Sudden cardiac arrest. Does it strike the victim without warning?

Sudden cardiac death (SCD) is the most frequent cause of out-of-hospital death in industrialized societies. In about 80 % of the victims SCD results from complications of underlying coronary heart disease, the remainder being due to a wide variety of inborn or acquired heart diseases. Analysis of clinical trials. If circumstances of SCD are analyzed in depth, an astonishing number of commonalities can be stated: about two thirds of cases occur at the home of the patient, two thirds in the presence of eye witnesses (most of them relatives), and the majority of victims has typical prodromal symptoms similar to those known from coronary heart disease. Moreover the characteristic warning symptoms are tolerated over a surprisingly long time. Patients and relatives, however, often do not understand the significance of these warning signs. In addition, bystander resuscitation rates in private surroundings are much lower compared to public places, resulting in worse survival rates. These findings point out a major potential to fight SCD by information and education of patients and relatives on the impact of prodromal symptoms preceding SCD, the necessity of rapid reaction and to train basic life support.