Diagnosis
Cardiovascular arrest triggers a series of distinctive physical changes. Logically, when the heart is not pumping, no more pulses can be felt. This happens especially in large arteries such as the carotid artery (Arteria carotis) and the femoral artery (Arteria femoralis) in the groin.
A few seconds later unconsciousness usually occurs, followed by gasping after about half a minute and respiratory arrest after a full minute. Other signs that also occur, such as a blue discoloration of the skin (cyanosis), absence of reflexes, cramps, rigidly dilated pupils or pulselessness of other arterial vessels are regarded as unsafe features, as they can also have other causes. In the event of a cardiac arrest, cardiopulmonary resuscitation must be started as soon as possible, since the brain suffers irreparable damage after only a few minutes without blood supply.
In many situations, it is therefore essential that this measure is taken immediately by the next possible person in addition to calling for help and emergency services. However, since these are often medical laymen, in reality this is unfortunately sometimes omitted due to fear of making mistakes. It can be said, however, that in such a situation nothing is worse than not doing anything and even an unsafe or even incorrectly performed cardiac pressure massage and ventilation can save lives.
In a clinical setting or after arrival of the emergency services at the scene of an emergency, depending on the cause, electronic shock of the heart muscle (defibrillation or cardioversion) and the administration of emergency drugs (amiodarone, adrenaline) may also be helpful. If the resuscitation is unsuccessful, intensive care medicine can then be used to replace cardiac and pulmonary activity with devices. Parallel to attempts at resuscitation, the clinical staff can also attempt to find and eliminate the cause of the cardiac arrest.
Prevention
A distinction is made between primary prevention, i.e. reducing the probability of cardiac arrest by a healthy lifestyle, and tertiary prevention, i.e. preventing a recurrence of such an event by changing behavior, medication or implantation of pacemakers or defibrillators. Secondary prophylaxis, i.e. early detection of the disease in a screening, is not possible because of its suddenness. Only relevant risk factors, such as coronary heart disease, can be detected and treated at an early stage, thus reducing the probability of cardiac arrest.