A Sudden Cardiac Arrest is an Electrical Problem: So Call an Electrician?

By now you have seen those colourful PSAs (public service announcements) explaining the difference between a sudden cardiac arrest and a heart attack. In most versions, the left side has a graphic image of a heart with lightning bolts and a caption “electrical problem” and on the right-hand side an image of a partially blocked artery captioned “circulation” or “plumbing problem”. The former is supposed to highlight the most salient fact about a sudden cardiac arrest and the latter about a heart attack. Of all the critical information to impart about a cardiac arrest, I do not think “electrical problem” is the most important for people to understand. When I see these posters, I imagine a group of bystanders standing over an unconscious body wondering “Is that an electrical problem or a plumbing problem?” I am puzzled. How will the information in these PSAs help save a life?

To help save lives, the practical alternative to these PSAs would be to clearly explain how to recognize and help someone who is experiencing a cardiac arrest. If the person is unconscious or unresponsive and not breathing, and you do not feel a heartbeat or pulse, call 911 and start CPR immediately. This information is more helpful than knowing the person you are trying to assist might be experiencing an electrical or plumbing problem. The information in these PSAs is irrelevant and unhelpful, especially given the acute seriousness of sudden cardiac arrests. It will not help save lives.

I also do not understand the rationale for making the comparison, that is, contrasting one serious cardiac problem with another – related and more prevalent – cardiac problem. Take PSAs about strokes, for example; with graphics and/or words, these PSAs list the signs of a stroke, to help people recognize when someone might need help. What these PSAs do not do is compare a stroke to epilepsy, concussions, drug overdoses, psychotic episodes or other conditions centred in the brain. A cut in your arm or leg can be trivial or serious. If it is a severed artery, however, it can precipitate a cardiac arrest if the bleeding is not stopped quickly. Exsanguination or bleeding to death is a plumbing problem – a burst pipe – that leads to an electrical problem, much like a heart attack can. Why isn’t this comparison on the sudden cardiac arrest PSA?  Why a heart attack?

These PSAs are only communicating what a sudden cardiac arrest is not. “It’s not a heart attack”, that’s the entire message and that’s why the comparison. It is not about informing the public, with a goal to saving lives. It is about differentiating sudden cardiac arrests from heart attacks, period. But why? Why spend valuable marketing dollars highlighting a difference between two related medical conditions that bystanders cannot use to identify and save someone who needs help?

As SCA survivors, we are acutely aware how people use the term “heart attack” very loosely, from describing their reaction to being surprised – “I almost had a heart attack” – to describing someone, like us, who had a sudden cardiac arrest. Apart from these harmless examples, I am aware of no evidence that the confusion between the two terms has caused any substantive harm or contributed to any loss of life. Yes, we survivors of a sudden cardiac arrest do get irate and a bit irrational when referred to as having had a heart attack. But your ego and self-image are not so fragile that you need a PSA to solve this for you, are they, when the money could be used to save lives? We gently correct the imprecision or ignore it and move on, looking for normalcy. And if we do need a PSA, let’s have one that is helpful, one that identifies the signs of a sudden cardiac arrest and actions necessary to save a life.

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