A new study has examined the most common warning signs associated with a deadly out-of-hospital sudden cardiac arrest and found that symptoms differ significantly between the sexes. The researchers hope their study will improve survival rates and educate people about when to call emergency services.
Only 10% of people survive an out-of-hospital sudden cardiac arrest, the unexpected loss of heart function, breathing and consciousness. To improve the prediction – and therefore prevention – of sudden cardiac arrest, a new study by researchers at Cedars-Sinai Medical Center has examined the warning signs that appear up to 24 hours before the event.
“Harnessing warning symptoms to perform effective triage for those who need to make a 911 call could lead to early intervention and prevention of imminent death,” said Sumeet Chugh, the study’s corresponding author. “Our findings could lead to a new paradigm for prevention of sudden cardiac death.”
The researchers obtained data from two established community-based studies, the Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO) study in Ventura County, California, and the Sudden Unexpected Death Study (SUDS), based in Portland, Oregon.
Participants were aged between 18 and 85, and their sudden cardiac arrest had to have been witnessed by a bystander or an emergency medical services (EMS) responder. The researchers evaluated the prevalence of symptoms prior to sudden cardiac arrest and compared the findings to a control group attended by EMS that did not have sudden cardiac arrest but who had symptoms that could’ve been mistaken for sudden cardiac arrest.
The data showed that, in the hours before sudden cardiac arrest, 50% of people who had a witnessed sudden cardiac arrest displayed at least one telltale symptom. Patients were more likely to experience dyspnea or shortness of breath (41%), chest pain (33%), sweating (12%), and seizure-like activity (11%) compared to the control group. Interestingly, symptoms differed between men and women. Among men, chest pain, dyspnea, and sweating were significantly associated with sudden cardiac arrest, whereas among women, only dyspnea was significantly associated with the condition.
“This is the first community-based study to evaluate the association of warning symptoms – or sets of symptoms – with imminent sudden cardiac arrest using a comparison group with EMS-documented symptoms recorded as part of routine emergency care,” said Eduardo Marbán, executive director of the Smidt Heart Institute at Cedars-Sinai but who was not involved in the study.
The researchers say their study paves the way for further studies that combine all symptoms with other features to enhance the prediction of sudden cardiac arrest.
“Next, we will supplement these key sex-specific warning symptoms with additional features – such as clinical profiles and biometric measures – for improved prediction of sudden cardiac arrest,” Chugh said.
The study was published in the journal The Lancet Digital Health.
Source: Cedars-Sinai Medical Center
