TUESDAY, Nov. 19, 2013 (HealthDay News) -- A new study counters
the commonly held belief that when most middle-aged men suffer
cardiac arrest, it typically comes completely out of the blue.
Researchers found that the majority of victims have symptoms in
the days and weeks before the emergency.
Most had chest pains between four weeks and one hour before a
sudden cardiac arrest -- when the heart stops abruptly -- the study
found. Others had noted shortness of breath, while a small
percentage experienced dizziness, fainting or heart
The study authors said that although middle-aged people are
considered to be in the prime of life, they are not immune to
"At least a third of cardiac arrests in men are happening in middle age," said study lead author Dr. Sumeet Chugh, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.
The recent death of
The Sopranosstar James Gandolfini at the age 51 highlighted
the fact that sudden cardiac arrest can affect relatively young
The study was scheduled for presentation Tuesday at the annual
meeting of the American Heart Association, in Dallas.
Sudden cardiac arrest occurs when the heart suddenly starts
beating either very quickly and erratically, or extremely slowly,
due to a failure of its electrical system, said Dr. Gregg Fonarow,
a cardiologist at the University of California, Los Angeles.
"That's different than a heart attack, where there is a blockage
that injures the muscle," he said.
About 360,000 out-of-hospital cardiac arrests are reported each
year in the United States, according to the American Heart
Association. Less than 10 percent of those who have a cardiac
arrest outside the hospital survive.
For the study, the scientists focused on the population of
Portland, Ore., assessing every man between the ages of 35 and 65
who had a sudden cardiac arrest within a period of almost 12 years.
Of the more than 800 total cases, 31 percent of the medical records
did not have enough information to identify whether symptoms were
present before the attack.
The researchers also reviewed the accounts of family members,
witnesses, emergency medical personnel and medical records from the
time period around the cardiac arrest.
In the remaining cases, 53 percent had symptoms that ranged from
episodes of chest pain to feeling like they had the flu.
Although the data helps point to the importance of recognizing
symptoms and seeking help, Chugh said, there are still more
questions than answers. For many people with early symptoms of
potential heart problems, doctors' exams may not show anything
"We're trying to improve the scope of a complete [cardiac] work-up, but there are big gaps in what we know," Chugh said. "What happens in the hour before cardiac arrest? What about in the 24 hours before, the week before or the month before?"
Part of the challenge is that a variety of problems may trigger
sudden cardiac arrest. Depending on genetic, anatomical and other
factors, people may respond differently.
"We are teasing out a million different variables at this point," Chugh said. "The nature of heart disease isn't so different from cancer. There's a genetic component ... and then there are clinical factors and some lifestyle factors."
The study results do not apply to women, and more research is
needed, Chugh said. "Women are different in so many ways," he
The research supports current recommendations for anyone having
these kinds of symptoms -- especially chest pain, shortness of
breath and dizziness -- to seek medical attention, UCLA's Fonarow
said. "Many people don't follow these recommendations and they
delay," he said. "Their health may really be at stake."
Chugh agreed. "We have not educated men in middle age very much,
and we need to do that," he said.
Because this study was presented at a medical meeting, the data
and conclusions should be viewed as preliminary until published in
a peer-reviewed journal.
Learn more about sudden cardiac arrest from the
U.S. National Heart, Lung, and Blood
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