Gelito Hero Pardo eBSN 3-e

Sudden cardiac death describes the unexpected natural death from a cardiac cause within a short time period, generally 1 hour from the onset of symptoms, in a person without any prior condition that would appear fatal.1 2 Such a rapid death is often attributed to a cardiac arrhythmia, but with the advent of monitoring capabilities from implantable cardioverter-defibrillators (ICDs), it is now well recognized that classifications based on clinical circumstances can be misleading and often impossible, because 40% of sudden deaths can be unwitnessed.3 Only an ECG or a ventricular electrogram recorded from an implanted device at the time of death can provide definitive information about an arrhythmia. Prodromal symptoms are often nonspecific, and even those taken to indicate ischemia (chest pain), a tachyarrhythmia (palpitations), or congestive heart failure symptoms (dyspnea) can only be considered suggestive. For these reasons, total mortality, rather than classifications of cardiac and arrhythmic mortality, should be used as primary objectives for many outcome studies.

Magnitude of the Problem

Sudden cardiac death accounts for 300 000 to 400 000 deaths annually in the United States, depending on the definition used.1 2 When restricted to death <2 hours from the onset of symptoms, 12% of all natural deaths were classified as sudden in one study, and 88% of those were due to cardiac disease.1 Sudden cardiac death is the most common and often the first manifestation of coronary heart disease and is responsible for 50% of the mortality from cardiovascular disease in the United States and other developed countries. In less-developed countries, sudden cardiac death rates parallel the rates of ischemic heart disease as a whole and therefore are lower. Several population-based studies have documented a 15% to 19% decline in the incidence of sudden cardiac deaths caused by coronary heart disease since the early 1980s. However, the increasing incidence of congestive heart failure may halt this decline in the future.

Risk Factors of Sudden Cardiac Death

Influence of Age, Race, and Sex Because up to 80% of individuals who suffer sudden cardiac death have coronary heart disease, the epidemiology of sudden cardiac death to a great extent parallels that of coronary heart disease. As such, the incidence of sudden cardiac death increases with age in both men and women, whites and nonwhites, because the prevalence of ischemic heart disease increases with age (Figure 2 ). However, among patients with coronary heart disease, the proportion of coronary deaths that are sudden decreases with age. Sudden cardiac death has a much higher incidence in men than women, reflecting sex differences in the incidence of coronary heart disease as well. Thus, 75% of sudden cardiac deaths occur in men, with an annual incidence 3 to 4 times higher than in women. The peaks in incidence of sudden cardiac death occur between birth and 6 months of age because of the sudden infant death syndrome, and then again between 45 and 75 years of age as a result of coronary artery disease. Sudden cardiac death accounts for 19% of sudden deaths in children between 1 and 13 years of age and 30% between 14 and 21 years of age. Engelstein ED, Zipes DP. Sudden cardiac death. In: Alexander RW, Schlant RC, Fuster V, eds. The Heart, Arteries and Veins. New York, NY: McGraw-Hill; 1998:10811112.

Seafood combats cardiac arrest

August 20, 1997

From Correspondent Eugenia Halsey ;WASHINGTON CNN Good news for seafood lovers theres new evidencethat seafood is good for your heart, and just a little seafood may go along way. According to a new study, people who ate just one serving offish a week dramatically reduced their chances of cardiac arrest. Astudy on the subject involving more than 800 people in the Seattle areawas published in this weeks Journal of the American MedicalAssociation.;The test subjects had an approximately 50 percent reduction in theirrisk of cardiac arrest, compared to persons who didnt eat anyseafood, said Dr. David Siscovick of the University of Washington.

Cooling is catching on for cardiac arrest patients

By Caleb Hellerman CNN Senior Medical Producer | August 5, 2009 Seated on a jetliner, Dr. Mary Gallagher and her husband, Don Dietrich, were about to take off for an anniversary vacation in Puerto Rico. But a glance at her husband of five years set off an alarm -- he was gasping for breath. Gallagher, an anesthesiologist, knew the signs: Dietrich was in cardiac arrest. Gallagher ran to tell the pilot; someone called 911 from a cell phone; another passenger started CPR. Paramedics appeared and then Gallagher made a crucial decision: Even though protocol called for Dietrich to be taken to the nearest hospital, three miles away, she insisted he go twice as far, to the University of Pennsylvania Hospital and its Center for Resuscitation Science.

New ways to survive cardiac arrest

By Dr. Sanjay Gupta CNN Chief Medical Correspondent | September 21, 2009 I am going to let you in on a secret: When a person's heart stops beating, it's not the end. Contrary to what you may think, death is not a single event. Instead, it's a process that can be interrupted. Mike Mertz knows this firsthand. On January 23, 2008, the 59-year-old Arizona man was driving home from work. The last thing he remembers is pulling into his complex's driveway. Then his heart stopped. Corey Ash, a passing UPS driver, noticed a silver Saturn wedged between a palm tree and a wall, with the engine running and a person slumped at the wheel.

Atkins diet author home after cardiac arrest

April 25, 2002 Nutrition expert and author Dr. Robert Atkins, creator of the high-protein/lowcarbohydrate "Atkins Diet," was released Wednesday from hospital care and is resting well after his heart stopped, a condition called cardiac arrest. Atkins was waiting for breakfast at a restaurant near his office last Thursday in Manhattan when he went into cardiac arrest. He was quickly revived by an associate and taken to the New York Weill Cornell Medical Center. The episode was caused by cardiomyopathy, a condition in which the heart's ability to pump blood is weakened because of enlargement, thickening or stiffening of the heart muscle.

In cardiac arrest, think 'Stayin' Alive'

By Elizabeth Cohen, CNN Senior Medical Correspondent | July 2, 2009 Debra Bader was taking a walk in the woods with her 53-year-old husband one morning when suddenly he collapsed. At first she thought the situation was hopeless. "I looked at him and said, 'He's dead,' because he wasn't moving or making any sounds at all," Bader remembers. "But I pulled the cell phone out of his pocket and called 911, and then a public service announcement I'd heard on the radio popped into my head. " The one-minute PSA from the American Heart Association instructed listeners, in the event of cardiac arrest, to perform chest compressions very hard to the beat of the 1970s Bee Gees song "Stayin' Alive.

Survival in Seattle: Cardiac-arrest deaths vary by city

By Theresa Tamkins | June 26, 2009 It always seems so straightforward on TV. You have a cardiac arrest, a handsome doctor rushes to your side, shouts "Clear!" and gives you a couple of zaps to the chest with electricity-generating paddles, and -- ta-da! -- you're back in business. Cue the tears and music. But in reality, a cardiac arrest is a much more complicated business, and one with considerably more peril than you might realize. One study shows that the chances of surviving a cardiac arrest outside a hospital are slim indeed -- around 1 in 22 (about 1 in 12 if someone tries re