Muiris Houston: Millions watching Christian Eriksen highlighted cardiac arrest danger

The absolute shock on the faces of his Denmark team mates as Christian Eriksen lay on the ground 43 minutes into the Euro 2020 championship soccer game against Finland will stay with people for a long time. Tom Carstensen, writing in the Guardian, describes the horror all too well.

“It opens a dark door to panic, fright and sadness. It grips me as I watch what looks like a lifeless man and the panic-ridden faces of players, coaches and fans. I’m not sure everybody in the room noticed the jolting body when the defibrillator is used. My wife then says he’s being given a heart massage.

“I don’t want to seem too panicky in front of my daughter but it becomes unbearable. Frankly, I panic. I leave her with my wife and her parents in the sitting room and go to the kitchen. With tears in my eyes and a burning feeling in my throat I do the dishes. I don’t do them well.”

Fortunately, one hour later, came the news everyone wanted to hear: Eriksen had responded to the treatment he had received on the pitch and was alive and well in a Copenhagen hospital.

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The key to bringing the Denmark midfielder back to life was a combination of an electric shock from a heart defibrillator and CPR – the manual cardiopulmonary resuscitation that involves repeated pushing down on the chest. He had gone into cardiac arrest and dropped to the ground.

A cardiac arrest is different from a heart attack, where the heart usually continues beating. With a cardiac arrest the heart stops functioning: it no longer pumps blood around the body, meaning the critical oxygen supply to the brain and other organs is cut off, presenting an immediate threat to life.

A heart attack occurs when the blood supply to the heart muscle is cut off, usually because of a clot in one of the coronary arteries that supply blood to the heart. It too can be life-threatening, but not with the suddenness of a cardiac arrest.

Survival rates

Only 10 per cent of people who suffer cardiac arrest outside of hospital survive. In the Republic some 5,000 people die from cardiac arrest every year, usually because they do not get CPR or defibrillation fast enough.

A Canadian study found a steep decline in survival rates in the first five minutes after a person suffered a cardiac arrest. Specifically the odds of survival decreased by 23 per cent for each additional minute’s delay in giving defibrillation. Defibrillators give the heart a controlled electric shock. The heart then restarts, with its intrinsic pacemaker bringing it to a regular rhythm.

There are a number of fast, abnormal heart rhythms which could have caused Eriksen’s collapse. The most dangerous is ventricular fibrillation – where the two large chambers of the heart shake like pieces of jelly.

In young fit people common reasons for the development of an arrhythmia are the presence of different forms of heart muscle disease and anomalies in the structure of the blood vessels supplying the heart. A thickening of the heart muscle disrupts the dividing wall down the middle of the heart. This wall carries the transmission system which both triggers and spreads a normal beat throughout the heart.

So as the heart muscle thickens, both its pumping efficiency and its ability to maintain a smooth heart rate is impaired.

Heart rhythm

After a series of cardiac tests it was decided that Eriksen would benefit from an implantable cardioverter-defibrillator (ICD). Placed under the skin of his chest wall it will continuously monitor his heart rhythm. A combination pacemaker and defibrillator, the device can send electrical pulses to restore a normal rhythm if needed.

Meanwhile will there be psychological effects for fans who watched continuous TV footage of Eriksen’s resuscitation?

While I could find no research on bystanders, there is evidence that those who provide CPR are emotionally challenged by the experience.

mhouston@irishtimes.com
muirishouston.com