Cardiac arrest (ICD-10-GM I46.-: Cardiac arrest) describes the sudden cessation of the heart‘s pumping function. Thus, organs are no longer supplied with oxygenated blood, which becomes particularly problematic for the brain. After only a few minutes of oxygen deprivation, brain cells already die. Within 20-30 seconds, the affected person becomes unconscious and no pulse is palpable.
There can be many different causes. Approximately 90% of cardiovascular arrest cases are caused by heart disease. Approximately 80% of cases are due to ischemic heart disease such as myocardial infarction (heart attack). In 10% of cases, cardiomyopathy (heart muscle disease) is present.
Cardiac arrest is about twice as common in the first three hours after waking as at other times of the day.
Sudden cardiac death (PHT; Sudden cardiac arrest, SCA; sudden unexpected cardiac death, SUCD); ICD-10-GM I46.1: Sudden cardiac death, so described) or also called “secondary death” (Sudden cardiac death, SCD) describes the death of the organism due to irreversible heart failure, which occurs suddenly and unexpectedly.
Sudden cardiac death is the most common fatal manifestation of heart disease.
Sex ratio: men are twice (to four times) as likely to die sudden cardiac death as women.
Frequency peak: risk of cardiac arrest increases by a factor of five at age > 60 years; one-third of patients are younger than 65 years. Men die most from sudden cardiac death after age 45 and before age 70.
The incidence (frequency of new cases) of sudden cardiac death is 1 per 1,000 per year (developed countries).
One in nine men die from sudden cardiac death. For women, the ratio is only one in 30.
In Germany, sudden cardiac death kills an estimated 100,000 to 200,000 people per year. For example, the presence of coronary heart disease (CHD; coronary artery disease) increases the risk of sudden cardiac death by a factor of 2 to 4.
Blood pressure is considered the best parameter for risk prediction of sudden cardiac death: Highest lifetime risk of sudden cardiac death was in men from the 45-year-old group with 16.3% who had blood pressure values above 160/100 mmHg, and smokers.
Course and prognosis: Without adequate therapy (resuscitation), cardiac arrest is fatal. Approximately 95% of those affected die before reaching the hospital. In patients with ventricular fibrillation and resulting cardiac arrest, the chances of survival are about 90% if defibrillation is started within the first minute after cardiac arrest. After this time, the chances of survival without resuscitation decrease by 7-10% for each minute that passes. In addition, the risk of irreversible brain damage increases for every minute without resuscitation. In most countries, it takes an average of between 8 and 13 minutes from receipt of the emergency call to the arrival of the emergency team.
Note: Autopsy-confirmed sudden cardiac deaths (SCDs; sudden unexpected cardiac death) were present in only 59% of cases in one study: of 525 WHO-defined SCDs, 301 (57%) had no history of cardiac disease. The most common causes of death were coronary artery disease (CAD; 32%), substance abuse (13.5%), cardiomyopathy (myocardial disease; 10%), cardiac hypertrophy (cardiac enlargement; 8%), and neurologic causes (5.5%).
