doctor's orders: 'cardiac arrest can happen at any age' without warning
know cpr, never exercise in a gym without a defibrillator, and control your risk factors, says dr. diego delgado, a cardiologist at toronto's university health network.
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healthing spoke with cardiologist dr. diego delgado of toronto’s university health network, who is also a professor of medicine at the university of toronto, about what we should all know about cardiac arrest and heart health.
what is a cardiac arrest, and how does it happen?
cardiac arrest is a sudden loss of heart function, and it’s almost always a fatal condition. according to statistics in general, only one in 10 patients survives a cardiac arrest. most cardiac arrest is caused by arrhythmias — abnormal heart rhythms. so when we talk about cardiac arrest, it’s really an electrical problem of the heart.
there are other causes of cardiac arrest, such as coronary artery disease, some patients could have congenital heart disease, childhood respiratory distress, recreational drug abuse. and what happens is basically, it’s a sudden event where the patient becomes unresponsive, and is not breathing. so basically, it’s a collapse.
one of the tricky things about heart health is that there are often no symptoms until cardiac arrest suddenly occurs. are there any warning signs, or things that people can look out for?
first, keep in mind that cardiac arrest can happen at any age, any time, people of all different [levels of] fitness, without any warning. however, there are patients who have more predispositions or risk factors. those are patients who have a family history of coronary artery disease, or patients with uncontrolled hypertension or high cholesterol, obesity, diabetes. it doesn’t mean that everybody with hypertension will have cardiac arrest, but these are patients who have a small increased risk of having cardiac events.
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so how do we prevent that? the modification of the risk factors is the key here. live a healthy lifestyle and control any underlying cardiac disease. there are patients who have genetic cardiac conditions or underlying arrhythmias, and that cannot be changed, so these patients need to be monitored closely and carefully.
as you said, even though cardiac arrest is more common in older people, it can happen at any age. is there a general age when people should start really seriously thinking about their heart health?
everybody, no matter what age you are, should be looking into lifestyle modifications — it applies to young people, teenagers, adults. but i will say that if you have a patient who turns 40, that’s a good age to have at least a cardiac consultation, or some basic cardiac tests.
it’s also a good practice, in my opinion, that anybody who is engaged in competitive sports, or even recreational sports, should be seen by a physician. this is my perspective, this is not in the national canadian guidelines. but in many countries around the world, people cannot even go to the gym without a cardiovascular assessment. you’ve probably heard about athletes who are running marathons and drop dead, or soccer players who drop dead on the field.
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oh, wow. i would have thought that those people aren’t at risk because they’re so healthy and athletic.
exactly. however, if you’re doing an extreme type of competitive sports, that puts your heart under significant stress. if you have an underlying cardiac condition that hasn’t been detected, that can trigger arrhythmias, and patients can die. so if you’re engaged in a competitive sport, you should have clearance for your cardiovascular health. and if you have a family history of cardiac disease, or if you have uncontrolled risk factors, i think it’s important even if you’re just engaged in physical activities at the gym, to have a clearance.
are there things you’d recommend people do for their heart health if they have a history of drug use?
drugs like cocaine and amphetamines, in high doses, can precipitate arrhythmias. so cessation of these drugs is essential. and again, this can happen in adults or in teenagers — it doesn’t matter what age, arrhythmias can occur at any time. and that’s a very common cause of sudden death.
again, controlling risk factors is important — i would say limit alcohol intake and unhealthy lifestyle [behaviours]. those are the things that can prevent these type of events.
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is there anything else you think the public needs to know about cardiac arrest or heart health?
as i mentioned, the survival rate is very small. but if cpr and a defibrillator are implemented right away, you can double the chances of survival. so, knowledge of cpr and [having] a defibrillator in places where we practice sports is important to consider. personally, i would never exercise in a gym or in any facility where there’s no defibrillator around, because it can happen. and knowledge of cpr is essential for the general population.
for more information about cardiac arrest, visit the heart and stroke foundation of canada.
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