Courtesy Sudden Cardiac Arrest Foundation
Sudden Cardiac Arrest: A Health Care Crisis
Sudden cardiac arrest (SCA) is a leading cause of death among adults over the age of 40 in the United States and other countries. In the United States alone, approximately 250,000 people die every year from SCA, according to the Centers for Disease Control and Prevention. In fact, more people die each year from SCA than the number who die from colorectal cancer, breast cancer, prostate cancer, auto accidents, AIDS, firearms, and house fires combined.
SCA also affects many young people. Approximately 10 percent of SCA events occur among people less than 40 years of age.
SCA is a life threatening condition that can be treated successfully through early intervention with cardiopulmonary resuscitation (CPR), defibrillation, advanced cardiac life support and hypothermia.
What is SCA?
Sudden cardiac arrest, or SCA, is the sudden unexpected loss of heart function, breathing and consciousness. SCA usually results from an abnormal heart rhythm, often as a result of underlying heart conditions. Unfortunately, many people do not realize they have underlying heart conditions– until SCA occurs. In fact, about two-thirds of unexpected cardiac deaths occur without prior indication of heart disease.
SCA is not the same as a heart attack, which occurs when blood vessels in the heart get clogged, preventing blood flow to sections of heart muscle. A heart attack, however, can lead to SCA by triggering an abnormal heart rhythm. SCA may be compared to an electrical problem in the heart, in contrast to a heart attack, which is more of a plumbing problem.
One of the common types of potentially fatal abnormal heart rhythms is ventricular fibrillation, or VF. To view a clip of VF click on the video below.
Without immediate treatment, SCA is fatal. Effective treatment generally involves cardiopulmonary resuscitation (CPR), use of a defibrillator to shock the heart back to a normal rhythm, and advanced life support including drug therapy and, increasingly, therapeutic hypothermia. The quicker treatment is delivered and circulation is restored, the greater the chances for survival.
Signs and Symptoms
Typically, SCA occurs without warning. Signs of SCA include:
- Sudden collapse
- Loss of consciousness
- Cessation of normal breathing
- Loss of pulse and blood pressure.
Symptoms of a heart attack, in contrast, include:
- Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest, lasting more than a few minutes
- Pain spreading to the shoulders, neck, or arms
- Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath
- Atypical chest pain, stomach, or abdominal pain
- Nausea or dizziness
- Shortness of breath and difficulty breathing
- Unexplained anxiety, weakness, or fatigue
- Palpitations, cold sweat, or paleness.
Facts and Figures about SCA
- The precise incidence of SCA is unknown because available epidemiological databases do not record deaths due to sudden cardiac arrests. Therefore estimates are based on surrogate data. Efforts are underway to establish a better way to capture accurate data.
- Each year in the U.S., 400,000 to 460,000 people die of unexpected sudden cardiac death in an emergency department or before reaching a hospital. (Circulation 2001;104:2158-63)
- The age-adjusted sudden cardiac death rate is higher among men than women. (MMWR Feb 15, 2002 51(06):123-6).
- Blacks have the highest age-adjusted rate of sudden cardiac death, followed by whites. (MMWR Feb 15, 2002 51(06):123-6).
- States with a high proportion of sudden cardiac deaths, in descending order, include: Wisconsin, Idaho, Utah, Colorado, Oregon, Connecticut, Rhode Island, South Dakota, Montana and Vermont. Hawaii has the lowest age-adjusted sudden cardiac death rate; Mississippi has the highest. (MMWR Feb 15, 2002 51(06):123-6).
- About two-thirds of unexpected cardiac deaths occur without prior indication of heart disease. (J Am Coll Cardiol 2004;44:1268-3008-13)
- About 60 percent of unexpected cardiac deaths are treated by emergency medical services (EMS). (JAMA 2002;288:3008-13)
- EMS treats about 100,000 to 250,000 cardiac arrests in the U.S. annually. (JAMA 2002;288:3008-13; Ann Emerg Med 1999;34:517-25)
- Of the cardiac arrests treated by EMS, 20 to 38 percent are found in ventricular fibrillation (VF) or ventricular tachycardia (VT) (21,000 to 91,000 cases), rhythms that can be treated with defibrillators. (Ann Emerg Med 1999;34:517-25)
- The incidence of VF is decreasing over time. (Ann Emerg Med 1999;34:517-25, Resuscitation 2004:63(1):17-24; Resuscitation 2005;67(1):51-4)
- Fifty-seven percent of adults in the U.S. say they have undergone training in cardiopulmonary resuscitation (CPR), most often due to work or school requirements. Most say they would be willing to use CPR to help a stranger. Most say they would be willing to use an automated external defibrillator (AED). Eleven percent say they have used CPR in an actual emergency. (Resuscitation 2000)
- The incidence of lay responder defibrillation was 2.05 percent in 2002. (American Heart Association)
- The incidence of SCA in children is unknown. Estimates vary widely. Research among high school athletes suggests the incidence ranges from 0.28 to 1.0 death per 100,000 high school athletes nationwide (J Am Coll Cardiol 1998:32:1881-4).
- The average survival SCA survival rate is 6-7%. (Prehosp Emerg Care 1997; 1(1):45-57.)