Chiropractors have been banned again from manipulating babies’ spines. Here’s what the evidence actually says
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Chiropractors in Australia will not be able to perform spinal manipulation on children under the age of two once more, following health concerns from doctors and politicians.
But what is the spinal treatment at the centre of the controversy? Does it work? Is there evidence of harm?
We’re a team of researchers who specialise in evidence-based musculoskeletal health. I (Matt) am a registered chiropractor, Joshua is a registered physiotherapist and Giovanni trained as a physiotherapist.
Here’s what the evidence says.
Remind me, how did this all come about?
A Melbourne-based chiropractor posted a video on social media in 2018 using a spring-loaded device (known as the Activator) to manipulate the spine of a two-week-old baby suspended upside down by the ankles.
The video sparked widespread concerns among the public, medical associations and politicians. It prompted a ban on the procedure in young children. The Victorian health minister commissioned Safer Care Victoria to conduct an independent review of spinal manipulation techniques on children.
Recently, the Chiropractic Board of Australia reinstated chiropractors’ authorisation to perform spinal manipulation on babies under two years old. But this week, it backflipped, following heavy criticism from medical associations and politicians.
What is spinal manipulation?
Spinal manipulation is a treatment used by chiropractors and other health professionals such as doctors, osteopaths and physiotherapists.
It is an umbrella term that includes popular “back cracking” techniques.
It also includes more gentle forms of treatment, such as massage or joint mobilisations. These involve applying pressure to joints without generating a “cracking” sound.
Does spinal manipulation in babies work?
Several international guidelines for health-care professionals recommend spinal manipulation to treat adults with conditions such as back pain and headache as there is an abundance of evidence on the topic. For example, spinal manipulation for back pain is supported by data from nearly 10,000 adults.
For children, it’s a different story. Safer Care Victoria’s 2019 review of spinal manipulation found very few studies testing whether this treatment was safe and effective in children.
Studies were generally small and were of poor quality. Some of those small, poor-quality studies, suggest spinal manipulation provides a very small benefit for back pain, colic and potentially bedwetting – some common reasons for parents to take their child to see a chiropractor. But overall, the review found the overall body of evidence was very poor.
However, for most other children’s conditions chiropractors treat – such as headache, asthma, otitis media (a type of ear infection), cerebral palsy, hyperactivity and torticollis (“twisted neck”) – there did not appear to be a benefit.
The number of studies investigating the effectiveness of spinal manipulation on babies under two years of age was even smaller.
There was one high-quality study and two small, poor quality studies. These did not show an appreciable benefit of spinal manipulation on colic, otitis media with effusion (known as glue ear) or twisted neck in babies.
Is spinal manipulation on babies safe?
In terms of safety, most studies in the review found serious complications were extremely rare. The review noted one baby or child dying (a report from Germany in 2001 after spinal manipulation by a physiotherapist). The most common complications were mild in nature such as increased crying and soreness.
However, because studies were very small, they cannot tell us anything about the safety of spinal manipulation in a reliable way. Studies that are designed to properly investigate if a treatment is safe typically include thousands of patients. And these studies have not yet been done.
Why do people see chiropractors?
Safer Care Victoria also conducted surveys with more than 20,000 people living in Australia who had taken their children under 12 years old to a chiropractor in the past ten years.
Nearly three-quarters said that was for treatment of a child aged two years or younger.
Nearly all people surveyed reported a positive experience when they took their child to a chiropractor and reported that their child’s condition improved with chiropractic care. Only a small number of people (0.3%) reported a negative experience, and this was mostly related to cost of treatment, lack of improvement in their child’s condition, excessive use of x-rays, and perceived pressure to avoid medications.
Many of the respondents had also consulted their GP or maternity/child health nurse.
What now for spinal manipulation in children?
At the request of state and federal ministers, the Chiropractic Board of Australia confirmed that spinal manipulation on babies under two years old will continue to be banned until it discusses the issue further with health ministers.
