Electrocardiographic manifestations of cardiac arrest

Apr 10, 2023 Source: Cainiu Health

Dr. Tian Hongbo

Introduction

The electrocardiogram (ECG) of cardiac arrest typically shows ventricular fibrillation or asystole, ventricular standstill, and pulseless electrical activity. When these signs appear during ECG monitoring, prompt emergency treatment should be initiated, including defibrillation or cardiopulmonary resuscitation (CPR) under medical guidance, to help save the patient's life to some extent.

Electrocardiographic findings in cardiac arrest typically include ventricular fibrillation and cessation, ventricular standstill, and pulseless electrical activity. The details are as follows:

1. Ventricular Fibrillation and Cessation

Within the first two to three minutes of cardiac arrest, a series of irregular or disorganized fibrillatory waves appear. If not treated promptly, these waves progressively deteriorate into a flat line.

2. Ventricular Standstill

The ventricles gradually lose their contractile activity. Initially, the QRS complex disappears, followed by fibrillatory waves of varying amplitude and morphology, eventually progressing to a flat line with no electrical activity.

3. Pulseless Electrical Activity

This refers to an organized electrical activity on electrocardiogram without detectable pulse. The ECG shows electrical complexes that may be normal, wide, or bizarre in shape, usually with low amplitude, despite the presence of electrical signals.

In addition, symptoms such as heart failure may also occur. When monitoring the ECG, if any of the above signs appear, immediate resuscitation should be initiated. Under medical guidance, treatments such as defibrillation or cardiopulmonary resuscitation (CPR) should be administered promptly to potentially save the patient’s life. However, there remains a significant chance that resuscitation may not be successful.

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What is the emergency treatment measure applicable only for respiratory and cardiac arrest caused by acute myocardial infarction?

Generally speaking, there is no such thing as an emergency measure that can only be used for respiratory or cardiac arrest caused by acute myocardial infarction. Commonly used emergency measures usually include cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and administration of medications. Cardiopulmonary resuscitation is an emergency procedure that uses manual techniques to maintain heart and lung function, including chest compressions and artificial ventilation.

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Symptoms of intermittent cardiac arrest

Intermittent cardiac arrest usually refers to intermittent episodes of sudden cessation of the heart's blood-pumping function, which commonly causes symptoms such as chest tightness, shortness of breath, nausea, vomiting, loss of consciousness, dizziness, and arrhythmia. It is recommended to seek timely medical attention at a hospital and, under a doctor's guidance, receive treatment with medications such as amiodarone hydrochloride tablets, lidocaine hydrochloride injection, and promethazine hydrochloride tablets.

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The most common cause of cardiac arrest is cardiac in origin.

The main causes of cardiac arrest of cardiac origin include acute myocardial infarction, arrhythmias, and cardiac tamponade. Cardiac arrest may also be associated with pericardial hemorrhage, pericardial effusion, and rupture of chordae tendineae or papillary muscles. Cardiac arrest is extremely dangerous; if artificial cardiopulmonary resuscitation is not performed promptly, the probability of patient death is very high.

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Emergency first aid measures for cardiac arrest

During cardiac arrest, immediate first aid should be administered using chest compressions. After confirming the scene is safe, call out and gently tap the patient's shoulder to check for consciousness. Locate the center point of the line connecting the two nipples, place your left hand over your right with fingers interlaced, keep your arms straight, and use your upper body weight to vertically press down on the center point with the heel of your right hand. Perform 30 compressions.