Researchers at the US-based Smidt Heart Institute are one step closer to helping people stop a cardiac arrest before it happens.
Tragic rise in sudden cardiac arrest cases among young individuals calls for urgent awareness and preventive measures. (Creative Common)
Cardiac arrest has become a burning topic of discussion in our day-to-day life, as we witness even the younger population being affected by it.
What if you have an idea that you are going to have a cardiac arrest, and the symptoms are identified according to your gender?
Investigators from the US-based Smidt Heart Institute at Cedars-Sinai are one step closer to helping individuals catch a sudden cardiac arrest before it happens, according to a study published in the journal The Lancet Digital Health.
The study found that 50 percent of individuals who experienced a sudden cardiac arrest also experienced a telling symptom 24 hours before their loss of heart function.
The investigators also learned that this warning symptom was different for women than it was for men.
For women, the most prominent symptom of an impending sudden cardiac arrest was shortness of breath, whereas men experienced chest pain. Smaller subgroups of both genders experienced abnormal sweating and seizure-like activity.
“In sex-specific models, chest pain, dyspnoea (shortness of breath), and diaphoresis (sweating) were associated with sudden cardiac arrest in men, but only dyspnoea was associated with sudden cardiac arrest among women. Most symptoms occurred alone rather than in sets of symptoms,” said the study.
It also said that “out-of-hospital sudden cardiac arrest claims the lives of 90 percent of people who experience it”, hence an urgent need to better predict — and prevent — the condition.
“Harnessing warning symptoms to perform effective triage for those who need to make an emergency call could lead to early intervention and prevention of imminent death,” said Sumeet Chugh, director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute and senior author of the study.
“Our findings could lead to a new paradigm for prevention of sudden cardiac death,” he added.
Smidt Heart Institute investigators evaluated the prevalence of individual symptoms and sets of symptoms prior to sudden cardiac arrest, then compared these findings to control groups that also sought emergency medical care.
“The study showed that 50 percent of the 823 people who had a sudden cardiac arrest witnessed by a bystander or emergency medicine professional, such as an emergency medicine service (EMS) responder, experienced at least one telltale symptom before their deadly event,” said Chugh.
This was the first community-based study to evaluate the association of warning symptoms — or sets of symptoms — with imminent sudden cardiac arrest using a comparison group with EMS-documented symptoms recorded as part of routine emergency care.
Such a study should pave the way for additional prospective studies that combine all symptoms with other features to enhance prediction of a sudden cardiac arrest.
“Next, we will supplement these key sex-specific warning symptoms with additional features — such as clinical profiles and biometric measures — for improved prediction of sudden cardiac arrest,” said Chugh.
However, the study said that the warning symptoms were common but might need to be supplemented with additional features, such as the clinical profile and biometric measures, for improved prediction.
“Potential future directions include combining symptoms with a patient’s clinical profile or dynamic alterations in clinical markers or biomarkers measured by wearables to identify stronger associations with imminent sudden cardiac arrest,” said the study.
Doctors speaking to South First said that the general perception was that men are more likely to experience cardiac arrest.
“Most of the symptoms, such as chest pain, are biased towards men, and when they have chest pain, doctors and everyone asks for an ECG. If there are some degree of changes, the doctors determine that men might experience a heart attack, which can lead to cardiac arrest. But here, in this study, we are talking about the symptoms in women as well,” Hyderabad’s Yashoda Hospitals Consultant Interventional Cardiologist Dr Jitender Jain told South First.
Many women in their 40s and 50s are not aware that heart diseases pose a significant risk to their well-being, as heart attacks are commonly associated with older men.
Heart diseases occur when the cardiovascular system is not functioning properly and can manifest as high blood pressure, coronary artery disease, aneurysm, or stroke.
“Women’s risk of heart diseases increases during menopause due to the drop in estrogen levels. This hormone usually acts as a guard against heart disease,” Jain told South First.
“Other risk factors for heart disease include unhealthy eating habits, physical inactivity, smoking, and high cholesterol,” he added.
“So when typical symptoms, such as shortness of breath and sweating, appear in women, we have to consider that there might be a possibility of cardiac arrest,” said Jain.
Dr Ashish Sapre of Medicover Hospital said that some women may feel nauseous or vomit when a cardiac arrest is imminent.
“Sudden and severe fatigue or weakness can be a warning sign for women. They may feel extremely tired, even with minimal physical exertion, but it often goes unnoticed,” Sapre told South First.
He added that cardiac arrest is definitely dependent on lifestyle for many patients, but there are other reasons as well, and it can affect any gender, including congenital long QT syndrome (LQTS), a genetic disorder that affects the electrical system of the heart.
It is characterised by abnormal heart rhythms, specifically prolonged QT intervals on an electrocardiogram (ECG).
The QT interval represents the time it takes for the heart’s ventricles to depolarize (beats going up) and repolarize (beats going down) during each heartbeat.
In congenital LQTS, a person has a 50 percent chance of inheriting the condition if one of their parents carries the gene mutation. However, in some cases, the condition can also occur sporadically without a family history.
Another factor being Hypertrophic cardiomyopathy (HCM), a genetic cardiovascular disorder characterised by the thickening of the heart muscle, specifically the left ventricle, the chamber responsible for pumping oxygenated blood to the body.
The thickening of the heart muscle can cause several problems, disrupting the normal flow of blood out of the heart.
This obstruction can result in symptoms like shortness of breath, chest pain, fatigue, and dizziness. This can be exacerbated by exercise or other physical activities.
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