Many chiropractors believe this is unfair, especially considering the strong consumer support for chiropractic care outlined in the Safer Care Victoria report, and the rarity of serious reported harms in children.
Others believe that in the absence of evidence of benefit and uncertainty around whether spinal manipulation is safe in children and babies, the precautionary principle should apply and children and babies should not receive spinal manipulation.
Ultimately, high quality research is urgently needed to better understand whether spinal manipulation is beneficial for the range of conditions chiropractors provide it for, and whether the benefit outweighs the extremely small chance of a serious complication.
This will help parents make an informed choice about health care for their child.
Matt Fernandez, Senior lecturer and researcher in chiropractic, CQUniversity Australia; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healthy Harissa Falafel Patties
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You can make these as regular falafel balls if you prefer, but patties are quicker and easier to cook, and are great for popping in a pitta.
You will need
For the falafels:
- 1 can chickpeas, drained, keep the chickpea water (aquafaba)
- 1 red onion, roughly chopped
- 2 tbsp chickpea flour (also called gram flour or garbanzo bean flour)
- 1 bunch parsley
- 1 tbsp harissa paste
- Extra virgin olive oil for frying
For the harissa sauce:
- ½ cup crème fraîche or plant-based equivalent (you can use our Plant-Based Healthy Cream Cheese recipe and add the juice of 1 lemon)*
- 1 tbsp harissa paste (or adjust this quantity per your heat preference)
*if doing this, rather than waste the zest of the lemon, you can add the zest to the falafels if you like, but it’s by no means necessary, just an option
For serving:
- Wholegrain pitta or other flatbread (you can use our Healthy Homemade Flatbreads recipe)
- Salad (your preference; we recommend some salad leaves, sliced tomato, sliced cucumber, maybe some sliced onion, that sort of thing)
Method
(we suggest you read everything at least once before doing anything)
1) Blend the chickpeas, 1 oz of the aquafaba, the onion, the parsley, and the harissa paste, until smooth. Then add in the chickpea flour until you get a thick batter. If you overdo it with the chickpea flour, add a little more of the aquafaba to equalize. Refrigerate the mixture for at least 30 minutes.
2) Heat some oil in a skillet, and spoon the falafel mixture into the pan to make the patties, cooking on both sides (you can use a spatula to gently turn them), and set them aside.
3) Mix the harissa sauce ingredients in a small bowl.
4) Assemble; best served warm, but enjoy it however you like!
Enjoy!
Want to learn more?
For those interested in more of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Capsaicin For Weight Loss And Against Inflammation
- Hero Homemade Hummus ← another great option
Take care!
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How To Keep On Keeping On?
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How To Keep On Keeping On… Long Term!
For many when it comes to health-related goals and practices, it’s easy to find ourselves in a bit of a motivational dip around this time of year. The enthusiasm of new year’s resolutions has been and gone, and there’s not yet much of a drive to “get a beach body” or “be summer-ready”.
A word to the wise on those before moving on, though:
- How to get a beach body: take your body to a beach. Voilà. Beach body.
- Remember: the beach is there for your pleasure and entertainment, not the other way around!
- How to be summer-ready: the real question is, will summer be ready for you?
But what is this, demotivational rhetoric to discourage you from getting fit and healthy?
Not at all, but rather, to be sure that you’re pursuing your own goals and not just what you feel might be expected of you.
All that in mind, let’s get to the tips…
Focus on adding health
It can be tempting (and even, good) to cut down on unhealthy things. But when it comes to motivation, it’s harder to stay motivated for deprivation, than it is for some healthy addition to life.
So for example, this philosophy would advocate for:
- Instead of counting calories, count steps! Or even…
- Instead of counting calories, count colors! Eat the rainbow and all that. No, skittles do not count, but eating a variety of naturally different-colored foods will tend to result in adding different nutrients to your diet.
