Do anti-depressants make the heart stop?

July 21, 2009 by  
Filed under DEPRESSION

pills-blue

Sudden cardiac death or sudden cardiac arrest (SCA) has gained worldwide attention because of Michael Jackson’s passing last month. To review some SCA statistics from the Sudden Cardiac Arrest Coalition:

As I’ve posted before, there are many things that can interfere with the heart’s electric system, leading to a full stop and death. A recent study by researchers at Columbia University indicates that depression – and the use of anti-depressants  – can also cause SCA. And it’s not about overdose on anti-depressants, but regular use at normally prescribed dosage.

The study followed up 63,469 women who were participants in the Nurses’ Health Study and who did not have a history of cardiovascular disease or any other life-threatening disorders. The participants were monitored for depressive symptoms and anti-depressant use for eight years. The study results confirmed what previous studies have reported: Depressive symptoms were significantly associated with cardiac events, and especially strongest with fatal events.

However, what is new is the fact that the use of antidepressants to manage the depressive symptoms does not actually lower the risk for cardiac events but rather increases the risk of SCA. According to the present study

“61% of subjects were using selective serotonin-reuptake inhibitors (SSRIs), while 39% used other, nonspecified antidepressants.”

It is not clear how these medications exactly can affect heart function but researchers believe it has something to be with triggering arrhythmia or irregular heart rhythms. A previous study has linked antidepressant use to increased high blood pressure.

The authors warn that more study is needed to confirm the antidepressant use – SCA link.

“It is unclear whether SSRI agents might cause [sudden cardiac arrest]. While cardiac events are well documented with . . . tricyclic antidepressants, evidence for a link with SSRIs is mixed… Moreover, it is quite possible that antidepressant use merely indicates that depression is of sufficient severity to merit treatment.”

There have been high profile deaths due to SCA mainly because of the widespread use of prescription drugs among celebrities as a means of coping with their stressful, high-flying lifestyles. Among these prescription drugs are sleeping pills, anti-depressants, and pain killers.

Stock.xchng

Cardiac arrest: what makes the heart stop?

June 29, 2009 by  
Filed under Featured, HEART AND STROKE

artificial-heartResource post for June

The King of Pop Michael Jackson was said to have suffered from cardiac arrest but the actual cause of death is unknown. This statement confused many people – why can’t cardiac arrest be the cause of death? To answer this question, we have to brush up a bit on what we know about cardiac arrest.

What is cardiac arrest?

According to the National Heart Lung and Blood Institute

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs.

If the heart does not start beating within a few minutes, death occurs.

There many things that can cause the heart to stop or “arrest” and sometimes it doesn’t even have anything to do with heart disease. The heart runs on an internal electrical system that regulates the rate and rhythm of the heart beat. From time to time, the electrical system can have problems, causing abnormal rhythms called arrhythmias. These abnormal heart rhythms can be too slow (bradycardia) or too fast (tachycardia) or it can complete stop. Some arrhythmias can cause the heart to stop pumping blood, causing sudden cardiac arrest.

Now, it is important for us to know that cardiac arrest is not synonymous to a heart attack or myocardial infarction in doctor speak. However, a cardiac arrest may be a complication of a heart attack. Although, people with heart problems have a high risk of SCA, most SCAs happen in completely healthy people with no history of heart disease.

Whatelectricity causes cardiac arrest?

So what can cause the heart to stop beating and lead to cardiac arrest? There are many things that can interfere with the heart’s electrical system and these are:

  • Coronary heart disease (CAD)/Heart attack. Blocked coronary arteries can lead to heart attacks but also interfere with the electrical system of the heart. A large number of SAC cases are due to CAD or heart attack.
  • Electric shock/electrocution. A strong electrical shock can stop the heart. Electrocution and lighting strikes can easily lead to SAC.
  • Respiratory arrest. This can happen when people choke, or drown or can’t breath, cutting off the oxygen supply to the heart.
  • Overdose on certain drugs. It is a know fact that certain drugs can interfere with heart rhythms. This is why new drugs are screened for pro-arrhythmic effects before approval. When taken in excessive amounts, certain drugs complete halt the heart, resulting in SAC.
  • Trauma. A strong sudden blow to the heart, or an injury that damages the heart can also lead to cardiac arrest.
  • Unknown causes. Some cases of SAC cannot be explained, unless an autopsy is conducted.

