical signal conduction.
Second-degree heart block. Not all electrical signals reach the ventricles. Some beats are "dropped," resulting in a slower and sometimes irregular rhythm.
Third-degree (complete) heart block. None of the electrical impulses from the atria reaches the ventricles. When this happens, a natural pacemaker takes over, but this results in slow and sometimes unreliable electrical impulses to control the beat of the ventricles.
Risk factors
Age
A key risk factor for bradycardia is age. Heart problems, which are often associated with bradycardia, are more common in older adults.

Risk factors related to heart disease
Bradycardia is often associated with damage to heart tissue from some type of heart disease.

Therefore, factors that increase your risk of heart disease can also increase the risk of bradycardia. Lifestyle changes or medical treatment might decrease the risk of heart disease associated with the following factors:

High blood pressure
Smoking
Heavy alcohol use
Recreational drug use
Psychological stress or anxiety
Complications
If bradycardia causes symptoms, possible complications can include:

Frequent fainting spells
Inability of the heart to pump enough blood (heart failure)
Sudden cardiac arrest or sudden death
Prevention
The most effective way to prevent bradycardia is to reduce your risk of developing heart disease. If you already have heart disease, monitor it and follow your treatment plan to lower your risk of bradycardia.

Prevent heart disease
Treat or eliminate risk factors that may lead to heart disease. Take the following steps:

Exercise and eat a healthy diet. Live a heart-healthy lifestyle by exercising regularly and eating a healthy, low-fat, low-salt, low-sugar diet that's rich in fruits, vegetables and whole grains.
Maintain a healthy weight. Being overweight increases your risk of developing heart disease.
Keep blood pressure and cholesterol under control. Make lifestyle changes and take medications as prescribed to correct high blood pressure (hypertension) or high cholesterol.
Don't smoke. If you smoke and can't quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit.
If you drink, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Ask your doctor if your condition means you should avoid alcohol. If you can't control your alcohol use, talk to your doctor about a program to quit drinking and manage other behaviors related to alcohol abuse.

Don't use recreational drugs. Talk to your doctor about an appropriate program for you if you need help ending recreational drug use.
Manage stress. Avoid unnecessary stress and learn coping techniques to handle normal stress in a healthy way.
Go to scheduled checkups. Have regular physical exams and report signs or symptoms to your doctor.
Monitor and treat existing heart disease
If you already have heart disease, there are steps you can take to lower your risk of developing bradycardia or another heart rhythm disorder:

Follow the plan. Be sure you understand your treatment plan, and take all medications as prescribed.
Report changes immediately. If your symptoms change or worsen or you develop new symptoms, tell your doctor immediately.

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What Is Angina?
If you feel pressure or a squeezing in your chest, it may be angina. It can feel like a heart attack, but often it's a warning sign. The chest pain happens because there isn't enough blood flowing to part of your heart. It's a symptom of heart disease, and it's occurs when something blocks the arteries or there's a decreased blood flow in the arteries that bring oxygen-rich blood to your heart.

Angina usually goes away quickly. Still, it can be a symptom of a life-threatening heart problem. Call your doctor if you have it. It's important to find out what's going on and to talk about what you can do to avoid a heart attack. There's a lot you can do to stop it from happening. Usually, medicine along with lifestyle changes can control it. If it's more severe, you may need surgery, too. Or you may need what’s called a stent, a tiny tube that props open arteries.


What are different types of angina?
Stable Angina is the most common. Physical activity or stress can trigger it. It usually lasts a few minutes, and it goes away when you rest. It isn't a heart attack, but it can be a sign that you're more likely to have one. Tell your doctor if this happens to you.

Unstable Angina: You can have this while you're at rest or not very active. The pain can be strong and long-lasting, and come back again and again. It can be a signal that you're about to have a heart attack, so see a doctor right away.

Prinzmetal's Angina (also called variant angina) is rare. It might happen at night while you're sleeping or resting. The heart arteries suddenly tighten or narrow. It can cause a lot of pain, and you should get it treated.