- Instead of cutting out sugar, add fruit! How many per day will you go for? If you don’t eat much fruit as it is, consider making it a goal to have even just one piece of fruit a day, then build up from there. Find fruit you like! If you pick the fruit you want instead of the fruit you think you “should” have, it’s basically a dessert snack.
We’ve recommended it before, and we’ll recommend it again, but if you’re interested in “adding health”, you should definitely check out:
Dr. Greger’s Daily Dozen (checklist, plus app if you want it)
More details: it’s a checklist of 12 things you should try to include in your diet, with a free streak-tracking app, if you want it, all based on the same scientific research as the best-selling book “How Not To Die”.
“Minimum effort!”
Did you see the movie “Deadpool”? The protagonist has a catch-phrase as he goes into battle, saying to himself “Maximum effort!”.
And, that’s all very well and good if your superpower is immediate recovery from pretty much anything, but for the rest of us, sometimes it’s good to hold ourselves to “minimum effort!”.
Sometimes, something worth doing is worth doing just a little a bit. It’s always better than nothing! Even if feels like you gained nothing from it, it’s the foundation of a habit, and the habit will grow and add up. Sometimes it may even take you by surprise…
Don’t feel like doing 20 bodyweight squats? Do literally just one. Make a deal with yourself: do just one, then you can stop if you like. Then after you’ve done one, you might think to yourself “huh, that wasn’t so bad”, and you try out a few more. Maybe after 5 you can feel your blood pumping a bit and you think “you know what, that’s enough for now”, and great, you did 5x as much exercise as you planned! Wonder what you’ll do tomorrow!
(personal note from your writer here: I’ve managed to “just extend this exercise a little bit more than last time” my way into hour-long exercise sessions before now; I started with “just 10 squats” or “just one sun salutation” etc, to get myself out of a no-exercise period that I’d slipped into, and it’s amazing how quickly adding just a little bit to the previous day’s “minimum effort!” adds up to a very respectable daily exercise session)
Wondering what a good, easy, respectable short term goal could be?
Check Out, For Example: The Seven-Minute Workout
(You might have heard of this one before; it’s an incredibly efficient well-optimized short complete workout that requires no special equipment, just a bit of floorspace and a wall—the above app allows for customizations of it per your preferences, but the basic routine is an excellent starting point for most people)
Commit to yourself (and do any self-negotiation up-front)
Really commit, though. No “or I will look silly because I told people I’d do it”, no “or I will donate x amount to charity” etc, just “I will do it and that’s that”. If you find yourself second-guessing yourself or renegotiating with yourself, just shut that down immediately and refuse to consider it.
Note: you should have break-clauses in this contract with yourself, though. For example, “unless I am ill or injured” is a sensible rule to have in advance for most exercise regimes that weren’t undertaken with your illness or injury in mind.
Make a “To-Don’t” list
Much like how addicts are often advised to not try to quit more than one thing at once, we must also be mindful of not taking on too much at once. It can be very tempting to think:
“I will turn my life around, now! I’ll quit alcohol and animal products and sugar and refined grains, and I’ll go for a run each morning, and I’ll do this and that and there, I’ve got it, here is the blueprint for my healthy perfect life from this day forth!”
And, it’s great to have any and all of that as your end goal if you want, but please, pick one or two things at most to start with, focus on those, and when those have become second nature to you and just a normal part of your life, then choose the next thing to work on.
(You can plan out the whole thing in advance if you want! i.e., I’ll do this, then this, then this, but just… make sure that you’ve really got each one down to a matter of comfort and ease before you take up the next one)
In summary:
- Focus on adding health, whatever that looks like to you
- Figure out what “minimum effort!” is for you, and let that be your baseline
- Commit to yourself (and do any self-negotiation up-front, not later)
- Decide what you’re not going to do yet, and stick to that, too.
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- How to get a beach body: take your body to a beach. Voilà. Beach body.
