Dropping Dead - What happens ?

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presta

Guru
OP Here - the autopsy came back as Ischemic heart disease - is the SCA we were talking about earlier in the thread ?
Ischaemia is blocked/constricted arteries. That sounds more like a heart attack than cardiac arrest I would have thought?
 

mrandmrspoves

Middle aged bald git.
Location
Narfuk
Ischaemia is blocked/constricted arteries. That sounds more like a heart attack than cardiac arrest I would have thought?

Ischaemic Heart Disease refers to a chronic condition where the blood vessels feeding the heart muscle (primarily the coronary arteries) are damaged and blood flow is reduced. Factors that increase risk of IHD include High Blood Pressure, Obesity, Diabetes, Hereditary Factors, High Cholesterol, Sedentary lifestyle and Smoking (especially smoking and even more so when in conjunction with any of the other factors) Unless it is very advanced, a person may have a degree of Ischaemic Heart Disease and not know it. Symptoms often only occur when the person exerts themself or is stressed and cardiac demand is increased. So if a person is fairly sedate they may not experience this.
The symptoms of IHD can be vague such as fatigue and tiredness but classically include shortness of breath and chest pain (angina)
Ischaemic Heart Disease can lead to sudden disruption in the heart's electrical output (cardiac arrhythmia) causing sudden cardiac arrest. A heart attack (myocardial infarction) may result from IHD but happens when a coronorary artery becomes blocked and the heart muscle that receives blood from that artery then dies. A myocardial infarction can lead to sudden heart failure followed by cardiac arrest or sudden arrhytmia and cardiac arrest - but not all myocardial infarctions lead to cardiac arrests and not all cardiac arrests are caused by myocardial infarctions.
In this particular case - no heart attack and sudden onset of cardiac arrhythmia would result in very sudden collapse with no pre warning. If you have to go and can't choose to go in your sleep, this would be the next best choice for all of us......although it would be nice to postpone it until a ripe old age.
 
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presta

Guru
sudden onset of cardiac arrhythmia would result in very sudden collapse with no pre warning.
Just how long does it take to lose consciousness when your heart stops? I can personally vouch that it's longer than 5 seconds, as I've had my heart stopped with adenosine for that long on a couple of occasions, and nothing much happened at all.
 

mrandmrspoves

Middle aged bald git.
Location
Narfuk
I can't
Just how long does it take to lose consciousness when your heart stops? I can personally vouch that it's longer than 5 seconds, as I've had my heart stopped with adenosine for that long on a couple of occasions, and nothing much happened at all.

I can't give a definitive answer as there are a number of variables. If you think about syncope (fainting) which is caused by a sudden drop in blood pressure a person may feel a bit woozy for a minute or so before they drop. If they are standing and their BP is already on the low side (perhaps because they are dehydrated and sweating on a hot day) then they may only get a few seconds warning.
Syncope is caused by a drop in BP whereas sudden cardiac arrest will plummet the BP down to zero in seconds.
In your case presumably, Adenosine would have been administered while you were lying down which will help maintain BP for a few seconds and they would have made sure that your blood oxygen levels were good too.
Where I have witnessed a SCA following a large MI, I have seen a patient go from stable and pain free to clutching their chest in pain and collapsing within about 10 seconds.
 

ColinJ

Puzzle game procrastinator!
If you think about syncope (fainting) which is caused by a sudden drop in blood pressure a person may feel a bit woozy for a minute or so before they drop. If they are standing and their BP is already on the low side (perhaps because they are dehydrated and sweating on a hot day) then they may only get a few seconds warning.
I suffer from syncope (I have fainted on at least 5 or 6 occasions). I sometimes got 15-20 seconds of feeling woozy, but I blacked out so fast a couple of times that I didn't even feel it coming on!
 

presta

Guru
I suffer from syncope (I have fainted on at least 5 or 6 occasions). I sometimes got 15-20 seconds of feeling woozy, but I blacked out so fast a couple of times that I didn't even feel it coming on!
When my AF was undiagnosed and unmedicated my HR would reach 200-250, and I would feel faint when standing, but I've never actually fainted, if I feel myself going I just sit down quick. On the morning of my first ever episode I had to shower sitting in the bath. The paramedic said "no wonder you're feeling faint, you're losing most of your blood pressure". I was on the verge of passing out when they discharged me from hospital once, they'd given me betablockers on top of my antiarrhythmics when they shouldn't have.