Symptoms of Angina
Chest pain is the symptom, but it affects people differently. You may feel:
Aching
Burning
Discomfort
Feeling of fullness in the chest
Heaviness
Pressure
Squeezing
You’re likely to have pain behind your breastbone, but it can spread to your shoulders, arms, neck, throat, jaw, or back.
It's possible to mistake an aching or burning for heartburn or gas.
Men often feel pain in their chest, neck, and shoulders. Women may feel discomfort in their belly, neck, jaw, throat, or back. You may also have shortness of breath, sweating, or dizziness. One study found that women were more likely to use the words "pressing" or "crushing" to describe the feeling.
Stable Angina often gets better with rest. Unstable Angina may not, and it could get worse.


Possible Causes of Angina:
Angina is usually due to heart disease. A fatty substance called plaque builds up in your arteries, blocking blood flow to the heart muscle. This forces your heart to work with less oxygen. That causes pain. You may also have blood clots in the arteries of your heart, which can cause heart attacks.

Other, less common causes of chest pain include:

A blockage in a major artery of the lungs (Pulmonary Embolism)
An enlarged or thickened heart (Hypertrophic Cardiomyopathy)
Narrowing of a valve in the main part of the heart (Aortic Stenosis)
Swelling of the sac around the heart (Pericarditis)
Tearing in the wall of the aorta, the largest artery in your body (aortic dissection)

What questions should you ask your Doctor?
Do I need any more tests?
What type of angina do I have?
Do I have heart damage?
What treatment do you recommend?
How will it make me feel?
What can I do to try to prevent a heart attack?
Are there activities I shouldn't do?
Will changing my diet help?


Angina Treatment:
It depends on how much damage there is to your heart. For people with mild angina, medicine and lifestyle changes can often help blood flow better and control symptoms.

Your doctor might prescribe medicines to:
Widen blood vessels, letting more blood flow to the heart
Slow the heart down, so it doesn't have to work as hard
Relax blood vessels, to let more blood flow to the heart
Prevent blood clots
If medicines aren't enough, you may need to have blocked arteries opened with a medical procedure or surgery. This could be:

Angioplasty /Stenting: The doctor threads a tiny tube, with a balloon inside, through a blood vessel and up to your heart. Then, he inflates the balloon inside the narrowed artery to widen it and restore blood flow. A small tube called a stent may be left inside the artery to help keep it open. The stent is usually permanent and made of metal. It can also be made of a material that the body absorbs over time. Some stents have medicine that helps keep the artery from getting blocked again.

The procedure usually takes less than 2 hours. You’ll probably stay overnight at the hospital.

Coronary Artery Bypass Grafting (CABG), or bypass surgery. The surgeon takes healthy arteries or veins from another part of your body and uses them to go around the blocked or narrowed blood vessels. You can expect to stay in the hospital about a week after you have this. You'll be in the intensive care unit for a day or two while nurses and doctors keep a close eye on your heart rate, blood pressure, and oxygen levels. You'll then move to a regular room to recover.

Taking Care of Yourself
You can still lead an active life, but it's important that you listen to your body. If you feel pain, stop what you’re doing and rest. Know what triggers your angina, like stress or intense exercise. Try to avoid things that tend to set it off. For example, if large meals cause problems, eat smaller ones and eat more often. It's important to talk to your doctor to have your medications changed or to be evaluated for further testing or procedures if you are feeling pain. Because angina can be an ominous sign, it is important to get fully evaluated.

These lifestyle changes may help protect your heart:

Stop Smoking: It can damage your blood vessels and increase your heart disease risk.

Eat a heart-healthy diet to lower your blood pressure and cholesterol levels. When those are out of normal range, your chance for heart disease can rise. Eat mainly fruits and vegetables, whole grains, fish, lean meat, and fat-free or low-fat dairy. Limit salt, fat, and sugar.

Use stress-relieving measures like meditation, deep breathing, or yoga to relax.
Exercise most days of the week.
See your doctor regularly.
If you have chest pain that is new or unusual for you, and you think you may be having a heart attack, call 911 right away. Don't wait. Quick treatment is very important. It can protect you from more damage.

