Recently, Australian cricket legend, Dean Jones succumbed to a Sudden Cardiac Arrest (SCA) in Mumbai. Dr. A.P.J. Abdul Kalam, the former President of India, too lost his life to a Sudden Cardiac Arrest. He collapsed while delivering a lecture at a reputed educational institution. Just like the families of these exemplary men, there may be many of us who have lost a close relative or a dear friend due to a sudden cardiac arrest.

SCA is a major cause of death around the world. In 2017, SCA caused about 3,56,500 deaths1 in the USA. In India, the estimated incidence of SCA should be between 5 to 10 lakhs per year, accounting for nearly 10 % of all deaths in India2.

Due to the COVID-19 Pandemic, most of us are experiencing reduced physical activity and increased mental stress. People are avoiding visiting doctors and hospitals for fear of exposure to the virus. This is invariably set to result in an increase in cardiac ailments and SCA. A major challenge is the fact that most of us are not informed enough about SCA. People may not know – how to respond when they witness a SCA. Therefore, let us learn a few things about SCA, which may help us save the life of a dear one.

The first question that comes to our mind is ‘What is ‘Sudden Cardiac Arrest’? Is it the same as a ‘heart attack’? Sudden Cardiac Arrest is not the same as a ‘Heart Attack’. A heart attack (myocardial infarction) occurs when the blood supply to a part of the heart muscle is stopped due to a blockage in the coronary artery. A heart attack usually causes chest pain and or breathlessness; the heart muscle becomes weak and the heart pumping reduces. If the heart attack is very severe, it may result into a Sudden Cardiac Arrest.

Sudden Cardiac Arrest (SCA) on the other hand, is a condition when the heart stops beating (suddenly & unexpectedly). This causes a stoppage of blood flow to the body. If the brain does not receive blood flow for more than three seconds, the person becomes unconscious. If there is no blood flow to the brain for up to 2 minutes, the brain starts to suffer from irreversible damage. If the heart is not restarted in a few minutes by an active intervention, the person dies. Every moment is precious and medical help needs to be provided on top most priority. Else, the situation more often than not can be fatal.

But Do all SCAs result in death of a person? The answer is No. Some simple steps may prevent death. The person (bystander) who witnesses this catastrophe, must act quickly and responsibly. Almost 85 % of SCAs occur outside the hospital. Hence it is important for everyone to know the basics of Cardio Pulmonary Resuscitation (CPR).


Who are at higher risk for having an SCA? People who are old and those who already have a heart disease, are at a higher risk of SCA. But even then, it may occur in young and apparently healthy individuals. SCA can occur at anytime, anywhere and to anyone.

Is there a difference between ‘Fainting’ and SCA? Yes. Fainting or ‘transient loss of conscious’ usually occurs when the blood pressure is low. The heart continues to beat. The victim regains conscious spontaneously, within seconds. The common causes of fainting are – severe emotional stress, severe physical exertion, severe pain, loss of fluid volume (as in diarrhoea or acute bleeding), cerebral stroke, irregular heartbeat or epileptic fit.

So, if someone faints, how do we know that this patient has SCA? What should we do? When you witness someone fainting, the first step is to make the victim lie down flat on the floor. Do not try to make him sit-up or stand. A person who has a simple fainting episode will usually regain conscious within 20 to 30 seconds. If the victim remains motionless for more than 40 – 50 seconds, it is likely to be an SCA. The first thing to do once you suspect SCA, is to shout for help from the people around. If alone, make a phone call to emergency services. Make sure the victim is lying flat on the floor. Give a firm tap on his shoulder and call out loudly to him, to check for responsiveness. In case, if there is no response, try to watch if he is breathing or not. Try to check if he has a pulse. If you are unable to find his pulse, immediately begin resuscitation by means of Chest Compression. As illustrated in the figure, give chest compression, by firmly pressing on the mid to lower part of the sternum (the area on chest between the two nipples), at a rate of about 100/minute. The sternum should be compressed about 5 to 6 cm.

What is an AED?
An AED is very simple life saving device and can usually be used by a layperson having no prior know how of the device. It is small, lightweight and easy to use. It has two electrodes (pads like stickers – shown in picture) which need to be connected to patient’s chest. The AED automatically analyses the cardiac condition of the patient and gives ‘step by step voice command instructions’, with audio & visual guidance. The machine does not give a shock unless it detects that it is a cardiac arrest. Hence, with the use of an AED, things cannot get worse than what they already are. Even a non-medical person can deliver a shock to restart the heart. Thus, an AED helps to save the life of the victim.

What is the chain of survival? The chain of survival refers to a series of actions that when properly executed, reduce the mortality associated with SCA. The “chain of survival” metaphor was developed by Mary M. Newman in 1987. After calling for help, the bystander should provide CPR immediately after the patient collapses. Quality CPR (properly performed CPR) can keep the heart in a shockable rhythm for some more time till one can access AED. Early defibrillation (electric shock with help of an AED) is most likely to improve survival.

Does an AED really save life? AED is a very safe device and is of great utility for saving lives. Without CPR, the survival from SCA is only about 1%. If chest compression is given by a bystander, the chance of survival improves to about 10 – 15%. If an AED is available and used in time, then the chances of survival increase to 25 – 30 %.

Ideally speaking, AED should be available at every public access area. In the developed countries, AEDs are usually kept at airports, hotels, railway stations, malls, sports complexes, etc. In India, AEDs are now slowly being made available at airports, railway stations and five-star hotels. An AED is not expensive, and it can be easily purchased and kept in office complexes and residential societies. One small step today, can save a life tomorrow!

Authored article by Dr. Bhavesh Vajifdar, MD, DNB, MNAMS, FACC, FSCAI, FSCI, FESC, Consultant & Interventional Cardiologist