It happens within a few seconds, usually without warning. A diseased heart is often the cause. Why sudden cardiac death occurs and how you can protect yourself.
Sudden cardiac death, also known as cardiac death in seconds, is the most common cause of death outside of hospitals. More than 65,000 people die from it in Germany every year. The immediate cause is almost always a life-threatening cardiac arrhythmia as a result of a heart disease. This leads to cardiac arrest within a few minutes.
The frequency of sudden cardiac death is clearly dependent on age and gender: men over 65 are particularly affected. The death rate for men over 79 is even twice as high as that for women in this age group.
The probability that certain heart diseases will cause sudden cardiac death also depends on age. “By far the most common cause in patients over 40 is coronary heart disease and the resulting heart attack, followed by heart failure, cardiomyopathy and myocarditis, as well as heart valve disease,” says Professor Thomas Voigtländer, Chairman of the German Heart Foundation, on the occasion of the nationwide Heart Week.
This year’s Heart Weeks have the motto “Heart disease? Protect yourself from cardiac arrest!”. As part of the awareness campaign, numerous information events are taking place nationwide. The focus is on the prevention, detection and consistent treatment of heart disease. The Heart Foundation offers a comprehensive range of information for those interested, which can be accessed at https://herzstiftung.de/herzwochen.
Even though the risk of sudden cardiac arrest is higher in older people, younger people are not immune. In the under-40 age group, it is primarily athletes who are at risk.
They suffer a sudden and unexpected cardiac arrest, usually without any prior symptoms. The most recent prominent example is Danish professional footballer Christian Eriksen, who survived cardiac arrest during the European Football Championship in 2021 thanks to immediate resuscitation.
The most common causes of sudden cardiac arrest before the age of 40 are congenital heart muscle disease, some forms of genetic heart disease, myocarditis and drug addiction.
In most cases, sudden cardiac death occurs suddenly and unexpectedly. It often strikes those affected while they are sleeping. However, there are sometimes warning signs in advance that enable patients to seek help in time.
The majority of patients who have survived sudden cardiac arrest after successful resuscitation report rapid heartbeat, shortness of breath, chest pain, dizziness, brief loss of consciousness or blacking out.
The causes of sudden cardiac death can vary greatly. The German Heart Foundation has summarized the most common ones.
In Germany, around five million people are known to suffer from coronary heart disease. This often results in circulatory disorders of the heart and calcification of the coronary arteries (arteriosclerosis). These are among the main causes of sudden cardiac death.
What is insidious about coronary heart disease is that, unnoticed by the patient for years, plaques made of calcium, connective tissue and cholesterol can cause changes to develop on the walls of coronary arteries, which only become noticeable when the narrowing of the arteries has reached a critical threshold of 70 to 80 percent and the heart muscle is undersupplied with oxygen and nutrients.
This can lead to chest pain, chest tightness (angina pectoris) or shortness of breath during physical exertion. “In this case, you should go to a hospital immediately,” warns Voigtländer. If the symptoms occur while you are resting and last longer than five minutes, a heart attack is suspected, which can turn into ventricular fibrillation at any moment and thus cause cardiac arrest. Those affected should then immediately call the emergency services on 112.
- Further information: Coronary heart disease often remains undetected for decades
Effective medications are available to treat coronary heart disease, both the underlying and concomitant diseases such as high blood pressure, high cholesterol and diabetes mellitus. In addition to medication, stent therapy (stent = vascular support) or bypass surgery are often used to treat vascular constrictions. In addition to therapy, lifestyle changes such as regular exercise, a balanced diet, stopping smoking and weight control are required.
Professor Dr. med. Thomas Voigtländer is Medical Director of the Agaplesion Bethanien Hospital and Cardioangiological Center Bethanien (CCB) in Frankfurt am Main and Chairman of the Board of the German Heart Foundation.
Sudden cardiac death also often occurs in cases of heart failure that has developed as a result of a heart attack, valve disease or heart muscle disease. “That is why early detection and treatment of these heart diseases are so important in order to prevent heart failure or to delay its progression,” says Voigtländer.
In the case of heart failure, the heart is no longer able to pump enough blood to supply the body with sufficient oxygen and nutrients. Patients with severely limited pumping capacity of the left ventricle are at risk of sudden cardiac death, usually due to the occurrence of malignant rapid arrhythmias in the ventricle. Therefore, the implantation of a cardioverter defibrillator (ICD), or “Defi” for short, may be advisable.