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Women’s Strength Training Anatomy Workouts – by Frédéric Delavier
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We’ve previously reviewed another book of Delavier’s, “Women’s Strength Training Anatomy“, which itself is great. This book adds a lot of practical advice to that one’s more informational format, but to gain full benefit of this one does not require having read that one.
A common reason that many women avoid strength-training is because they do not want to look muscular. Largely this is based on a faulty assumption, since you will never look like a bodybuilder unless you also eat like a bodybuilder, for example.
However, for those for whom the concern remains, today’s book is an excellent guide to strength-training with aesthetics in mind as well as functionality.
The exercises are divided into sections, thus: round your glutes / tone your quadriceps / shape your hamstrings / trim your calves / flatten your abs / curve your shoulders / develop a pain-free upper back / protect your lower back / enhance your chest / firm up your arms.
As you can see, a lot of these are mindful of aesthetics, but there’s nothing here that’s antithetical to function, and some (especially for example “develop a pain-free upper back” and “protect your lower back“) are very functional indeed.
Bottom line: Delavier’s anatomy and exercise books are top-tier, and this one is no exception. If you are a woman and would like to strength-train (or perhaps you already do, and would like to refine your training), then this book is an excellent choice.
Click here to check out Women’s Strength Training Anatomy Workouts, and have the body you want!
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We don’t all need regular skin cancer screening – but you can know your risk and check yourself
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Australia has one of the highest skin cancer rates globally, with nearly 19,000 Australians diagnosed with invasive melanoma – the most lethal type of skin cancer – each year.
While advanced melanoma can be fatal, it is highly treatable when detected early.
But Australian clinical practice guidelines and health authorities do not recommend screening for melanoma in the general population.
Given our reputation as the skin cancer capital of the world, why isn’t there a national screening program? Australia currently screens for breast, cervical and bowel cancer and will begin lung cancer screening in 2025.
It turns out the question of whether to screen everyone for melanoma and other skin cancers is complex. Here’s why.
Pixel-Shot/Shutterstock The current approach
On top of the 19,000 invasive melanoma diagnoses each year, around 28,000 people are diagnosed with in-situ melanoma.
In-situ melanoma refers to a very early stage melanoma where the cancerous cells are confined to the outer layer of the skin (the epidermis).
Instead of a blanket screening program, Australia promotes skin protection, skin awareness and regular skin checks (at least annually) for those at high risk.
About one in three Australian adults have had a clinical skin check within the past year.
Those with fairer skin or a family history may be at greater risk of skin cancer. Halfpoint/Shutterstock Why not just do skin checks for everyone?
The goal of screening is to find disease early, before symptoms appear, which helps save lives and reduce morbidity.
But there are a couple of reasons a national screening program is not yet in place.
We need to ask:
1. Does it save lives?
Many researchers would argue this is the goal of universal screening. But while universal skin cancer screening would likely lead to more melanoma diagnoses, this might not necessarily save lives. It could result in indolent (slow-growing) cancers being diagnosed that might have never caused harm. This is known as “overdiagnosis”.
Screening will pick up some cancers people could have safely lived with, if they didn’t know about them. The difficulty is in recognising which cancers are slow-growing and can be safely left alone.
Receiving a diagnosis causes stress and is more likely to lead to additional medical procedures (such as surgeries), which carry their own risks.
2. Is it value for money?
Implementing a nationwide screening program involves significant investment and resources. Its value to the health system would need to be calculated, to ensure this is the best use of resources.
Narrower targets for better results
Instead of screening everyone, targeting high-risk groups has shown better results. This focuses efforts where they’re needed most. Risk factors for skin cancer include fair skin, red hair, a history of sunburns, many moles and/or a family history.
Research has shown the public would be mostly accepting of a risk-tailored approach to screening for melanoma.
There are moves underway to establish a national targeted skin cancer screening program in Australia, with the government recently pledging $10.3 million to help tackle “the most common cancer in our sunburnt country, skin cancer” by focusing on those at greater risk.
