Early Symptoms May Foretell "Sudden Cardiac Death"
"Sudden cardiac death" often is not all that sudden, and lives can be saved by training people about the symptoms of impending cardiac arrest and what action to take, according to a report in the journal Circulation.
According to the American Heart Association (AHA), cardiac arrest is the sudden loss of heart function. The victim may or may not have diagnosed heart disease; the most common cause of death is coronary heart disease.
The AHA estimates that 330,000 Americans die each year from heart disease before reaching a hospital and urges cardiopulmonary resuscitation (CPR) training on a large scale.
Study lead author Dr. Dirk Muller says, "A study of 406 sudden cardiac death patients indicates that they often have symptoms, especially the typical symptom angina pectoris [chest pain] for as long as 120 minutes before an arrest."
Dr. Muller is a cardiologist and emergency physician at the Medical Clinic II, Cardiology and Pulmonology, in Berlin, Germany.
"Two-thirds of cardiac arrest patients have a history that predisposes them to sudden cardiac death," says Dr. Muller, so efforts to reduce the toll should focus on teaching their family members to recognize the symptoms and how to perform CPR.
In the study, 72 percent of cardiac-arrest cases occurred at home, and two-thirds were witnessed by others. The researchers collected information about symptoms preceding cardiac arrest for 323 patients.
The most common warning sign was chest pain, which occurred for at least 20 minutes, and, in some cases, for hours, before cardiac arrest.
Chest pain occurred in 25 percent of the patients whose cardiac arrest was witnessed by other persons and in one-third of other cases.
Breathlessness was the next most common symptom, seen in 17 percent of witnessed arrests and 30 percent of other cases. Other common symptoms were nausea, vomiting, dizziness, or fainting.
CPR was performed on 57 patients, and 13 of them survived to be discharged from the hospital. The survival rate for those who did not get CPR was 4 percent - 13 of 349 patients.
One notable fact was that CPR was more likely to be performed when cardiac arrest occurred in public cases - 26 percent of the time, compared to 11 percent of the time when the attack occurred at home.
There are two significant messages from the study, explains Dr. Ann Bolger, a professor of clinical medicine at the University of California, San Francisco, and a spokeswoman for the AHA.
"The first is that people need to be educated about how cardiac symptoms can present," says Dr. Bolger. "We always try to encourage people not to discount such things as shortness of breath, things that really should demand a response, because they could be a harbinger of early death.
"The second thing is that the family is important," she adds. "Many of these patients have a known history of heart problems. They are not taking us by surprise. We know that one of these things can happen to them, so, it is important to get education that if there is chest pain that does not respond to nitroglycerine, they should call 911.”
Dr. Bolger continues, “When a patient has active heart disease, I try to make sure that they and their family get basic training about calling 911 and get the emergency medical service on the scene. People who don't get CPR before they get to the hospital have much worse outcomes."
Always consult your physician for more information.
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Each year, heart disease is at the top of the list of the country's most serious health problems. In fact, statistics show that cardiovascular disease is America's leading health problem, and the leading cause of death.
Consider the most recent statistics released by the American Heart Association (AHA):
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At least 70 million people in this country suffer from some form of heart disease.
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One person in four suffers from some form of cardiovascular disease. This includes high blood pressure - 65 million; coronary heart disease - 13 million; stroke - 5.4 million; congenital cardiovascular defects - 1 million; and congestive heart failure - 4.9 million.
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Rheumatic heart disease/rheumatic fever kills almost 3,579 Americans each year.
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Almost one out of every 2.6 deaths result from cardiovascular disease.
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More than 2,600 Americans die of cardiovascular disease each day, an average of one death every 34 seconds.
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Cardiovascular disease is the cause of more deaths than the next five causes of death combined, which are cancer, chronic lower respiratory diseases, accidents, diabetes mellitus, and flu/pneumonia.
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It is a myth that heart disease is a man's disease. In fact, cardiovascular diseases are the number one killer of women (and men). These diseases currently claim the lives of more than a half a million females every year.
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About one-third of cardiovascular disease deaths occurred prematurely (before age 75, the approximate average life expectancy in that year).
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On average, someone in the US suffers a stroke every 45 seconds; someone dies every three minutes from stroke.
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Stroke is a leading cause of serious, long-term disability that accounts for more than half of all patients hospitalized for a neurological disease. Stroke deaths have been increasing in recent years.
Always consult your physician for more information.
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