A drug overdose can cause cardiovascular failure

Sudden Cardiac Arrest Causes

Examples of some of the causes of sudden cardiac arrest include:

  • The electrical irritability may be due to a heart attack (myocardial infarction), in which a blood vessel in the heart is blocked and prevents oxygen-rich blood from getting to heart cells. This can cause a fatal heart rhythm called ventricular fibrillation characterized by electrical activity that is so chaotic, that the heart just jiggles and does not beat effectively to pump blood.
  • The same irritability may be caused by hyperkalemia, abnormally high potassium levels in the blood stream.
  • Abnormal heart rhythms may be a complication of accidental poisoning or drug overdoses, in which the drug is directly toxic to the heart or else potentially blocks oxygen from getting into the blood stream.
  • Carbon monoxide and cyanide attach tightly to red blood cells, preventing them from accessing oxygen. Not only does the smoke of a house fire contain carbon monoxide, but the chemicals in drapes, rugs, and furniture release cyanide.
  • Drugs such as cocaine and methamphetamine act like adrenaline in the body and can put the heart’s electrical system into a deadly overdrive.
  • Downer drugs (depressant drugs that diminish the function of the central nervous system) such as narcotics and alcohol can depress brain function and it “forgets” to tell the body breathe, which is detrimental to the heart.
  • Sudden cardiac arrest occurs in young athletes with previously undetected heart valve problems.
  • It occurs in SIDS, sudden infant death syndrome.
  • Sudden cardiac arrest can occur in people at the end of a long healthy life when they die quietly in their sleep.

Common blood pressure drug may increase cardiac arrest risk

A preliminary study concludes that a drug that doctors commonly prescribe to treat angina and blood pressure might increase the risk of sudden cardiac arrest.

Share on PinterestA recent study looked at the risk factors behind cardiac arrest.

Cardiac arrest occurs when the heart stops pumping blood around the body. If a person does not receive treatment, cardiac arrest can be lethal within minutes.

According to the American Heart Association (AHA), in the United States, around 475,000 people die from cardiac arrest each year.

It claims more lives than colorectal cancer, breast cancer, prostate cancer, pneumonia, influenza, vehicle accidents, firearms, HIV, and house fires combined.

The AHA describe cardiac arrest “as one of the most lethal public health problems in the U.S.” So, because cardiac arrest is both serious and common, understanding the risk factors involved is essential.

To this end, the European Resuscitation Council set up a project that collects data on cardiac arrest, called the European Sudden Cardiac Arrest network (ESCAPE-NET).

A new risk factor?

A recent study using ESCAPE-NET data investigated whether a common group of drugs might play a role in cardiac arrest.

Healthcare providers use dihydropyridines to treat high blood pressure and angina, which is chest pain related to reduced blood flow to the heart. The project focused on two dihydropyridines: nifedipine and amlodipine.

The scientists had access to data from the Dutch Amsterdam Resuscitation Studies registry and the Danish Cardiac Arrest Registry, both of which form part of ESCAPE-NET.

The researchers presented their findings at EHRA 2019, the annual congress of the European Heart Rhythm Association, which is taking place in Lisbon, Portugal.

In total, they had access to data from more than 10,000 people who were taking dihydropyridines and 50,000 controls.

Their analysis showed that those who took high-dose nifedipine were significantly more likely to have an out-of-hospital cardiac arrest than those who were not taking dihydropyridines or who were taking amlodipine.

Why might this be happening?

The scientists moved into the laboratory to examine why the actions of the two drugs differed. Both use the same mechanism, so why does one increase the risk of cardiac arrest while the other appears to make no difference?

Dihydropyridines work by blocking L-type calcium channels. When these channels are blocked, the action potential of cardiac cells becomes shorter.

The phrase “action potential” describes a change in the charge of a membrane associated with the transmission of an impulse. They occur in nerves and muscle cells.

This change could, potentially, drive the arrhythmias that lead to cardiac arrests.

Interestingly, these in vitro experiments matched the findings of the population study. High doses of nifedipine shortened action potentials significantly more than high-dose amlodipine.

