Saving People in Cardiac Arrest
It's often the quick actions of strangers that make a difference between life and death
Heather Von Kurtze (left) and her daughter, Alexandra, were at a playground when Michael Liu, an avid runner, stopped by with his son, Nathan, and collapsed suddenly. Photo by Ben Tankersley
SITTING ON HIS living room couch in shorts and a T-shirt, Michael Liu looks good for someone whose heart stopped beating last year. The 32-year-old’s sinewy legs and lean torso are more like those of an athlete than a cardiac patient. But on May 14, 2014, he came within seconds of dying.
It was a Wednesday afternoon, and Liu—a patent examiner for the U.S. Patent and Trademark Office who teleworks from his Rockville home—went for a run with his son, Nathan, who was in a stroller. A veteran of four marathons, Liu was running 5 miles almost every day. He usually stopped midway through his route to let Nathan, then 22 months, play in a park.
Liu remembers nothing from that day, but Rockville residents Heather Von Kurtze and her daughter, Alexandra Hofacre, do. Von Kurtze had picked up 9-year-old Alexandra from school and gone to College Gardens Park, where she sat on a bench and worked while the fourth-grader played.
A cool mist fell on the playground, keeping the crowds away. Von Kurtze and Alexandra were alone when Liu arrived with Nathan and collapsed suddenly, falling face down onto the ground just a few yards away.
ALTHOUGH THE TERMS are often used interchangeably, sudden cardiac arrest is not the same as a heart attack. Cardiac arrest occurs when the heart stops beating properly and blood no longer supplies oxygen and other nutrients to the heart, brain, kidneys and other organs. It is often the result of a heart attack—a blockage of a coronary artery that can cause heart muscle tissue to die—but there are other causes as well. The American Heart Association (AHA) estimates that more than 325,000 people experience cardiac arrest outside of a hospital in the United States each year. Risk factors include cardiovascular disease or a family history of cardiac arrest. Men are two to three times more likely than women to suffer from sudden cardiac arrest.
In most cases, the heart’s electrical activity does not cease completely. Instead, the heart’s electrical pathways go awry—the cells are still firing, but in a disorganized, chaotic pattern that doesn’t allow the muscle to contract. An electrical shock, or defibrillation, can stop the aberrant activity, and often the heart will resume beating. Without that jolt, the lack of blood flow will almost certainly be fatal within minutes.
Liu still doesn’t know why his heart stopped that afternoon. When a healthy and athletic person in his 30s suffers sudden cardiac arrest, experts say, heart attacks often are not the cause. There were no known heart problems in Liu’s family. Doctors found no blockages or clots in his coronary arteries, and he hadn’t used cocaine or other drugs sometimes linked to cardiac events.
Sometimes the heart stops and no one can figure out why. It can be due to genetic abnormalities that aren’t visible on electrocardiograms, or medications that make people more susceptible to abnormal heart rhythms, according to cardiologists. Liu went into cardiac arrest while he was running, something he did all the time without difficulty. Looking back, he says, there were signs over the past few years that something might have been wrong. He had felt light-headed a few times while running or playing basketball, but those episodes passed quickly.
“Fainting during exercise, while playing basketball for example, has a much worse prognosis than fainting that occurs while someone’s not exercising,” says Dr. Eric Lieberman, a cardiologist with Johns Hopkins Community Physicians Heart Care in Rockville. “A person who faints while getting their blood drawn or at rest, that’s not associated with an increased risk of cardiac arrest. [But] if there’s a history of losing consciousness during exercise—that should be evaluated.”
Liu went to his cardiologist after his near-fainting spells. The doctor performed EKGs and a stress test, but saw nothing that concerned him.