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Parada cardíaca súbita ou Morte súbita

O que é? Qual é o tratamento?

Na parada cardíaca súbita, o coração deixa de pulsar de modo abrupto e imprevisto por um problema no sistema elétrico do coração. Às vezes, uma arritmia – um ritmo cardíaco irregular – pode fazer com que a frequência cardíaca mude a uma frequência rápida e grave, denominada taquicardia ventricular (TV), e se acelerar muito e for instável e irregular, pode converter-se em um ritmo bem mais perigoso denominado fibrilação ventricular (FV). Com a fibrilação ventricular, o coração vibra rapidamente e não pode bombear sangue ao corpo todo. A pessoa perde a consciência rapidamente, não respira, e se não receber tratamento imediato com um desfibrilador, pode sofrer dano cerebral. Trata-se de uma emergência médica grave e com risco de morte. As probabilidades de sobreviver a uma parada cardíaca súbita diminuem entre 7 e 10% a cada minuto que passa, sem não for aplicada uma descarga elétrica de socorro. Depois dos 10 minutos, poucas tentativas de reanimação têm sucesso. Em mais de 90% dos casos a morte ocorre de forma abrupta e imprevista. A diferença com um ataque cardíaco consiste em que, nesse caso, há um problema de “conexão” provocado por uma ou mais obstruções nos vasos sanguíneos do coração, que evitam a passagem do fluxo apropriado. Parte do músculo cardíaco morre, mas o paciente está consciente e respira.

Por que isso acontece?

A parada cardíaca súbita pode ser o resultado de uma doença arterial coronária ou de outros problemas cardíacos, e acontece em pessoas de qualquer idade, gênero e raça, inclusive naquelas que parecem gozar de boa saúde. Existem casos de atletas profissionais com um nível de treinamento ideal, que morreram de repente durante um evento esportivo, devido a uma parada cardíaca súbita.

Quais são os fatores de risco?

A maioria das doenças cardíacas e dos vasos sanguíneos pode resultar em uma parada cardíaca súbita. Entre os fatores que aumentam o risco estão: antecedentes familiares de cardiopatias, hipertensão, colesterol alto, obesidade, diabete, sedentarismo, fumar, consumo excessivo de álcool e idade. Outros aspectos que influenciam são antecedentes pessoais ou familiares de arritmias ou de parada cardíaca súbita, ataque cardíaco ou insuficiência cardíaca prévia e abuso de drogas.

Quais são os sintomas?

Embora não existam signos de advertência antes de uma parada cardíaca súbita, é possível que antes se apresentem sintomas como fadiga ou fraqueza, dificuldade para respirar, desmaios, tonturas ou atordoamento, palpitações e/ou dor no peito. Porém, o primeiro sintoma, e com frequência o único sintoma de uma parada cardíaca súbita, é a perda de consciência devido à falta de sangue no cérebro.

Ao identificar esses sintomas, consulte seu médico.

Como é diagnosticada?

A parada cardíaca súbita é diagnosticada depois de ter ocorrido um episódio e, em um eletrocardiograma, pode aparecer como fibrilação ventricular. Se uma pessoa apresentar algum dos fatores de risco indicados, o médico pode sugerir-lhe determinados exames, como o eletrocardiograma, que avalia o sistema elétrico do coração, ou o ecocardiograma, que controla a forma com que ele é bombeado através de um ultrassom, para criar imagens de seu coração segundo as pulsações. Também existem exames que analisam como os pulsos elétricos viajam através do músculo cardíaco.

Qual é o tratamento?

Quando uma parada cardíaca é produzida, é preciso realizar técnicas de reanimação cardiopulmonar (RCP) e usar um desfibrilador durante os primeiros minutos, para restituir a atividade elétrica do coração e reviver sua função de bombeamento.

  • RCP: é a realização de pressões no peito com respiração assistida, um passo importante para que a terapia da desfibrilação externa seja eficaz.
  • Desfibrilação: é o uso de um aparelho (desfibrilador) que envia uma descarga elétrica forte ao coração, para deter a arritmia e restituir a pulsação normal. Existem dois tipos de desfibriladores: os externos, que utilizam paletas para gerar a descarga desde o exterior do corpo; e os cardiodesfibriladores implantáveis, que são dispositivos parecidos aos marcapassos que detectam as arritmias e enviam descargas de socorro.

Antes de iniciar o tratamento, consultar sempre um médico.

Prevenção  

As recomendações são: ter uma vida saudável, exercícios, dieta com baixa ingestão de gorduras e alta em fibras e não fumar, entre outros. Porém, a terapia com o desfibrilador detém eficazmente 95%, ou mais, dos ritmos cardíacos perigosamente rápidos. Por outra parte, apenas uma de cada vinte pessoas sobrevive a um episódio de ataque cardíaco súbito. Com um desfibrilador, a proporção é exatamente inversa.