“Nifedipine and amlodipine are often used by many cardiologists and other physicians, and the choice often depends on the prescriber’s preference and personal experience.”

ESCAPE-NET project leader Dr. Hanno Tan

Dr. Tan adds, “Both drugs are generally considered to be equally effective and safe and neither has been associated with sudden cardiac arrest.”

“This study suggests that high-dose nifedipine may increase the risk of sudden cardiac arrest due to fatal cardiac arrhythmia while amlodipine does not.”

It is important to note that because this is a new line of investigation, it will be vital to replicate the findings using more participants and other demographics.

As Dr. Tan concludes, “If these findings are confirmed in other studies, they may have to be taken into account when the use of either drug is considered.”

Can depression cause heart attacks?

You find yourself in tears for no good reason. Your outlook is gloomy for weeks at a time. Your family, friends and coworkers are all tiresome and taxing, and you could really do without them. Your daily routine is something you dread, and you’d rather just stay in bed. Nobody seems to understand how you feel, so you keep it to yourself. Occasionally it seems like it’d just be whole lot simpler if you weren’t even alive.

If any of these symptoms sound familiar, then you’re likely suffering from clinical depression. What’s worse, that depression may be taking its toll on your heart.

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Heart Health Pictures

Speculative links between heart disease and depression were first established in the late 1980s. Since then, further research has concluded that depression may be a contributing factor toward heart troubles. There are a few obvious reasons why people who are depressed are more likely to suffer from heart disease:

  • Depressed people are more likely to smoke, drink excessive amounts of alcohol and avoid exercise.
  • They’re less likely to take heart medication if they already suffer from heart disease.
  • Mental stress that comes with depression may increase plaque formation in the arteries.
  • Depression could increase the production of free radicals and fatty acids, damaging the lining of the blood vessels.

The people most likely to suffer from depression linked to heart disease are the elderly. And sadly, they’re the least likely to seek treatment for depression. Nineteen to 30 percent of people age 65 and older experience signs of depression . Women are generally more depressed than men, and those living alone are more prone to be depressed. A study performed by Dr. Curt D. Furberg of Wake Forest University found that in 4,500 elderly participants with no history of heart disease, those who showed signs of depression had a 40 percent higher risk of developing coronary disease.

A­nother study in Baltimore, Md., found that depressed people of all ages are four times more likely to have a heart attack in the next 14 years following the study. When you consider that one in three Americans will die from some form of heart disease and that medical doctors often miss the diagnosis of depression, it’s clear there’s a real problem. Research is still in the early stages, but some researchers feel that depression may be as much of a factor in heart disease as high cholesterol and blood pressure.

The link between heart attacks and depression is clear — what’s fuzzy is which came first, the chicken or the egg? People that are depressed are more likely to have a heart attack, and heart attack victims are more likely to be depressed.

12 Surprising Ways Drugs and Supplements Can Cause Heart Failure

You may know that heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. But did you know that certain dietary supplements and over-the-counter drugs may actually cause heart failure?

A new statement from the American Heart Association, published in August 2016 in Circulation, highlights some of these drugs and supplements that are commonly used — many of which you can get without a prescription. You may be thinking that if these medications and supplements are too risky for use, they wouldn’t be easily available to the public; but they are. Here’s how they can harm your heart.

