It can be scary to hear about sudden cardiac arrest cases in young, seemingly healthy runners in the news, and these rep might leave you wondering if you’re at risk.
Since sudden cardiac arrest typically comes on with little to no warning, we tapped cardiologist Brad Oldemeyer, M.D., of UCHealth in Fort Collins, Colorado, to explain what to look out for and how to respond if you suspect cardiac arrest in someone else.
What is cardiac arrest?
Cardiac arrest can be somewhat difficult to define, explains Oldemeyer, but sudden cardiac arrest occurs when your heart unexpectedly has an abnormal rhythm (arrhythmia) and stops pumping blood to vital organs such as the brain and lungs. This spontaneous, abnormal heart rhythm, where the heart beats either too fast or slow is incompatible with life. About 90 percent of people who experience sudden cardiac arrest outside of a hospital die, according to the American Heart Association.
A heart attack, on the other hand, occurs when a blocked artery prevents oxygenated blood from reaching a section of the heart. If the blockage remains, the part of the heart normally nourished by that artery begins to die.
Think of it like sudden cardiac arrest is an electrical issue in which there’s a short circuit, but a heart attack is more like a plumbing issue, in which a pipe is blocked.
What are early signs of cardiac arrest?
Sudden cardiac arrest comes on, well—suddenly. But, precursors to cardiac arrest may be symptoms associated with feeling overexerted or fatigued—out of the norm—when you are training. Recent research published in CMAJ found that 29 percent of athletes who died suddenly of cardiac arrest during activity experience red-flag symptoms beforehand. All athletes have symptoms associated with exertion, which are normal, but when there is a change in baseline, that’s when you should be concerned, Oldemeyer explains.
“Classic symptoms of a heart abnormality can be hard to spot,” Oldemeyer says.
If you are no longer able to keep up your typical exercise routine, or you have a change in endurance—say you’re struggling to maintain a pace that you know should be no problem, or have shortness of breath or chest pain that’s out of the norm—you should talk to your doctor about a cardiovascular risk assessment as you may be experiencing one of the red-flag symptoms. And, if you ever pass out or lose consciousness during exercise, that is a huge sign that you should seek a doctor’s care, Oldemeyer says.
Symptoms to look out for:
- Unexpected shortness of breath during exercise
- Chest tightness
- Pressure, pain, or discomfort especially if it occurs during exercise or effort
- Loss of consciousness, particularly during exercise
- Severe and unexpected heart palpitations, or an unpleasant sensation of rapid heart beating when you do not expect it to be beating rapidly or so fast
- Severe or sudden onset temporary dizziness, lightheadedness, or near fainting
Who is at risk?
A review published in CMAJ looked at existing research and guidelines to suggest care and prevention of sudden cardiac arrest in athletes found that they actually are rare occurrences, though you may be hearing about them more and more in the media. Results showed the rate of sudden cardiac arrest in athletes is just about 0.75 per 100,000 per year.
That said, people who have genetic predispositions to arrhythmia (an abnormal heart rate) may be more at risk for sudden cardiac arrest. However, athletes who are training for long races should undergo a physician’s evaluation to assess for any symptoms or high-risk features in their family or medical history. If any are present, this may prompt more vigorous testing
What causes cardiac arrest?
Cardiac arrest often comes on suddenly and without warning, and the cause is often unknown. The CMAJ review found that cardiac arrest is often caused by a clot in the artery that delivers blood to the heart in most non-athletes and some athletes.
What are signs and symptoms of a heart attack?
If you experience any symptoms of heart attack, such as pressure, tightness, chest pain or discomfort, or a squeezing or aching sensation in your chest or either arm that may spread to your neck, jaw or back, nausea, indigestion, heartburn or abdominal pain, shortness of breath, heart palpitations, rapid or irregular heartbeats, cold sweat, lightheadedness or sudden dizziness, regardless of gender, you should call 911 immediately.
In fact, recent research published in the Journal of the American Heart Association found that chest pain was the most common symptom reported by about 93 percent of people of either sex who had a heart attack. And, the research found that 41 percent of men who had a heart attack experienced atypical symptoms, such as heartburn, back pain, or pain that was similar to indigestion, while 23 percent of women experienced these symptoms.
Are signs and symptoms different in men and women?
Yes and no. Cardiac arrest comes on quickly, but regardless of gender, if you experience any of the symptoms listed above, you should call 911 immediately.
Here’s what to do if you suspect cardiac arrest.
First, you should get help, Oldemeyer says. Call 911 immediately and get the assistance of anyone else around you. Getting 911 on the phone is of utmost importance to get medical professionals on the scene quickly. And, be sure to stay on the phone—911 operators are trained to talk you through administering CPR.
For safe measure, it’s good practice to locate the nearest automated external defibrillators (AED)—a device that will deliver a shock to heart to restore normal rhythm—near your home, work, gym, and common running routes. AED requirements and regulations vary by state, but you can generally find them in police stations or cars, certain public schools, and health clubs with over 500 members.
The two things that matter most are how quickly and effectively CPR is started, which will replace the function the heart (circulating blood throughout the body) and how fast the heart can be defibrillated—given a shock administered by an AED to return the heart to normal rhythm. CPR and AED certification classes are available to anyone through the American Red Cross.
It’s important you don’t drive yourself or the person experiencing cardiac arrest to the hospital as that could delay CPR or the use of an AED. Call 911 right away—operators are trained to guide you through lifesaving measure like CPR until trained responders arrive.
In a perfect world, everybody would be certified in CPR, Oldemeyer says. But in general, cardiac arrest is not something you can predict ahead of time, so the best you can do is take proper precautions and always listen closely to your body.