I know medical shows aren’t accurate but I’ve been watching House MD and something commonly repeated is that heart failure is always dangerous because the lack of oxygen to the brain can cause irreparable damage in a matter of minutes.
Modern medicine is so advanced, why isn’t there a way to get oxygen to the brain if the heart stops pumping? Or is it not feasible to fix the heart problem and get it pumping again if the defibrillator doesn’t work?
In: Biology
You could put the patient on a bypass machine to get oxygenated blood to the brain, but they’d be dead in the time it would take to do that.
It’s not that they can’t it’s that it’d be too slow
Also, a defibrillator won’t start a stopped heart, that’s a lie brought to you by tv
There are machines that can take over the function of the charts and lungs temporary. [https://en.wikipedia.org/wiki/Cardiopulmonary_bypass](https://en.wikipedia.org/wiki/Cardiopulmonary_bypass) is commonly used in hear surgery.
The problem during a hear attack is simply time because you need open the chest cavity and attach the machine to arteries and veins close to the heart. So the correct personnel and equipment need to be ready, this would be very hard thing to manage in time.
You can, with an ECMO.
https://www.mayoclinic.org/tests-procedures/ecmo/about/pac-20484615
Why don’t we? There’s more going on than the heart not working right, and you can’t sit on the machine forever. If your heart is done, there’s likely a reason and that reason will kill you. We can keep people alive during a bypass or a heart transplant, but those don’t last forever.
I think you’re referring to cardiac arrest rather than heart failure (more on that below).
When the heart that was responsible for carrying oxygen to the brain stops doing that, that’s an extreme emergency because of how fast hypoxic or anoxic brain injury happens. So you have to fix the blood circulation immediately. The way to do that quickly is through CPR (chest compressions).
If someone’s heart barely works, though, an LVAD is an option – that’s an artificial heart, partially implanted and partially carried outside the body. People can live for years on it under certain circumstances. Interesting is that they don’t have a pulse. (Some older devices do give the patient a pulse, but they weren’t as effective apparently.)
In hospital environments, there is ECMO/cardiopulmonary bypass, too.
Also, some terms:
heart failure is not the same as cardiac arrest. Heart failure means the heart is working poorly; cardiac arrest means the heart stops beating. People can live with heart failure for years, but only minutes with cardiac arrest.
A heart attack (myocardial infarction) means a blood clot has blocked the blood flow to the heart muscle, and now (part of) the heart muscle is dying. This can (and usually does) *cause* heart failure or cardiac arrest, but it’s not the same thing.
Asystole means “flatlining”, most cardiac arrests aren’t flatlining. You can’t shock (defibrillate) an asystole into being a good heartbeat again, you can do CPR while you (well, someone else) tries to find and reverse the cause.
TV shows do often defibrillate people who are flatlining.
So, TL;DR: yes, there is a way to get oxygen to the brain in an emergency: it’s CPR = chest compressions. And medical staff can do the chest compressions ([or have a CPR machine do them!](https://www.youtube.com/watch?v=eUwWeMbOmIY)) for an extended period of time while other staff try to fix the underlying problem.
If you saw House, then you saw the episode with Amber right? She was on bypass then.
Intra-aortic balloon pumps can help increase the amount of blood pumped by the heart in those with heart failure, separate from the full support of ECMO. The problem with heart failure is that regardless of extra assistance, a failing heart will inevitably remodel itself in an attempt to improve blood flow, to the point of diminishing returns. It becomes so large and stretchy that it can no longer contract effectively, or so thick and tough that it can no longer expand effectively. You’d be surprised the number of heart transplants that are received by these patients, you can’t undo damage to the one you’re born with.
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