Cardiac arrest symptoms
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Cardiac Arrest Symptoms: Key Insights from Recent Research
Common Prodromal Symptoms of Cardiac Arrest
Breathing Problems and Dyspnea
Breathing problems, particularly dyspnea, are frequently reported as prodromal symptoms of cardiac arrest. Studies indicate that dyspnea is a common symptom preceding both cardiac and non-cardiac origin out-of-hospital cardiac arrests (OHCA) . In one study, dyspnea was reported in 27.6% of cardiac-origin cases and 40.7% of non-cardiac-origin cases. Another study found that 59.4% of patients who called emergency services within 24 hours before their OHCA reported breathing problems.
Chest Pain
Chest pain is another significant symptom associated with imminent cardiac arrest. It was reported by 20.7% of patients with cardiac-origin OHCA and was less common in non-cardiac cases. In a case-control study, chest pain was present in 33% of sudden cardiac arrest (SCA) cases, highlighting its importance as a warning sign. Additionally, chest pain was more prevalent among middle-aged men compared to women.
Unconsciousness and CNS-Related Symptoms
Symptoms related to the central nervous system (CNS), such as unconsciousness and confusion, are also notable. Unconsciousness was reported in 20.2% of pre-arrest calls, and CNS-related symptoms were registered in 15% of calls to medical helplines within 30 days before OHCA. These symptoms often necessitate immediate medical attention and can be critical indicators of an impending cardiac event.
Other Symptoms: Paleness, Sweating, and Syncope
Other symptoms such as paleness, sweating, and syncope (fainting) are also reported. Paleness was noted in 19.1% of pre-arrest calls, often co-occurring with breathing problems. Syncope was reported in 12.7% of cardiac-origin OHCA cases, and sweating was a common co-occurring symptom with other warning signs.
Impact of Recognizing Warning Symptoms
Early Activation of Emergency Medical Services
Recognizing and acting on these warning symptoms can significantly impact outcomes. Early activation of emergency medical services (EMS) is associated with better neurological outcomes and higher survival rates . Patients who called EMS before their cardiac arrest had higher rates of return of spontaneous circulation (ROSC) and survival to discharge.
Symptom Clusters and Prognosis
Research has identified clusters of prodromal symptoms that may indicate a worse prognosis after resuscitation. For instance, a cluster including mental confusion, restlessness, and palpitations was associated with longer hospital stays and poorer outcomes. Understanding these clusters can help in risk stratification and timely intervention.
Conclusion
Prodromal symptoms such as dyspnea, chest pain, unconsciousness, and other CNS-related symptoms are critical indicators of an impending cardiac arrest. Early recognition and response to these symptoms by activating EMS can improve survival rates and outcomes. Further research into symptom clusters and their impact on prognosis can enhance predictive algorithms and preventive strategies for cardiac arrest.
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