In late October, 22-year-old New Jersey man, Brad Phelps, stepped onto the field for his first soccer match. The next thing he remembers is waking up in the hospital.
Phelps had experienced a sudden cardiac arrest and his heart had stopped beating for a full 12 minutes . Paramedics were able to shock his heart with a defibrillator, after which he was rushed to Mount Sinai Hospital.
With his heart now beating again, doctors had another concern: the condition of his brain. To prevent further brain damage they used a surprising technique known as Therapeutic Hypothermia.
Cardiac Arrest Versus Heart Attack
In order to understand why doctors were so concerned with Phelp’s brain, it is important to understand the difference between cardiac arrest and a heart attack.
A heart attack occurs when an artery that brings oxygen-rich blood to the heart is blocked. If the artery is not opened quickly, the part of the heart that it is supposed to be delivering oxygen to begins to die. The amount of damage to the heart will increase as time passes without effective treatment. Contrary to what you might think, the heart does not usually stop beating during a heart attack .
Cardiac arrest, on the other hand, occurs when there is an electrical malfunction in the heart. It usually happens suddenly and without warning, and triggers an arrhythmia, a.k.a. an irregular heartbeat. The result is that the heart can no longer pump sufficient blood to the brain, lungs and other organs. The person will lose consciousness, no longer have a pulse, and can die within minutes .
There is a link between these two conditions. A heart attack increases the risk for sudden cardiac arrest, and cardiac arrest can occur after a heart attack or during recovery. Often, when cardiac arrest occurs it was caused by a heart attack, however other congenital heart problems that disrupt the heart’s rhythm can trigger cardiac arrest as well .
Danger to the Brain
The survival rate after sudden cardiac arrest is alarmingly low. Only about one in ten EMS-treated victims survive, which is less than twelve percent .
For those who do survive, there are concerns that extend beyond the heart. The primary issue is known as cerebral ischemia. This is when there is a lack of blood flow to the brain, and can lead to permanent brain damage, death of brain cells or even a stroke .
Hypothermia to Prevent Brain Damage
Ordinarily, hypothermia is viewed as an undesirable and dangerous condition, however doctors and medical researchers have found a way to use mild hypothermia to lessen or prevent brain damage after cardiac arrest .
Therapeutic Hypothermia involves lowering the patient’s body temperature to 91°F (32°C) over a period of 24 hours . The goal of the treatment is to lower the body’s temperature to slow down chemical reactions in the body and lessen inflammation in the brain .
“We want to take away the work burden of the brain and let it recover,” explained Phelps’ cardiologist, Dr. Ali Zaidi. “When the hypothermia ends, we reverse the cooling and let the body go back to normal, and we wait to see how the brain responds.” 
Congenital Heart Defects
So how does a young, fit and healthy 22-year-old end up with cardiac arrest? When Phelps was five years old he suffered from Kawasaki disease. This is a childhood cardiac illness that causes swelling in the medium-sized arteries in the body . Most children recover without any serious problems, however, they can experience lifelong cardiac problems and it is recommended for them to continue to see a cardiologist .
Congenital heart defects are much more common than you might think, with reported rates varying between four and ten per 1000 births . Many adults who suffered from cardiac illness as children but who no longer experience symptoms begin to think that they are cured. This issue puts a large burden on the healthcare system, and it is very important for those who are affected to continue to see a pediatric specialist, and then switch to an adult cardiologist as they age.
“It’s really not the patients’ fault,” Zaidi said. “We need to educate these patients to know that they need to have the appropriate follow up.” 
A Miraculous Recovery
Brad Phelps is one of the extremely fortunate ones. He woke up shortly after his body temperature returned to normal, suffered no brain damage and began walking just days after the event .
“He is very lucky,” Zaidi said. “The heart has made a good recovery, but his brain is in remarkable shape despite everything that happened.” 
And while Phelps’ story has a happy ending, he is quick to point out that it is a reminder to others with similar conditions to continue monitoring the health of their hearts.
“We were not taking care of the condition because we got so many positive reports,” he said. “ It becomes less of a straightforward priority. I’ve learned how important it is to keep constantly monitoring.” 
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