Currently, Australian clinical practice guidelines recommend doctors properly evaluate all patients for their future risk of melanoma.
Looking with new technological eyes
Technological advances are improving the accuracy of skin cancer diagnosis and risk assessment.
For example, researchers are investigating 3D total body skin imaging to monitor changes to spots and moles over time.
Artificial intelligence (AI) algorithms can analyse images of skin lesions, and support doctors’ decision making.
Genetic testing can now identify risk markers for more personalised screening.
And telehealth has made remote consultations possible, increasing access to specialists, particularly in rural areas.
Check yourself – 4 things to look for
Skin cancer can affect all skin types, so it’s a good idea to become familiar with your own skin. The Skin Cancer College Australasia has introduced a guide called SCAN your skin, which tells people to look for skin spots or areas that are:
1. sore (scaly, itchy, bleeding, tender) and don’t heal within six weeks
2. changing in size, shape, colour or texture
3. abnormal for you and look different or feel different, or stand out when compared to your other spots and moles
4. new and have appeared on your skin recently. Any new moles or spots should be checked, especially if you are over 40.
If something seems different, make an appointment with your doctor.
You can self-assess your melanoma risk online via the Melanoma Institute Australia or QIMR Berghofer Medical Research Institute.
H. Peter Soyer, Professor of Dermatology, The University of Queensland; Anne Cust, Professor of Cancer Epidemiology, The Daffodil Centre and Melanoma Institute Australia, University of Sydney; Caitlin Horsham, Research Manager, The University of Queensland, and Monika Janda, Professor in Behavioural Science, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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There are ‘forever chemicals’ in our drinking water. Should standards change to protect our health?
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Today’s news coverage reports potentially unsafe levels of “forever chemicals” detected in drinking water supplies around Australia. These include human-made chemicals: perfluorooctane sulfonate (known as PFOS) and perflurooctanic acid (PFOA). They are classed under the broader category of per- and polyfluoroalkyl substances or PFAS chemicals.
The contaminants found in our drinking water are the same ones United States authorities warn can cause cancer over a long period of time, with reports warning there is “no safe level of exposure”.
In April, the US Environmental Protection Agency (USEPA) sent shock waves through the water industry around the world when it announced stricter advice on safe levels of PFOS/PFOA in drinking water. This reduced limits considered safe in supplies to zero and gave the water industry five years to meet legally enforceable limits of 4 parts per trillion.
So, should the same limits be enforced here in Australia? And how worried should we be that the drinking in many parts of Australia would fail the new US standards?
What are the health risks?
Medical knowledge about the human health effects of PFOS/PFOA is still emerging. An important factor is the bioaccumulation of these chemicals in different organs in the body over time.
Increased exposure of people to these chemicals has been associated with several adverse health effects. These include higher cholesterol, lower birth weights, modified immune responses, kidney and testicular cancer.
It has been very difficult to accurately track and measure effects of different levels of PFAS exposure on people. People may be exposed to PFAS chemicals in their everyday life through waterproofing of clothes, non-stick cookware coatings or through food and drinking water. PFAS can also be in pesticides, paints and cosmetics.
The International Agency for Research on Cancer (on behalf of the World Health Organization) regards PFOA as being carcinogenic to humans and PFOS as possibly carcinogenic to humans.
Is our drinking water safe? What about long-term risks? Volodymyr TVERDOKHLIB/Shutterstock Our guidelines
Australian drinking water supplies are assessed against national water quality standards. These Australian Drinking Water Guidelines are continuously reviewed by industry and health experts that scan the international literature and update them accordingly.
All city and town water supplies across Australia are subject to a wide range of physical and chemical water tests. The results are compared to Australian water guidelines.
Some tests relate to human health considerations, such as levels of lead or bacteria. Others relate to “aesthetic” considerations, such as the appearance or taste of water. Most water authorities across Australia make water quality information and compliance with Australian guidelines freely available.
