Early identification of individuals at risk of out-of-hospital cardiac arrest remains challenging because little is known about the symptoms presented when contacting an emergency unit prior to an event. The study presented by Mr Filip Gnesin (Nordsjaellands Hospital, Denmark) intended to take a closer look at this important issue.
Mr Gnesin and his team identified patients from the Danish Cardiac Arrest Registry who experienced an out-of-hospital cardiac arrest from 2016 through 2018 and had phoned the Copenhagen Emergency Medical Services up to 24 hours before their arrest. The researchers systematically evaluated these pre-arrest calls and noted symptoms reported by the caller, who could be the patient or a bystander. Finally, these patients were linked to nationwide databases to collect other data such as survival.
Of 4,071 patients with an out-of-hospital cardiac arrest, 481 (11.8%) made a pre-arrest call. The median age of patients with pre-arrest calls was 74 years and 40.1% were women. The most reported symptoms were breathing problems (59.4%), confusion (23.0%), unconsciousness (20.2%), chest pain (19.5%), and paleness (19.1%).
The most commonly occurring symptom pairs were breathing problems in combination with paleness (14.5%), confusion (14.1%), unconsciousness (13.5%), sweating (13.0%), and chest pain (11.9%), respectively. An urgent medical response was dispatched in 68.7% of calls reporting breathing problems compared with 83.0% reporting chest pain.
Mr Gnesin said: âMore than 10% of patients experiencing an out-of-hospital cardiac arrest had a phone call to the emergency medical services up to 24 hours before their arrest either made by themselves or a bystander. Breathing difficulty was the most common complaint and much more common than chest pain. Despite this, compared to chest pain, patients with breathing issues were less likely to receive emergency medical help and more likely to die within 30 days after the arrest. These findings indicate that breathing problems are an underrated warning sign of cardiac arrestâ [2].
Mr Gnesin concluded that creating awareness of breathing problems as a common early symptom of cardiac arrest may contribute, together with more research, to identifying more characteristics specific to cardiac arrest so that early intervention might be possible.
- Gnesin F. Symptoms reported in calls to emergency medical services 24 hours prior to out-of-hospital cardiac arrest. Session: Coronary Artery Disease (Chronic)/Chronic Coronary Syndromes ePosters. ESC Congress 2021, 27â30 August.
- Gnesin F. Press conference âPreventing sudden cardiac death.â ESC Congress 2021, 27â30 August.
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Table of Contents: ESC 2021
Featured articles
2021 ESC Clinical Practice Guidelines
2021 ESC Guidelines on Heart Failure
2021 ESC/EACTS Guidelines on Valvular Heart Disease
2021 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronisation Therapy
2021 ESC Guidelines on Cardiovascular Disease Prevention
Best of the Hotline Sessions
Empagliflozin: First drug with clear benefit in HFpEF patients
CardioMEMS: neutral outcome but possible benefit prior to COVID-19
Cardiac arrest without ST-elevation: instant angiogram does not improve mortality
Older hypertensive patients benefit from intensive blood pressure control
Antagonising the mineralocorticoid receptor beneficial for patients with diabetes and CKD
Late-Breaking Science in Heart Failure
Valsartan seems to attenuate hypertrophic cardiomyopathy progression
Dapagliflozin reduces incidence of sudden death in HFrEF patients
Late-Breaking Science in Hypertension
Smartphone app improves BP control independent of age, sex, and BMI
QUARTET demonstrates that simplicity is key in BP control
Salt substitutes: a successful strategy to improve blood pressure
Late-Breaking Science in Prevention
NATURE-PCSK9: Vaccine-like strategy successful in lowering CV events
Polypill: A successful tool in primary prevention
Important Results in Special Populations
VOYAGER PAD: Fragile or diabetic patients also benefit from rivaroxaban
COVID-19 and the Heart
Rivaroxaban improves clinical outcomes in discharged COVID-19 patients
COVID-19: Thromboembolic risk reduction with therapeutic heparin dosing
Long COVID symptoms â Is ongoing cardiac damage the culprit?
ESC Spotlight of the Year 2021: Sudden Cardiac Death
Breathing problems: the most frequently reported symptom before cardiac arrest
Lay responders can improve survival in out-of-hospital cardiac arrest
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