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Sudden cardiac death: who is at risk? How can you protect yourself?
Around 65,000 people die of sudden cardiac death in Germany every year. As part of a nationwide information campaign, experts explain which groups of people are particularly at risk and which measures can be used to protect themselves.
Sudden cardiac death (also cardiac death or second death) occurs - as the name suggests - quickly and mostly completely unexpectedly. Around 65,000 people die of it every year in Germany. According to the German Center for Cardiovascular Research e. V. (DZHK) corresponds to 20 percent of all deaths caused by cardiovascular diseases. “There is only a chance of survival if countermeasures are started immediately. Because with every minute that the heart stops, the person's chance of survival drops by ten percent, ”writes the DZHK. As part of a nationwide information campaign, the German Heart Foundation explains what needs to be done in an emergency, who is particularly at risk and how you can protect yourself.
Protect yourself from coronary artery disease
"People with a coronary artery disease that did not need to be known are particularly at risk," warns emergency physician and cardiac specialist Prof. Dr. med. Dietrich Andresen, CEO of the German Heart Foundation, in a message. "Sudden cardiac death is usually not a fateful event from which there is no escape, but rather a complication of long-term coronary artery disease, also called coronary artery disease," said the cardiologist. "The best protection against sudden cardiac death is therefore protection against coronary artery disease."
Sudden cardiac death is mainly caused by ventricular fibrillation
Sudden cardiac death is primarily initiated by the most malignant arrhythmia, ventricular fibrillation. This leads to circulatory collapse within a few seconds: the heart stops beating, the blood pressure drops to "zero", explains the heart foundation. After four seconds, the patient feels an "emptiness" in the head. And after eight seconds he collapses unconscious. After about two to three minutes, he stops breathing. Death occurs after about ten minutes.
But what can we do? "Every effort must be made to protect patients from such a fate," says Andresen. For this reason, the Heart Foundation has organized the nationwide Heart Week from November 1 to 30, 2019 under the motto "Threatening arrhythmias: How can I protect myself from sudden cardiac death?". The educational campaign is designed to inform people about how the threatening heart diseases that cause cardiac death occur. What are the symptoms and how can you most effectively protect yourself from sudden cardiac death?
Which people are particularly at risk
The Heart Foundation offers an online risk test. Coronary artery disease (CHD) is the most common cause of second death. For patients over the age of 40, this plays the greatest role. According to the information, autopsies of suddenly deceased have shown a frequency of CHD of up to 75 percent. Experts estimate that around six million people in Germany have CAD, which in turn is caused by high-risk diseases such as high blood pressure, diabetes or fat metabolism disorders (high cholesterol). Other rarer causes of sudden cardiac death are heart valve disease, congenital heart defects and high blood pressure.
Younger people are also affected
Although the CHD is the most important cause of sudden cardiac death, rarer illnesses should not be overlooked. This can lead to sudden cardiac death, even less often, even in younger patients before the age of 40. The causes are myocardial inflammation, congenital heart defects and genetic electrical heart diseases (ion channel diseases). Drug use (e.g. cocaine, amphetamines) is also one of the causes of sudden cardiac death in this phase of life. The tricky thing about the heart diseases mentioned is that they can often go on for a long time without complaints.
Identify and treat heart diseases and risk factors early
The best strategy against sudden cardiac death is to identify and treat heart diseases - especially the CHD and its risk factors - at an early stage. "We advise men and women from 40 years of age - if they have a family history earlier - for early diagnosis through regular check-ups at the family doctor," explains the Heart Foundation Chairman. If the heart is diagnosed, the heart foundation advises regular checks at the cardiologist or internist. Adults with congenital heart disease (EMAH) should have their heart checked regularly by an EMAH specialist.
"We have to manage to suppress the CHD through consistent education and sustainable preventive measures and to identify patients with undetected heart diseases," said Andresen. "If one day we were able to defeat coronary artery disease, sudden cardiac death would also have lost its horror," says the Berlin heart specialist. But: "Until then, it is still a long and rocky road."
Pay attention to certain warning signs
With the following warning signs, those affected should generally see a cardiologist. The doctor can examine whether there is an irregular heartbeat as a result of a CAD or other heart disease that requires treatment:
- Chest pain (angina pectoris) and / or shortness of breath
- Rapid heartbeat with limited resilience
- Stubborn heart stumbling
- Brief loss of consciousness
- Dizziness, impending loss of consciousness
In the event of typical heart attack symptoms, those affected should immediately alert the emergency doctor (112). These are, in particular, sudden onset of severe pain that lasts longer than five minutes and does not improve at rest (often: cold sweat, paleness, nausea, shortness of breath, restlessness and fear). The pain is predominantly in the chest, often behind the sternum, but sometimes only in the back between the shoulder blades or in the upper abdomen. The pain can radiate into the arm, neck or jaw.
What to do in case of cardiac arrest
Patients with a cardiovascular arrest only have one chance to survive: if there are witnesses on site who observe what is going on, assess it correctly and start resuscitation measures immediately after alerting the emergency number (112). The good news: According to a study by Prof. Dietrich Andresen and colleagues, 60 to 70 percent of cardiac arrests are observed, the witnesses correctly identify them as an emergency, and the emergency number 112 is also alerted. The bad news: Not even half of the witnesses start resuscitation after making the emergency call. The majority remain inactive, mostly because they are afraid of doing something wrong. The following applies:
Without primary care from an observer present, a patient with cardiovascular arrest has little chance of being successfully resuscitated.
A resuscitation by first responders (medical laypersons) to bridge the time until the rescue team arrives (only after eight to nine minutes) is essential.
Every adult must be able to recognize cardiovascular arrest and take the necessary steps to rescue the person. One-off instruction, for example as part of a driver's license test, is not sufficient.
The German Heart Foundation provides easy-to-understand information on the individual steps of a lay animation. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Deutsche Herzstiftung: Sudden and unexpected: Cardiac death in seconds - who is at risk, how do you protect yourself ?, (accessed: October 29, 2019), Deutsche Herzstiftung
- German Center for Cardiovascular Research e. (DZHK): Sudden cardiac death, (accessed: October 29, 2019), German Center for Cardiovascular Research e. (DZHK)
- German Heart Foundation: Heart Attack Risk Test, (accessed: October 29, 2019), German Heart Foundation
- Resuscitation: Public access resuscitation program including defibrillator training for laypersons: a randomized trial to evaluate the impact of training course duration, (accessed: October 29, 2019), Resuscitation
- Deutsche Herzstiftung: Correct behavior in the event of a heart attack and cardiac arrest, (accessed: October 29, 2019), Deutsche Herzstiftung