Having my heart stopped altogether with adenosine was surprisingly uneventful though, I just felt a bit woozy and spaced out. The consultant said " this is going to make you feel lousy for a few seconds", but afterwards I said "I feel worse than that after I've been cycling". ^_^
 
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Dave7

Legendary Member
Location
Cheshire
I'm going to be quite cold and maybe heartless now. She's not bothered what happens now, she's dead.
But this will affect you, tonight and in the next few weeks. Seek any help you can in the form of support and counseling, don't try to brush off the event or 'tough it out'.
The people left behind are the ones that suffer and you are likely to have some pretty bad feelings if inadequacy and mortality in the weeks and months ahead. To be the one present at such a sudden and unexpected ending to a life will fill you with doubts that maybe you could have done more (you couldn't) or that it might be your turn next (highly unlikely).
Accept any support that you can :hugs:
Could be very true that (depending on the OPs make up of course).
When I was about 10 years old a neighbour asked me to climb through their bedroom window as they couldn't open the door.
When I did I found the old man dead and hanging out of the bed.
60 years on and I still see it.
Saw my wifes dad then mum die. Saw my mum and dad die..........not a problem as it was expected.
So...... as Skol says, dont be afraid to ask for help if its needed.
 

presta

Guru
Defibrillators don't and can't restart an arrested (stopped) heart, they actually stop the heart, interrupting an abnormal rhythm, so it starts again hopefully in proper rhythm.
I don't think that's correct, that's what adenosine does (or is supposed to do). Have a look at the traces below, the top one is a defibrillator, the bottom set are adenosine. It's the adenosine that stops that my heart for about 5 seconds, but the defibrillator doesn't.

During normal sinus rhythm, the sinus node (the heart's natural pacemaker) generates an electrical impulse to trigger each heartbeat. These then spread across the heart muscle a bit like a ripple across the pond when you drop a pebble in, or a Mexican wave in a stadium. During fibrillation muscle cells start contracting by themselves without a trigger from the sinus node, creating random chaotic contractions that are all out of sync with each other. I think the function of the defibrillator is to re-synchronise the cells by hitting them with a huge charge so that they're all reset into the same state simultaneously.

If you compare that with the adenosine trace, my heart stopped for a few seconds as you describe, and it was supposed to revert my heart back to normal, but as you can see, it didn't work, and my heart continued in AF when it restarted.
503146


503152
 

mrandmrspoves

Middle aged bald git.
Location
Narfuk
I don't think that's correct, that's what adenosine does (or is supposed to do). Have a look at the traces below, the top one is a defibrillator, the bottom set are adenosine. It's the adenosine that stops that my heart for about 5 seconds, but the defibrillator doesn't.

During normal sinus rhythm, the sinus node (the heart's natural pacemaker) generates an electrical impulse to trigger each heartbeat. These then spread across the heart muscle a bit like a ripple across the pond when you drop a pebble in, or a Mexican wave in a stadium. During fibrillation muscle cells start contracting by themselves without a trigger from the sinus node, creating random chaotic contractions that are all out of sync with each other. I think the function of the defibrillator is to re-synchronise the cells by hitting them with a huge charge so that they're all reset into the same state simultaneously.

If you compare that with the adenosine trace, my heart stopped for a few seconds as you describe, and it was supposed to revert my heart back to normal, but as you can see, it didn't work, and my heart continued in AF when it restarted.
View attachment 503146

View attachment 503152
In very basic terms (the ones I understand!) Adenosine causes a very short acting Atrio Ventricular Block (in effect it stops the electrical signal being transmitted from the AV node to the Ventricles for about 10 seconds)
A defibrillator aims to stop the electrical activity for a split second.
 
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