Just Dropping Dead

People sometimes say, “He dropped dead, just like that!” And it seems worse when it’s a relatively young person, when a serious heart event is so unexpected. But it seems that so-called sudden cardiac death may not be quite so sudden.

A report in the medical journal Circulation describes information collected on 400 patients in Berlin with presumed cardiac arrest - they all occurred out of hospital. Over 70% of them occurred at home – out of reach of public defibrillator. Bystanders attempted resuscitation in a small number (14%), and about a quarter of these cases survived.

The majority of patients had a history of heart disease or typical symptoms of coronary heart disease, or at least risk factors for same. Information was available on preceding symptoms for three out of four sudden cardiac deaths. Angina was present for an average of 2 hours in 22%, shortness of breath for 30 minutes in 15%, nausea or vomiting in 7%, and dizziness or faintness in 6%. Only 25% of patients had no complaints before “dropping dead”.

This interesting study makes several points:

1. Public defibrillators may not be much help – most people had their attacks at home.

2. There was a poor success rate for CPR – in Berlin , anyway. More general training is needed.

3. The majority of the patients were “at risk”, and ¾ of them had warning symptoms, often for an hour or more. Such patients should be instructed to get to the Emergency Room if they experience warning symptoms – angina, shortness of breath, nausea, dizziness, or faintness – without another good reason.

We ought to be able to reduce the number of people who appear to just drop dead.