What about Australian PFOS and PFOA standards?
These chemicals can enter our drinking water system from many potential sources, such as via their use in fire-fighting foams or pesticides.
According to the Australian Drinking Water Guidelines, PFOS should not exceed 0.07 micrograms per litre in drinking water. And PFOA should not exceed 0.56 micrograms per litre. One microgram is equivalent to one part per billion.
The concentration of these chemicals in water is incredibly small. And much of the advice on their concentration is provided in different units. Sometimes in micrograms or nannograms. The USEPA uses parts per trillion.
In parts per trillion (ppt) the Australian Guidelines for PFOS is 70 ppt and PFOA is 560 ppt. The USEPA’s new maximum contaminant levels (enforceable levels) are 4 ppt for both PFOS and also PFOA. Previous news reports have pointed out Australian guidelines for these chemicals in drinking water are up to 140 times higher than the USEPA permits.
Yikes! That seems like a lot
Today’s news report cites PFOS and PFOA water tests done at many different water supplies across Australia. Some water samples did not detect either chemicals. But most did, with the highest PFOS concentration 15.1–15.6 parts per trillion from Glenunga, South Australia. The highest PFOA concentration was reported from a small water supply in western Sydney, where it was detected at 5.17–9.66 parts per trillion.
Australia and the US are not alone. This is an enormous global problem.
One of the obvious challenges for the Australian water industry is that current water treatment processes may not be effective at removing PFOS or PFOA. The Australian Drinking Water Guidelines provide this advice:
Standard water treatment technologies including coagulation followed by physical separation, aeration, chemical oxidation, UV irradiation, and disinfection have little or no effect on PFOS or PFOA concentrations.
Filtering with activated carbon and reverse osmosis may remove many PFAS chemicals. But no treatment systems appear to be completely effective at their removal.
Removing these contaminants might be particularly difficult for small regional water supplies already struggling to maintain their water infrastructure. The NSW Auditor General criticised the planning for, and funding of, town water infrastructure in regional NSW back in 2020.
Where to from here?
The Australian water industry likely has little choice but to follow the US lead and address PFOS/PFAS contamination in drinking water. Along with lower thresholds, the US committed US$1 billion to water infrastructure to improve detection and water treatment. They will also now require:
Public water systems must monitor for these PFAS and have three years to complete initial monitoring (by 2027) […]
As today’s report notes, it is very difficult to find any recent data on PFOS and PFOA in Australian drinking water supplies. Australian regulators should also require ongoing and widespread monitoring of our major city and regional water supplies for these “forever chemicals”.
The bottom line for drinking tap water is to keep watching this space. Buying bottled water might not be effective (2021 US research detected PFAS in 39 out of 100 bottled waters). The USEPA suggests people can reduce PFAS exposure with measures including avoiding fish from contaminated waters and considering home filtration systems.
Correction: this article previously listed the maximum Australian Drinking Water Guidelines PFOA level as 0.056 micrograms per litre. The figure has been updated to show the correct level of 0.56 micrograms per litre.
Ian A. Wright, Associate Professor in Environmental Science, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring
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In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.
Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.
A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.
With some background in how the heart works, we can see how they differ and how they’re related.
Explode/Shutterstock Understanding the heart
The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.
For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.
This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.
Heart attack or cardiac arrest?
Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.
A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.
In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.
Why do they happen? Who’s at risk?
Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.
The underlying cause in about 75% of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.
Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.
Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.
Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.
Here’s a simple way to remember the difference. Author provided But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:
- ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
- ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
- pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
- asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Remember this flat-line rhythm from the movies? It’s asystole, when there’s no electrical activity in the heart. Kateryna Kon/Shutterstock Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.
But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70% of all cases.
So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.
So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.
What do they look like?
Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.
But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.
What’s the take-home message?
While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.
A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.
Despite their different nature both conditions can have severe consequences and require immediate medical attention.
Michael Todorovic, Associate Professor of Medicine, Bond University and Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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