  1. Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, may increase heart failure risk. NSAIDs can increase salt and fluid retention, lower your body’s response to diuretics that help eliminate fluids, and increase your blood vessel (vascular) resistance, which makes your heart work harder.
  2. Vitamin E in doses of more than 400 international units (IU) per day increased risk of congestive heart failure by 21 to 50 percent (compared to a placebo) in patients with heart disease who’d had prior heart attacks, found a study published in May 2006 in the Journal of Cardiovascular Medicine. Unfortunately, many similar trials that showed this risk were designed in hopes of showing that vitamin E would actually protect the heart from coronary artery disease and, ultimately, heart failure.
  3. Products containing ephedra (ma huang), such as traditional Chinese herbal remedies and herbal teas, can increase heart rate, blood pressure, and the heart’s overall workload. In a weakened heart, these products can also result in life-threatening abnormal heart rhythms.
  4. Danshen, garlic, ginkgo, motherwort, saw palmetto, hawthorn, and licorice are complementary and alternative medicines that can impair blood platelet function. These medications can also raise the risk of severe bleeding in people with heart disease who take anticoagulant (blood-thinning) or antiplatelet drugs. Examples of blood thinners are Coumadin and Jantoven (warfarin); Pradaxa (dabigatran); Xarelto (rivaroxaban); Eliquis (apixaban); and Savaysa (edoxaban).
  5. Dong Quai, motherwort, and licorice may impair blood clotting. In people with heart disease who also take anticoagulant or antiplatelet drugs, these herbal products may also increase the risk of severe bleeding.
  6. Aconite is a poisonous plant used in traditional Chinese medicine that reduces heart rate in order to compensate for a weakened heart muscle. But research shows it also increases the risk of lethal abnormal heart rhythms — a condition called ventricular tachycardia.
  7. Ginseng can increase your risk of low blood pressure shortly after use, particularly when you’re taking medication to lower your blood pressure. Ginseng initially increases nitric oxide synthesis in the body, which would be healthy, but ironically chronic use increases risk of high blood pressure. Ginseng can also lower the kidneys’ response to diuretic medications used to eliminate excess fluid from the body.
  8. Gossypol is a toxic chemical from the cotton plant that, in small doses, increases the effects of diuretic medications. Taking gossypol can result in low blood pressure and increased risk of kidney injury.
  9. Gynura, a vegetable also known as longevity spinach, increases the risk of hypotension (low blood pressure) by inhibiting the body’s own angiotensin-converting enzyme (ACE), which is similar to the drug class used in heart failure: ACE inhibitors.
  10. Licorice raises the risk of high blood pressure and fluid retention, both of which increase the heart’s workload.
  11. Lily of the valley increases the risk of a slow heart rate and electrical heart block — and is similar to the medication digitalis. Lily of the valley can increase the risk of a severely slow heart rate when used with other drugs such as beta blockers, digoxin, and calcium channel blockers that also slow the heart rate.
  12. Yohimbine, an extract from tree bark, raises blood pressure by increasing the stress hormone norepinephrine, which can make the heart work harder and increase the risk of abnormal heart rhythms.

I wanted to share this information not as an attack on dietary supplements, but to provide information on potential risks. Even though many of these are natural products, they have drug-like effects in the body.

Finally, I want to note that the AHA statement in Circulation reports on many prescription drugs that come with heart failure risks. I haven’t discussed these here as they’re not available without a prescription, and the physician prescribing them should educate you regarding these drugs and their risks.

PHOTO: Getty Images

Home Remedies: Emergency care for a heart attack

  • If an automated external defibrillator (AED) is available and the person is unconscious, begin CPR while the device is retrieved and set up. Attach the device and follow instructions that will be provided by the AED after it has evaluated the person’s condition.
  • Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack:

    • Avoid smoke. The most important thing you can do to improve your heart’s health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help.
    • Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored.
    • Get regular medical checkups. Some of the major risk factors for heart attack — high blood cholesterol, high blood pressure and diabetes — cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary.
    • Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn’t be vigorous. Walking 30 minutes a day, five days a week can improve your health.
    • Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes.
    • Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains.
    • Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes.
    • Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life.
    • If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger.

    People often use these terms interchangeably, but they are not synonyms. A heart attack is when blood flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops beating unexpectedly. A heart attack is a “circulation” problem and sudden cardiac arrest is an “electrical” problem.

    What is a heart attack?

    A heart attack occurs when a blocked artery prevents oxygen-rich blood from reaching a section of the heart. If the blocked artery is not reopened quickly, the part of the heart normally nourished by that artery begins to die. The longer a person goes without treatment, the greater the damage.

    Symptoms of a heart attack may be immediate and intense. More often, though, symptoms start slowly and persist for hours, days or weeks before a heart attack. Unlike with sudden cardiac arrest, the heart usually does not stop beating during a heart attack. The heart attack symptoms in women can be different than men.

