October 23, 2008

Speedy Care After Heart Attack Key to Survival

THURSDAY, Oct. 23 (HealthDay News) -- Getting a heart beating again is only the first step in saving a life after a sudden cardiac arrest, a new report shows.

An advisory, published in the Oct. 23 issue of Circulation, said that health-care providers must move more quickly after resuscitation or risk the losing the patient to the original cause of the heart failure.

"Although we have become better at restarting the heart, we are only beginning to learn and implement the best ways to keep patients alive and minimize brain damage after their heart is re-started," Dr. Robert W. Neumar, head of the heart association's statement writing committee and associate director of the Center for Resuscitation Science at the University of Pennsylvania in Philadelphia.

A 2006 report on cardiac arrest resuscitation found that of more than 20,000 people whose hearts were re-started, the in-hospital mortality rates were 67 percent for adults and 55 percent for children.

Brain injury, heart dysfunction, systemic inflammation and the underlying disease that caused the cardiac arrest all contributed to this high death rate. Collectively, these symptoms are known as post-cardiac arrest syndrome.

Among the treatments the advisory statement said may hold hope for improving the prognosis of these patients:

• Giving adults mild therapeutic hypothermia -- the cooling of the body to 32 to 34 degrees Celsius (89.6 to 93.2 degrees Fahrenheit) for at least 12 to 24 hours. This can improve survival and lower the risk of brain damage.
• Performing coronary angiography, an X-ray of the heart arteries, to look for artery blockages in patients resuscitated after a heart attack (as determined by an electrocardiogram). This could lead to lifesaving treatment, such as artery-opening angioplasty or the use of clot-busting drugs to restore blood flow to the heart.

The advisory also called for inserting an implantable cardioverter defibrillator (ICD), if needed, in patients with good neurological function. It also reinforced the need for treating high blood sugar, seizures and infection, common conditions that follow cardiac arrest resuscitation.

More information

The American Heart Association has more about signs of a cardiac arrest.

-- Kevin McKeever
SOURCE: American Heart Association, news release, Oct. 23, 2008
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