What are the signs of SAC?

According to the American Heart Association (AHA), the warning signs for SAC are

  • Loss of consciousness
  • Cessation of normal breathingheart-stethoscope
  • Absence of pulse
  • Absence of blood pressure

Death occurs within 4 to 6 minutes after cardiac arrest. It is estimated that 95% of SAC cases result in death.

How can cardiac arrest be reversed?

In SAC, every second counts. To save the patient, it is imperative that the heart be restarted as soon as possible. It can happen that heart function is restored but brain death has already set in due to interruption of blood and oxygen supply.

There are several ways to restore a normal heartbeat:

  • Electric shock using defibrillators, a scene that we often see in emergency rooms. In settings away from hospitals, the use of automated external defibrillators (AEDs) has saved many lives.
  • Cardiopulmonary resuscitation (CPR) is to manually restore the heart beat by applying pressure on the chest region.

According to the AHA

Cardiac arrest can be reversed if it’s treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim’s chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation. Few attempts at resuscitation succeed after 10 minutes… It’s estimated that more than 95% of cardiac arrest victims die before reaching the hospital. In cities where defibrillation is provided within 5 to 7 minutes, the survival rate from sudden cardiac arrest is as high as 30-45 percent.

Because SAC is very time critical, waitdefibrillator1ing for emergency services to arrive may be too late. This is why AEDs are available in crowded public places, e.g. airports, sports stadiums, public events where people gather. In Zurich, Switzerland, AEDs are strategically located in telephone booths in the city center. Equally important is bystander awareness. AEDs are designed to be used by almost anybody, even without any medical training. Yet, many people are hesitant to “get involved.” Health groups, including the AHA are campaigning for more active bystander involvement in the prevention of SAC.

Photo credit: stock.xchng

Ready to perform effective bystander CPR?

June 3, 2009 by  
Filed under HEART AND STROKE

defibrillatorIt’s CPR and AED Awareness Week (June 1 to 7) in the United States.

Why is CPR important?

Cardiopulmonary resuscitation (CPR) saves lives. Here are the reasons why we need to know CPR (source: American Heart Association):

  • About 80% of cases of sudden cardiac arrest (SCA) happen at home.
  • Less than a third of SCA victims receive CPR from a bystander. Only 6.4% of the victims survive because there is nobody in their vicinity who can perform life-saving CPR.
  • 12 to 20% of Americans feel confident in performing CPR should the need arises.
  • 37 to 39% (about 4 in 10) are most likely to perform a CPR on somebody they know personally.

Are you ready to save those of your loved ones? Are you one of those bystanders who feel confident enough to save the life of others?

What can you do?

Here is what you can do/ how you can help:

  • Get CPR training. The American Heart Association recommends everybody to get trained in CPR. Furthermore, training shouldn’t just be a one time thing. It should be constantly practiced and updated. Furthermore, you can even do training online!
  • Keep a record of your training. When was your last training? Are you ready to act in case of emergency? Be a part of the 1 million CPR-trained people in the US!
  • Share your time. As a CPR instructor or other types of volunteer work.
  • Donate. Your donation goes into training programs that save lives all over the country! The goal is to train one million Americans. So far, 150,000 have been trained. A little help will go a long, long way.
  • Spread the word. Help spread CPR Awareness through emails, word of mouth, your blogs (that’s what I’m doing now!), your social networks (it’s in Facebook, Twitter, Linked in!).
  • Check out Mini Anne, an inflatable, portable mannequin that you can practice on. It only takes 22 minutes!