    What is cardiac arrest?

    Sudden cardiac arrest occurs suddenly and often without warning. It is triggered by an electrical malfunction in the heart that causes an irregular heartbeat (arrhythmia). With its pumping action disrupted, the heart cannot pump blood to the brain, lungs and other organs. Seconds later, a person loses consciousness and has no pulse. Death occurs within minutes if the victim does not receive treatment.

    What is the link?

    These two distinct heart conditions are linked. Sudden cardiac arrest can occur after a heart attack, or during recovery. Heart attacks increase the risk for sudden cardiac arrest. Most heart attacks do not lead to sudden cardiac arrest. But when sudden cardiac arrest occurs, heart attack is a common cause. Other heart conditions may also disrupt the heart’s rhythm and lead to sudden cardiac arrest. These include a thickened heart muscle (cardiomyopathy), heart failure, arrhythmias, particularly ventricular fibrillation, and long Q-T syndrome.

    Fast action can save lives. Find out what to do if someone experiences a heart attack or cardiac arrest.

    What to do: Heart Attack

    Even if you’re not sure it’s a heart attack, call 911 or your emergency response number. Every minute matters! It’s best to call EMS to get to the emergency room right away. Emergency medical services staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

    What to do: Sudden Cardiac Arrest

    Cardiac arrest is reversible in most victims if it’s treated within a few minutes. First, call 911 for emergency medical services. Then get an automated external defibrillator if one is available and use it as soon as it arrives. Begin CPR immediately and continue until professional emergency medical services arrive. If two people are available to help, one should begin CPR immediately while the other calls 911 and finds an AED.

    Sudden cardiac arrest is a leading cause of death – over 320,000 out-of-hospital cardiac arrests occur annually in the United States. By performing Hands-Only CPR to the beat of the classic disco song “Stayin’ Alive,” you can double or even triple a victim’s chance of survival. Learn the two easy steps to save a life at heart.org/handsonlycpr.

    How to Stop a Heart Attack in Its Tracks

    • Heart and Vascular Health
    • Heart Health

    Women. Wisdom. Wellness. May 10, 2017

    It could be the most important 60 seconds of your life, so now is the time to prepare yourself.

    Seriously, to survive a heart attack, you need to know the signs and how to respond, well before it ever happens. You can’t afford to wait. Not even for a minute.

    A heart attack occurs when a coronary artery is blocked and blood can’t reach the heart. When this happens, the heart muscle will begin to die. This can permanently damage your heart, and result in death.

    Familiarize yourself with the symptoms of heart attack now, while you’re healthy, and know what action to take before a heart attack ever strikes. The faster you get to a hospital, the greater your chances of restoring blood flow to the heart, saving heart muscle and your life.

    Be Prepared for a Heart Attack

    What does a heart attack feel like? For women (and often for men, too), it’s not the crushing, chest-grabbing pain you often see in the movies. While women may experience debilitating pain, it’s more likely you’ll feel an uncomfortable chest pressure or squeezing, shortness of breath, something like heartburn, or even mild symptoms like fatigue or lightheadedness.

    But even before symptoms strike, you can prepare by knowing which hospitals in your area have 24-hour emergency cardiac care. Also, keep a list of emergency phone numbers next to your phone and with you at all times, as well as a list of your medications.

    Calling 9-1-1: Just Do It

    If you think you are in the throes of a heart attack, don’t try to wait it out, no matter how mild your symptoms. Act immediately. Here’s how:

    DO:

    1. Call 9-1-1. Do this before doing anything else.
    2. Take an aspirin. Chew one uncoated 325-milligram aspirin (not a baby aspirin). It may not stop the heart attack, but it could lessen the damage by thinning the blood and breaking up clots.
    3. Take nitroglycerin for chest pain if you have a prescription.
    4. Unlock the door so the paramedics can get in.
    5. Call a friend or neighbor to wait with you.
    6. Rest while waiting.
    7. Speak up! Let the 9-1-1 operator, the paramedics, the doctors, the nurses, and anyone else you speak to know that you think you are having a heart attack.
    8. Trust your instincts. Don’t allow anyone (including medical personnel) to brush off your symptoms or talk you out of seeking help.

