Sudden cardiac arrest is the leading cause of death in the United States. According to the Sudden Cardiac Arrest Foundation, there are more than 356,000 out-of-hospital cardiac arrests annually in the U.S. and nearly 90% of them are fatal.
For National Sudden Cardiac Arrest Awareness Month in October, Demetri Yannopoulos, MD, with the University of Minnesota Medical School and M Health Fairview, talks about cardiac arrest symptoms and care innovation in Minnesota.
Q: What is sudden cardiac arrest?
Dr. Yannopoulos: Sudden cardiac arrest is a mechanical malfunction of the heart that is immediate and unexpected. The result is that blood stops pumping throughout your body and the ability to bring oxygen to vital organs such as your brain is compromised. This results in someone becoming suddenly unresponsive and requires immediate action, such as calling 911 and providing CPR. According to the American Heart Association, survival from sudden cardiac arrest is approximately 10% nationwide. In areas such as Minnesota, where the Center for Resuscitation Medicine has focused efforts to improve outcomes through a systemwide approach, survival can be as high as 40% in cases where early recognition and bystander CPR are present.
Q: What are the symptoms of sudden cardiac arrest? Are they different from a heart attack?
Dr. Yannopoulos: The primary symptom of a sudden cardiac arrest is the sudden loss of consciousness with an absence of breathing or pulse. Some patients have heart attacks before or during their sudden cardiac arrest. As such, heart attacks — blocked arteries of the heart — are a common cause for sudden death. A person suffering from a heart attack can have chest pain; weakness; discomfort in the jaw, neck or back; and shortness of breath. A heart attack can trigger an electrical malfunction that leads to cardiac arrest.
Q: Are the symptoms of cardiac arrest different for men and women?
Dr. Yannopoulos: The symptoms of cardiac arrest are the same for both men and women, however, heart attack symptoms can vary. Most heart attack symptoms are the same and include chest pain and weakness or lightheadedness. Women may be more likely to have back pain, nausea and shortness of breath. With any symptoms, you should be examined, or if symptoms are obvious, call 911. In the event of a cardiac arrest, recent studies have shown that women are less likely to receive bystander CPR and have lower overall survival rates. Currently, there are several campaigns to improve CPR response for women.
Q: How is the University advancing care for cardiac arrest in Minnesota?
Dr. Yannopoulos: The University of Minnesota has been at the forefront of major scientific developments in the constant battle against sudden cardiac death. We have invented new ways to improve blood flow during CPR, better ways to ventilate and new drugs to treat cardiac arrest. We have collaborated with all EMS agencies in the state and organized together a best-in-the-world advanced resuscitation program that treats all victims of sudden cardiac arrest with the most advanced and skilled team that is currently available. We use a machine called ECMO (extracorporeal membrane oxygenation) that acts like the heart and lungs through the major blood vessels to allow time to find the underlying cause, treat it and then continue to support the patients in an intensive care unit.
With this novel strategy that is now the standard of care in our community, patients that have primary electrical storm related sudden death have a six to seven times higher survival rate compared to the national standard of care. We are in the process of spreading the knowledge and process to be applied nationwide, and we are working tirelessly to even further improve the outcomes for patients surviving neurologically intact.
Q: How have the collaborations with The Leona M. and Harry B. Helmsley Charitable Trust forwarded our care to patients in rural areas?
Dr. Yannopoulos: The Helmsley Charitable Trust has been a strong supporter of cardiac care improvement in Minnesota. They have supported the mobile ECMO project in the metropolitan area that continues to expand further into rural Minnesota. Recently, the Helmsley Charitable Trust supported an AED project through the Center for Resuscitation Medicine to place new AEDs in all law enforcement vehicles throughout Minnesota. Law enforcement officers are often the first responders on scene, especially in rural communities, and these devices will help them provide critical lifesaving care.
Demetri Yannopoulos, MD, is a professor in the Center for Resuscitation Medicine in the Medical School on the Twin Cities campus and a cardiologist at M Health Fairview. His clinical interests include emergent cardiac care, coronary-artery disease and congenital and peripheral intervention.
In collaboration with The Leona M. and Harry B. Helmsley Charitable Trust, Dr. Yannopoulos is the University lead in increasing access to cardiac care in Minnesota through the Minnesota Mobile Resuscitation Consortium by launching the ECMO truck, three ECMO SUVs and outfitting law enforcement agencies and first responders statewide with state-of-the-art automated external defibrillators. Law enforcement agencies interested in participating in the AED program can enroll at [email protected]
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About the University of Minnesota Medical School
The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We acknowledge that the U of M Medical School, both the Twin Cities campus and Duluth campus, is located on traditional, ancestral and contemporary lands of the Dakota and the Ojibwe, and scores of other Indigenous people, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relations with tribal nations. For more information about the U of M Medical School, please visit med.umn.edu.
Minnesota Mobile Resuscitation Consortium
Under the Office of Academic Clinical Affairs, the Minnesota Mobile Resuscitation Consortium (MMRC) is a non-profit community resource that is an extension of the University’s ECMO resuscitation program that started in 2015. The U of M has more ECMO experience than any other organization in the U.S., having treated more than 300 cardiac arrest ECMO cases since its inception, with a 40% survival rate — comparatively higher than the average survival rate of less than 10% at other locations that treat similar patient populations.
This is a collaborative initiative funded by an $18.6 million grant from The Leona M. and Harry B. Helmsley Charitable Trust and in-kind donations from industry and private donors. Other recognized donors are Zoll Medical, Stryker Emergency Care, Getinge Incorporated and General Electric. Health care system partners include Fairview Health Services, Regions Hospital (HealthPartners) and North Memorial Health Care System, with contractual partnership for physician services with M Health Fairview, Health Partners, U of M Physicians, Hennepin Healthcare and Lifelink III for clinicians
