Cardiac Arrest

Women who have a cardiac arrest outside the hospital setting are less likely to receive resuscitation from bystanders and more likely to die than men, according to new research publish in the European Heart Journal today. The researchers, led by cardiologist Dr. Hanno Tan (MD, Ph.D.) at the University of Amsterdam (The Netherlands), find that men and women did not receive equal treatment when suffering a cardiac arrest in the community.

The chest compression

An important factor in this was that people did not recognize that women who collapse were having a cardiac arrest, leading to delays in calling the emergency services and delays in providing resuscitation treatment. Cardiac arrest occurs when the heart goes into an irregular rhythm and then stops beating completely. It is different to a heart attack (or myocardial infarction).

At this point it is too late for defibrillation to work and the only remaining option is chest compression to try to restore circulation sufficiently for the heart to regain its electrical and mechanical activity. The ability to recognise and treat a cardiac arrest within minutes is, therefore, crucial to being able to treat patients while they still have a shockable initial rhythm and before their heart stops.

This suggests that the lower proportion of women with shockable initial rhythm is not fully explain by women being more likely to have pre-existing diseases or by different resuscitation factors, and that other, as yet undiscovered, factors also play a role. However, when we look only at cardiac arrest victims who did have a shockable initial rhythm, we found there was no difference in overall survival rates between men and women.

The researchers say that a possible reason why fewer women have shockable initial rhythm by the time the emergency services reach them may be because fewer women than men tend to have a cardiac arrest when there were other people around to see it happen, and because the symptoms of a heart attack may not be recognise so quickly in women.

Most cardiac arrest

People may be less aware that cardiac arrest can occur; so as often in women as in men, and the women themselves may not recognise the urgency of their symptoms,” said Dr. Tan. Women may have symptoms of an impending heart attack; so that are less easy to interpret, such as fatigue, fainting, vomiting and neck or jaw pain; hence whereas men are more likely to report typical complaints such as chest pain.

The researchers call for a range of measures to tackle the problem; its of survival differences between men and women; so ranging from public awareness campaigns about heart attack; also cardiac arrest in women to reorganisation of health care systems in order to provide faster resuscitation to women; so particularly those living on their own, for instance; hence by wearable devices that monitor heart rate and circulation and that can send alerts to monitoring systems.

Limitations to the study include the fact; so that 181 surviving patients; hence were not include because they did not consent, and data on pre existing diseases; hence in 27.5% of heart attack patients were missing; so although in both cases the missing data were distribute evenly between the sexes. The researchers had no information on symptoms patients; which may have report before their heart attacks; which may have influence how quickly witnesses might make an emergency call.