    DON’T:

    1. Wait to call 9-1-1. Don’t call your doctor’s office first. Don’t go on the internet to consult Dr. Google. Don’t wait to see if your condition changes. Don’t ask your spouse or friends what they think. Just call.
    2. Drive yourself to the hospital. And don’t let someone else drive you, either. Leave the driving to the emergency crew. First off, you could die in the car. Second, the paramedics can start taking your vital signs and may even save your life if the situation gets worse before you get to the hospital. This includes administering life-saving treatments right there in the ambulance.
    3. Be afraid of embarrassing yourself. The medical team treating you are professionals. They don’t want you to risk your life because you’re afraid of what they might think. And they’re not going to shake their heads and gossip about your bad case of indigestion as you leave. And even if they did — would you rather die of embarrassment, or die from a heart attack?

    Diagnosis on the Run

    In the ambulance, paramedics may perform an electrocardiogram (ECG or EKG). In this procedure, wires are connected to your chest and to a monitor. Your heart activity will be recorded and the test will confirm whether you are having a heart attack. The paramedics will send the EKG results to the emergency department (ED) so that the staff is ready to treat you as soon as you’re brought through the door. In some circumstances, they also may begin treatment, such as administering clot-busting drugs.

    Familiarize yourself with the symptoms of heart attack now, while you’re healthy, and know what action to take before a heart attack ever strikes.

    Rapid Treatment Saves Lives

    Treatment may begin immediately in the ED, even before doctors have confirmed that you are having a heart attack. This may include giving you aspirin or nitroglycerin, oxygen therapy, and/or treatment to reduce your chest pain.

    If a heart attack is diagnosed (or strongly suspected), doctors will act quickly to restore blood flow to the heart. This may include giving you clot-busting medicines (thrombolytic medicines) that dissolve the clots that are blocking the coronary arteries.

    Another treatment is balloon angioplasty, in which a thin, flexible tube with a balloon at the end is threaded through your artery to the blockage. Once the blockage is reached, the balloon is inflated, pressing the clot against the artery walls and restoring blood flow. Doctors also may place a stent (kind of like a springy, wire mesh basket) in the area of the blockage to hold the artery open and allow blood to continue to flow.

    Don’t Become a Statistic

    Of course, all of these life-saving treatments are of no use if you don’t respond immediately to the warning signs of heart attacks.

    According to a study published in Circulation (the journal of the American Heart Association), more than half of the 1.2 million people who have a heart attack or coronary death each year in the U.S. die in an ED or before reaching a hospital within an hour of the onset of symptoms.

    Speed is of the essence in stopping heart attacks. Lifesaving measures are only effective for a brief period of time after symptoms begin, before heart muscle begins to die and your heart ceases to function. Heed the advice. And just. Don’t. Wait.

    Source: American Heart Association; National Institutes of Health; SecondsCount.org (The Society for Cardiovascular Angiography and Interventions); American Association of Retired Persons

    Heart Attack Causes & Risk Factors

    How to Find Out If You May Have a Problem

    Of course, it is normal for your heart rate to vary widely during the course of a day, depending on whether you’re active or resting. For example, you can expect your heart rate to increase when you are exercising, but not when you are sitting still. What is not normal is a heart rate that is fast or slow because of a problem with the conduction system. If you have certain symptoms, your doctor may want to test your conduction system.

    Conduction problems like arrhythmias can sometimes go unnoticed.

    Other times they can cause the following symptoms:

    • Reduced energy levels
    • Fatigue
    • Shortness of breath
    • Palpitations (feeling your heart skip a beat or pound quickly)
    • Chest pain
    • Dizziness
    • Lightheadedness

    The good news is that tests can show if you have conduction problems. That’s why you should check with your doctor if you have any of these symptoms. You know your body well enough to tell when something doesn’t feel right.

    To check for problems, your doctor might recommend one or more tests. But keep in mind that if you are referred for testing, it doesn’t automatically mean that you have conduction problems. These tests can also help determine if you don’t have conduction problems.

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