Newly discovered warning symptoms of sudden cardiac arrest can save lives

Only about 1 in 14 people survive a sudden cardiac arrest (SCA), yet at least half experience warning symptoms in the weeks before that would greatly improve their chance of survival—if only they were to heed the warning, according to a study published online December 22, 2015 in Annals of Internal Medicine.

The study showed that the most common warning symptoms of SCA were chest pain and dyspnea, which occurred within 4 weeks before SCA—and most often recurred within 24 hours before SCA. Those who experienced symptoms and called 911 greatly improved their chance of survival.

“Fewer than 7% survive a sudden cardiac arrest, which has historically made it difficult to pinpoint symptoms. These research findings suggest that we could use an entirely novel approach to predict and prevent this devastating condition,” said the study’s lead author Sumeet S. Chugh, MD, Medical Director of the Heart Rhythm Center at Cedars-Sinai Heart Institute, in Los Angeles, CA.

For this study, Dr. Chugh and colleagues analyzed data on 839 patients from the ongoing Oregon Sudden Unexpected Death Study (Oregon-SUDS). The researchers also interviewed first responders and patients’ family members. Results showed:

• 51% of patients experienced at least one warning symptom prior to SCA. This occurred equally in men and women.
• 46% of patients had chest pain—the most common symptom that occurred.
• 20% had symptoms related to abdominal or other complaints; 18% of patients had dyspnea; 10% had ongoing influenza-like symptoms; 5% experienced syncope or palpitations.
• 33% of patients with chest pain also developed concomitant acute dyspnea prior to SCA.
• Men experienced more chest pain than women, and women experienced more dyspnea.
• Only 12% of patients with symptoms had consulted a physician, and were investigated with a systematic work-up, within the 30 days prior to SCA.
• 93% of patients who had symptoms experienced them again in the 24 hours preceding SCA.

Of note, only 19% of those who experienced symptoms called emergency medical services—and these patients had a survival rate of 32%. Those who didn’t call EMS had a survival rate of 6%.

“These new findings give good reason not to ignore unusual sensations, as vague as they may be. Better to seek medical attention early than to risk dying suddenly,” said Eduardo Marbán, MD, PhD, Director of the Cedars-Sinai Heart Institute.

Dr. Chugh advised, “For patients who are known to have heart disease—especially in the holiday season and the new year coming up, when we identify a peak in sudden cardiac arrest—if they have unusual symptoms of chest pain or palpitations or passing out, then they need to contact their health care provider. If it looks like the symptoms are dire, then the sooner you call 911, the better it will be.”