Sudden cardiac arrest (SCA)

Sudden cardiac arrest (SCA) following a heart attack is fatal 95 percent of the time. Find out why this second heart event happens and how one man beat the odds.

It sounds like a cruel joke — surviving a heart attack only to be felled by a second heart event, sudden cardiac arrest. Heart attack and sudden cardiac arrest are not the same thing, but the first can put you at increased risk of the other. A heart attack, also called a myocardial infarction, happens because of decreased blood supply to your heart’s muscle. Sudden cardiac arrest (SCA) occurs when your heart goes into a dangerous heart rhythm and suddenly stops working.

Heart attack is rarely fatal, but SCA is fatal in 95 percent of cases. SCA can follow a heart attack, and the greatest risk is during the first 30 days after a heart attack. SCA kills about 1,000 people a day, one person every 90 seconds — more than lung cancer and breast cancer combined.

When Darren Califano, 47, was driving to work in his truck on December 22, 2011, he had no way of knowing that over the next two weeks he would survive both a heart attack and an SCA. “At about 7 a.m., I started noticing indigestion; by 10, it had become chest tightness; by 11, I had jaw pain and cold sweats. I knew something was really wrong,” said Califano.

Califano got himself to a fire station where he had an EKG and a blood pressure reading. “Within one hour, I was told that I had suffered a heart attack, and I was at the hospital having a stent put in my heart,” he recalled.

Risk of Sudden Cardiac Arrest After Heart Attack

While recovering at the Highline Medical Center in Seattle, Califano met cardiologist Arun Kalyanasundaram, MD. “Dr. Kalyanasundaram told me that I was at risk for sudden cardiac arrest because my heart was not pumping blood efficiently enough yet,” said Califano.

Cardiologists measure heart-pumping efficiency by measuring the heart’s ejection fraction, the amount of blood pumped by each heartbeat. A normal heart pumps out about 60 to 65 percent of the blood on the left side of the heart with each beat. Califano’s ejection fraction showed that his heart was pumping at only 20 percent efficiency.

A study published in the European Heart Journal followed over 11,000 patients after a heart attack. They found that the risk of SCA after a heart attack was 8.6 percent, with the highest risk during the first 30 days after the patient leaves the hospital. One of the predictors of SCA was an ejection fraction of less than 40 percent — just what Califano was facing.

Guarding Against SCA After a Heart Attack

“Darren was a young man recovering from a serious heart attack, somewhat overweight, and his ejection fraction was only about 20 percent. I felt he was at significant risk for sudden cardiac arrest,” said Dr. Kalyanasundaram. “An implantable cardioverter defibrillator, or ICD, can protect a patient from SCA by recognizing a dangerous heart rhythm and shocking the heart back into a normal rhythm. But it is too invasive a procedure to do right away because sometimes heart pumping ability improves.”

“Dr. Kalyanasundaram did not want me going home unprotected, so he suggested something called a ‘life vest.’ It sounded kind of crazy,” said Califano. The Zoll LifeVest is a temporary, wearable defibrillator that will recognize an SCA and shock the heart back to life. The LifeVest monitors the heart around the clock and can be worn underneath clothing.

Less than 10 days after leaving the hospital, at 5 a.m., Califano’s LifeVest saved his life. “The LifeVest had an alarm that would go off if my heart started to go into cardiac arrest. My wife heard the alarm and heard the vest give me two shocks. I only remember sitting up in bed. I was gone, and then I was back,” Califano said.

“Once your heart goes into sudden cardiac arrest, you only have about five minutes to get it back. That’s why a sudden cardiac arrest outside of a hospital is only survived less than five percent of the time,” explained Kalyanasundaram.

Today, Califano is back in his truck, and about 70 pounds lighter. He works as a project manager for a construction company and lives with his wife and four children south of Seattle. He has been fitted with an ICD and has not had any more cardiac events. “I am now a vegetarian, in great shape, and I have never felt better. I will always be grateful for Dr. Kalyanasundaram and for that LifeVest,” said Califano.

Source: https://www.everydayhealth.com/heart-health/surviving-sudden-cardiac-arrest-after-heart-attack.aspx