Causes, circumstances, and potential preventability of cardiac arrest in the young: insights from a state-wide clinical and forensic registry

Causes, circumstances, and potential preventability of cardiac arrest in the young: insights from a state-wide clinical and forensic registry.

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Item Type: Article
Status: Published
Official URL:
Journal or Publication Title: EP Europace
Date: 29 August 2022
Divisions: Molecular Cardiology
Depositing User: General Admin
Identification Number: 10.1093/europace/euac141
ISSN: 1099-5129
Date Deposited: 08 Jan 2023 23:10

Aims: The causes, circumstances, and preventability of young sudden cardiac arrest remain uncertain.

Methods and results: A prospective state-wide multi-source registry identified all out-of-hospital cardiac arrests (OHCAs) in 1-50 year olds in Victoria, Australia, from 2019 to 2021. Cases were adjudicated using hospital and forensic records, clinic assessments and interviews of survivors and family members. For confirmed cardiac causes of OHCA, circumstances and cardiac history were collected. National time-use data was used to contextualize circumstances. 1319 OHCAs were included. 725 (55.0%) cases had a cardiac aetiology of OHCA, with coronary disease (n = 314, 23.8%) the most common pathology. Drug toxicity (n = 226, 17.1%) was the most common non-cardiac cause of OHCA and the second-most common cause overall. OHCAs were most likely to occur in sleep (n = 233, 41.2%). However, when compared to the typical Australian day, OHCAs occurred disproportionately more commonly during exercise (9% of patients vs. 1.3% of typical day, P = 0.018) and less commonly while sedentary (39.6 vs. 54.6%, P = 0.047). 38.2% of patients had known standard modifiable cardiovascular risk factors. 77% of patients with a cardiac cause of OHCA had not reported cardiac symptoms nor been evaluated by a cardiologist prior to their OHCA.

Conclusion: Approximately half of OHCAs in the young have a cardiac cause, with coronary disease and drug toxicity dominant aetiologies. OHCAs disproportionately occur during exercise. Of patients with cardiac cause of OHCA, almost two-thirds have no standard modifiable cardiovascular risk factors, and more than three-quarters had no prior warning symptoms or interaction with a cardiologist.

Keywords: Cardiac arrest; Epidemiology; Out-of-hospital; Resuscitation; Symptoms.

Paratz, Elizabeth D
van Heusden, Alexander
Zentner, Dominica
Morgan, Natalie
Smith, Karen
Thompson, Tina
James, Paul
Connell, Vanessa
Pflaumer, Andreas
Semsarian, Christopher
Ingles, Jodie
Parsons, Sarah
Stub, Dion
Gerche, Andre La
Last Modified: 08 Jan 2023 23:10

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