What about AED?

Another way of resuscitating cardiac arrest victims is by using an Automated External Defibrillator or AED. AEDs are now available in many public places which have been identified as high risk locations. The new devices have been designed to be simple and easy to use, even by those who do not have any medical training. Once activated, the person manning the AED gets visual and audio instructions how to operate the machine as well as perform a CPR.

Remember, for cardiac arrest patients, every second counts. Together, CPR and AED can save precious seconds and save lives.

Resource Post for October: National Sudden Cardiac Arrest Awareness Month

October 13, 2008 by  
Filed under HEART AND STROKE

October 2008 is the first ever National Sudden Cardiac Arrest (SCA) Awareness Month. To mark this event, let us a take a look at SCA.

What is sudden cardiac arrest?

SCA occurs when the heart suddenly stops working as a consequence of electrical malfunction so that blood supply to other parts of the body is also stopped. It could happen to anybody, to any of us, without warning.

Here are some statistics about SCA:

  • Most CVD deaths are SCA-related. SCA has a mortality rate of 95%.
  • One person dies of SCA-related events every two minutes. This equivalent to more 650 lives lost each day.
  • More people die of SCA-related events than from breast cancer, lung cancer, stroke, or AIDS.
  • SCA is not synonymous to a heart attack. A heart attack (myocardial infarction) occurs when a blood vessel supplying blood to the heart is blocked causing the heart muscle to starve and die. SCA occurs when the electrical system of the heart fails, e.g. “power failure” of the heart.

95% of those who experience SCA die because they do not receive life-saving defibrillation within 4 to 6 minutes, before brain and permanent death start to occur. It can happen to people of all ages – without warning – and even when there are warning signs, most don’t recognize them.

Lack of Awareness

According to a poll by the Heart Rhythm Society in 2007,

four out of five Americans vastly underestimate the severity of this serious public health issue that causes more than 250,000 deaths each year…

The poll results show that there is a lack of awareness among Americans regarding SCA. Here are some things that we should know:

  • SCA deaths are most common among women aged 35 to 44 years old.
  • African Americans have higher SCA risk than whites.
  • SCA can occur without warning even among people who have no previous signs of heart disease.
  • Many people do not know their risk for SCA, basically because there is currently no effective screening tool for SCA.
  • There is very little knowledge about preventive measures for SCA.

SCA treatments

SCA victims should receive emergency treatment within 4 to 6 minutes of the attack in order to have a chance to survive.

Life-saving treatments for SCA are:

See previous posts on AEDs and ICDs.

Sudden Cardiac Arrest Resolutions

In July of this year, US legislators introduced the Senate Concurrent Resolution 93 and House Concurrent Resolution 393, a move which led to the designation of October as the National Sudden Cardiac Arrest (SCA) Awareness Month.

“The resolutions will support efforts to raise awareness about the risk of SCA, improve the public’s ability to identify warning signs, encourage individuals to seek medical attention in a timely manner and promote the need for further research into the causes of this leading killer”, according to the Heart Rhythm Society.

The passing of the resolutions were largely due to the lobbying efforts of the Sudden Cardiac Arrest Coalition.

According to the coalition:

…while the federal government has made great strides in research and treatment advances for many of our major health threats – breast cancer, lung cancer, AIDS, and stroke – they have not yet done enough on SCA to educate the public or arm the medical community with the resources it needs… With increased federal funding for research, education, and access to treatment, we could go a long way towards saving lives.

Sudden Cardiac Arrest Coalition

The resolutions are supported by the organizations that comprise the Sudden Cardiac Arrest Coalition. The coalition is a result of 29 heart organizations and advocacy groups who joined forces to fight SCA.

The members include:

Photo credit: Stock.xchng photos by

luizduarte

LeoSynapse

Juliaf

Related Posts with Thumbnails

NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.