From the Guidelines
Cardiac arrest is most commonly caused by cardiac conditions, particularly myocardial infarction and electric disturbances, as well as non-cardiac etiologies such as respiratory failure, toxic ingestion, pulmonary embolism, and drowning. The causes of cardiac arrest can be broadly categorized into cardiac and non-cardiac origins. Cardiac causes include:
- Myocardial infarction
- Electric disturbances, such as ventricular fibrillation and ventricular tachycardia 1 Non-cardiac causes, on the other hand, include:
- Respiratory failure
- Toxic ingestion, such as opioid overdose
- Pulmonary embolism
- Drowning 1 It is essential to recognize these underlying causes, as treatment and outcomes may vary significantly. For instance, cardiac arrest due to myocardial infarction may require immediate coronary intervention, while cardiac arrest due to opioid overdose may require administration of naloxone. Prompt recognition and treatment of the underlying cause are crucial for improving survival and recovery from cardiac arrest. According to the 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, survival and recovery from adult cardiac arrest depend on a complex system working together to secure the best outcome for the victim 1.
From the Research
Common Causes of Cardiac Arrest
- Cardiac arrest can be caused by various factors, including shockable rhythms such as pulseless ventricular tachycardia and ventricular fibrillation, as well as non-shockable rhythms like asystole and pulseless electrical activity 2
- Coronary artery disease is a common underlying condition that can lead to ventricular tachyarrhythmias, which are a type of abnormal heart rhythm that can cause cardiac arrest 3
- Chronic total occlusion, a condition where a coronary artery is completely blocked, can increase the risk of ventricular arrhythmias in survivors of out-of-hospital cardiac arrest 4
- Refractory out-of-hospital ventricular fibrillation cardiac arrest is often associated with complex coronary artery disease, and early transport to a cardiac catheterization laboratory for extracorporeal life support and revascularization may improve survival rates 5
- The incidence of ventricular fibrillation, a type of shockable rhythm, has been decreasing in recent years, possibly due to improved medical and surgical therapies for ischemic heart disease and the use of implantable cardiac defibrillators 6
Underlying Conditions
- Coronary artery disease is a major risk factor for cardiac arrest, and can lead to ventricular tachyarrhythmias and other abnormal heart rhythms 3, 4, 5
- Chronic total occlusion and other complex coronary artery disease conditions can increase the risk of cardiac arrest and ventricular arrhythmias 4, 5
- Ischemic heart disease and other underlying medical conditions can contribute to the development of cardiac arrest 2, 3, 6
Treatment and Management
- Cardiopulmonary resuscitation (CPR) is a critical component of cardiac arrest management, and includes high-quality chest compressions and ventilations 2
- Implantable cardiac defibrillators (ICDs) can be effective in preventing sudden cardiac death and improving survival rates in patients with high-risk conditions 3, 6
- Early transport to a cardiac catheterization laboratory for extracorporeal life support and revascularization may improve survival rates in patients with refractory out-of-hospital ventricular fibrillation cardiac arrest 5