Tomatoes are a staple food item in all Indian households. Almost all our dishes and curries are prepared with chopped or pureed tomatoes, which not only add a bright red colour to the meals but also bring in a lot of nutritional properties. Another common way of consuming tomatoes is by juicing them. Be it pure tomato juice, mixed vegetable juice or even soup, tomato juice lends its delightful tangy flavour to any beverage it is mixed in. Now, there's another reason to glug a glass of tomato juice. A new study, published in the journal of Food Science and Nutrition, has claimed that unsalted tomato juice may help in boosting heart health by cutting down the risk of heart-related ailments.

The findings of the study suggest that unsalted tomato juice plays an important role in suppressing high blood pressure and cholesterol levels in adults as they are more prone to heart-related problems.

Researchers from the Tokyo Medical and Dental University in Japan studied around 500 participants, of which, 184 were males and 297 were females.

The team discovered lowered levels of blood pressure in 94 participants with untreated pre-hypertension or hypertension. Systolic blood pressure went down from an average of 141.2 to 137 mmHg, and diastolic blood pressure saw a drop from an average of 83.3 to 80.9 mmHg. In 125 people, bad cholesterol (LDL) was reduced from an average of 155 to 149.9 mg/dL.

The results showed a similar pattern across both the genders - males and females - and also across all age groups.

Tomato juice contains some unique nutritional properties that make it beneficial for heart health. Tomato juice is rich in fibre and a compound called niacin, which helps in cutting down of LDL cholesterol. Tomato juice is full of antioxidant - beta-carotene and phytonutrient - lycopene, which prevents the occurrence of cardiovascular issues.

Barley is a grain commonly found in bread, beverages, and various cuisines of every culture. It is one of the most widely consumed grains in the entire world. Barley is high in fibre, has twice the protein and almost half the calories of oats as well as an important consideration for people with weight or dietary concerns. It is used for lowering blood sugar, blood pressure, and cholesterol, and for promoting weight loss. It is also used for digestive complaints including diarrhea, stomach pain, and inflammatory bowel conditions.

According to a new study conducted by St Michael's Hospital in Canada consuming barley as food or in food recipes can significantly reduce the levels of "bad cholesterol" that are associated with heart disease risk, suggesting that barley has similar cholesterol-lowering effects as oats.

The review, published in The European Journal of Clinical Nutrition, included 14 studies on clinical trials conducted in seven countries, including Canada.
The results showed that barley reduced by seven per cent both low-density lipoprotein, or LDL and non-high-density lipoprotein, or non-HDL. "The findings are most important for populations at high risk for cardiovascular disease, such as Type 2 diabetics, who have normal levels of LDL cholesterol but elevated levels of non-HDL or apolipoprotein B," said Scientist Vladimir Vuksan.

Barley has a lowering effect on the total bad cholesterol in high-risk individuals, but can also benefit people without high cholesterol. High cholesterol and diabetes are the major risk factors for heart disease and stroke. Measuring non-HDL and or apoB -- a lipoprotein that carries bad cholesterol through the blood, provides a more accurate assessment for heart disease risk, as they account for the total 'bad cholesterol' found in the blood.

Despite its benefits, barley is not as well established as some other health-recommended foods -- such as oats, the researchers rued, adding that barley consumption by humans has fallen by 35 per cent in the last 10 years.

According to Bangalore based Nutritionist Anju Sood, "Fibre increases the ability of your heart to do away with the bad cholesterol. Barley Water is a good source of fibre hence it is essential for patients who suffer from cholesterol problems. Moreover it is good for individuals who have a low water retention problem and is recommended to them."

Dr. Nitesh
Dr. Nitesh
MS/MD - Ayurveda, Ayurveda, 8 yrs, Pune
Dr. Chhaya Helambe
Dr. Chhaya Helambe
BAMS, Ayurveda Family Physician, 20 yrs, Pune
Dr. Harshada Giri
Dr. Harshada Giri
BDS, Dental Surgeon, 13 yrs, Pune
Dr. Sandeep Jagtap
Dr. Sandeep Jagtap
MD - Allopathy, HIV Specialist Pain Management Specialist, 15 yrs, Pune
Dr. Vipul Jaiswal
Dr. Vipul Jaiswal
MS/MD - Ayurveda, Ayurveda General Physician, 11 yrs, Pune
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