Each day in the United States, more than 930 lives are lost to sudden cardiac death (SCD). Every 90 seconds, this insidious killer claims another victim. Sudden cardiac death is the leading cause of natural deaths in the United States, taking more than 335,000 lives each year, more than are lost to lung cancer, breast cancer and AIDS combined. Yet, because there are few warning signs or symptoms to identify people at risk, and since SCD is by definition fatal, there are few survivors to spread the word about this devastating killer. Until SCD hits close to home, most people usually are unaware of its prevalence and the danger that it poses, even to young, seemingly healthy people. It often strikes adults in their mid-30s to mid-40s, though it can strike teenagers as well as senior citizens.
Sudden cardiac death, also called sudden cardiac arrest (SCA), is a term used to describe a situation in which the heart stops working, abruptly and without warning, so no blood can be pumped to the rest of the body. It is responsible for more than half of all heart disease deaths in this country. And, while overall death rates for heart disease are decreasing, those from sudden cardiac death continue to increase. Sudden cardiac death is not a heart attack, which occurs when a blockage in a blood vessel interrupts the flow of oxygen-rich blood to the heart, causing heart muscle to die.
Sudden cardiac death occurs when the heart's electrical system malfunctions. The most common cause of SCD is a heart rhythm disorder, or arrhythmia, called ventricular fibrillation (VF) (a quivering of the heart's lower chambers) or ventricular tachycardia (extremely rapid but ineffective beating of the heart's lower chambers).
This irregular heart rhythm causes the heart suddenly to stop pumping blood to the rest of the body. If blood does not flow to the brain, it becomes starved of oxygen, and the person loses consciousness in a matter of seconds.
Death can occur within ten minutes unless CPR is administered and an emergency shock is delivered to the heart with a defibrillator to restore its normal rhythm. Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and defibrillation. A victim's chances of survival are reduced by seven to ten percent with every minute of delay until defibrillation. The VF sudden cardiac arrest survival rate is only two to five per cent if defibrillation is provided more than twelve minutes after collapse. It is estimated that about 95% of sudden cardiac arrest victims die before reaching the hospital.
SCD often occurs in active, seemingly fit and healthy people with no known heart disease or other health problems. But in reality sudden cardiac death is not an arbitrary incident.
Most victims have heart disease or other health problems, although they may not know it and may have had no symptoms until their heart suddenly stops pumping blood to the rest of their body. There can be numerous contributors to sudden cardiac arrest, but some of the more prevalent ones are:
There are many tests your doctor may perform to evaluate your risk for SCD. Among these are:
What are the treatments for survivors?
If an episode of sudden cardiac arrest was due to ventricular tachycardia or ventricular fibrillation, survivors are at risk for another arrest, especially if they have underlying heart disease. Survivors of sudden cardiac arrest must have all causes corrected to prevent future episodes.
Depending on the underlying cause of sudden cardiac arrest, possible tests and treatments include:
Living a heart-healthy life can help reduce the chances of dying from sudden cardiac arrest or other heart conditions. This includes eating a healthy diet, exercising regularly, maintaining a reasonable weight and avoiding smoking. It also is important to monitor and treat diseases and conditions that can contribute to heart problems, including high blood pressure, high cholesterol and diabetes. For some people, preventing sudden cardiac death means controlling the abnormal heart rhythms that may trigger ventricular fibrillation.
Treatment can include medication, an implantable cardioverter defibrillator or other medical interventions. Consult with your doctor to determine the treatment plan that is best for you.
Generally, athletes are in peak physical form. Yet, even well conditioned athletes may be at risk for SCD. The earliest documented case of sudden cardiac death occurred in 490 B.C., when Pheidippides, a Greek soldier and conditioned runner, ran from Marathon to Athens to announce the military victory over Persia, only to deliver his message then collapse and die. More recently, SCD has claimed the lives of some high-profile athletes. In 1993, professional basketball player Reggie Lewis collapsed and died during an off-season practice. He was only 27. Olympic gold-medal ice skater Sergei Grinkov died from SCD at the age of 28. Steve Gootter, a fit and healthy, accomplished amateur athlete, was stricken by sudden cardiac death at the age of 42, with no previous warning signs of any health problem.
Sudden cardiac death in professional athletes is still relatively rare. Yet, health experts worry that "weekend warriors" may unknowingly be at risk. Researchers estimate that sudden cardiac death strikes one out of every 15,000 to 18,000 joggers or vigorous exercisers age 35 and older. Most of these people are unaware that they are at risk for the condition. Doctors urge health screenings for all marathon runners and those who regularly participate in vigorous exercise. Younger runners may have congenital heart problems that put them at risk for sudden cardiac death. Runners over 35 may have early signs of coronary artery disease. Often, they are unaware of their risk because they have no symptoms. Before launching any exercise or training program, always consult your doctor and get an evaluation of your risk for SCD and other heart disease.
Learn how sudden cardiac death is different from a heart attack - WebMD
Learn about steps you can take to prevent a heart attack at National Heart, Lung and Blood Institute
Learn continuous chest compression CPR from UofA Sarver Heart Center
Read about Continuous Chest Compression CPR from Emergency Medical Services
See a schedule of training for Continuous Chest Compression CPR at UofA Sarver Heart Center
Study proves effectiveness of use of AEDs in public settings - Sarver Heart Center
"We cannot begin to express our thanks to you and your Foundation for making it possible for San Miguel High School to be equipped with, trained on, our very own automated external defibrillator. It is a gift we hope to never have to use, but find comfort in knowing that we have this life saving machine at arms length. Your support of San Miguel High School is very much appreciated and we are humbled that you have made this available to us."
Leslie Shultz-Crist, President and Br. Nick Gonzales, FSC, Principal – San Miguel High School
"Our heartfelt thanks to you and your associates for the gift of the automated external defibrillator (AED) to St. Frances Cabrini. We have our share of older people among the 2,000 members of our parish. But I know the AED is meant for people of all ages. It is with a sense of gratitude and satisfaction as we determine placement and proceed with training. In the name of our whole community, I express deepest gratitude for this outstanding gift."
Msgr. Robert D. Fuller - St. Frances Cabrini Parish
"The purpose of this letter is to extend to you our deep appreciation for your donation of an AED device to Sunrise Drive Elementary School. We are very grateful not only for your generosity, but for increasing the likelihood of saving someones life who needs immediate assistance while on our campus."
Julie A. Sherrill, Ph.D., Principal – Sunrise Drive Elementary School
"Having the ability to possibly save the lives of our theater patrons who are at risk for sudden cardiac death is of crucial benefit and we are very happy to help further the mission of the Steven M. Gootter Foundation. Thank you for your generous support to our organization and for your commitment to the community."
Clyde W. Kunz, CFRE, Chief Development Officer - Arizona Theater Company
"It is so wonderful to have the AED on property. I now have peace of mind that I have the right equipment on hand in the Nurses office with the number of students and staff in our school. I appreciate everything the Gootter Foundation has done to facilitate getting us our AED."
Margaret Eller, RN (School Nurse) - Sunnyside Unified School District
"The AED donated by the Gootter Foundation is the first line of defense with with any cardiac problem. Specifically, the first AED was a stepping stone. Receiving it at my High School made others aware and we were able to apply to the school for funding to get another one. Additionally, the two other High Schools in the district were able to get approval for AED. The Gootter Foundation opened the door, increased awareness and made the community receptive and supportive of our need to be prepared."
Juan F. Prieto, Head Athletic Trainer - Amphitheater Public Schools