Sudden cardiac arrest: 5 things women need to know


Aside from COVID-19, sudden cardiac arrest (SCA) is the leading cause of natural death in the United States. Each year, more than 350,000 people suffer cardiac arrest outside of the hospital setting. Nearly 90% of the cases are fatal.

Unlike a heart attack, there is no warning of SCA, according to Olujimi Ajijola, MD, PhD, a clinical cardiac electrophysiologist at the Ronald Reagan UCLA Medical Center. “Once the heart stops working, you lose consciousness instantaneously or within seconds,” he says. “If you have sudden cardiac arrest, you wouldn’t even know it’s happening.”

For women, who make up almost 40% of SCA occurrences, understanding SCA and knowing the risk may be lifesaving. Just as women may experience different symptoms of heart disease than men, their risk of SCA slightly differs too. Here’s what women need to know:

1. Sudden cardiac arrest is not the same as a heart attack

Many people confuse SCA with a heart attack. During a heart attack, a blockage in the heart’s arteries cuts off the delivery of blood and oxygen. As the heart muscle slowly dies, there are persistent signs or symptoms, including chest pain, shortness of breath and fatigue. In contrast, SCA is an electrical disturbance to the heart’s rhythm that causes it to immediately stop beating without any warning.

“Most people think of the heart as a pump. But the fundamental property that makes it work the way it does is electricity,” Dr. Ajijola says. “If that electrical system is damaged or injured, it can alter how electricity spreads through the heart and cause chaotic electrical activity. If not immediately corrected, sudden cardiac arrest quickly leads to death.”

2. Heart disease is the biggest risk factor of sudden cardiac arrest

If you have heart disease or previously had a heart attack, your risk for SCA greatly increases. “Many people have a heart attack and do not have sudden death,” Dr. Ajijola says. “But if you’ve had a heart attack, the heart is clearly not working well and your risk for SCA goes up.”

Cardiac arrest may be caused by most heart conditions, but other factors do play a role. Risk factors for SCA in women include:

  • Coronary artery disease (CAD), accounting for 80% of SCA cases in men and women combined
  • Depression, which increases a woman’s risk for sudden cardiac death and heart arrhythmias (heart rhythm problems)
  • Dilated cardiomyopathy, which decreases the heart’s ability to pump and is linked to 10% of SCA in all cases
  • Family history, if it includes SCA or certain abnormal heart rhythms
  • Hypertrophic cardiomyopathy, when the heart muscle is abnormally thick
  • Previous heart attack, which causes scarring of the heart tissue and is linked to 75% of all SCA occurrences

3. Many women don’t know they are at risk for sudden cardiac arrest

Cardiac arrest is not as common in women as in men. But all the same heart-related factors that cause SCA in men also cause it in women. The problem for women, according to Dr. Ajijola, is that the signs of heart disease are not always as obvious.

“Heart disease symptoms present differently in women versus men,” he says. “I think the issue for women is that they often don’t recognize that the symptoms they are having are heart-related. You could have an elevated risk and not even be aware of it.”

Dr. Ajijola advises women to review their family’s health history for an incidence of sudden death, cardiac arrests and heart disease. Talk with your provider to determine your risk for heart disease and don’t wait to have any possible symptoms evaluated.

4. Surviving sudden cardiac arrest depends on the people around you

Surviving SCA is possible, but action needs to be taken immediately by a bystander or family member. If you see someone suffering from what looks like SCA, call 9-1-1 and immediately initiate CPR (cardiopulmonary resuscitation), which can triple the chances of survival. It will keep blood flowing to the person’s heart and brain.

“People can be resuscitated but it needs to happen right away,” Dr. Ajijola says. “If it’s too long, it’s often too late. The person will die, or if revived too late, will likely be left with multi-organ dysfunction and unable to recover brain function.”

While CPR keeps blood flowing for a time, an automated external defibrillator (AED) can restore a normal heart rhythm. Medical professionals use AEDs to jolt your heart, but they are also available in many public places for bystanders to use. Dr. Ajijola recommends that everyone familiarize themselves and their families with lifesaving procedures for SCA – you never know when it may save a life.

5. Women at high risk can prevent sudden cardiac arrest

If you are at high risk for SCA, your doctor may suggest an implanted cardioverter defibrillator (ICD). This battery-powered device is placed under the skin to monitor your heart rate. If it detects an abnormal heart rhythm, it delivers an electric shock to restore a normal heartbeat.

“ICDs are appropriate for people who survived prior cardiac arrest, people with heart damage that leaves the heart pumping below 35% efficiency and people with other heart disorders that put them at risk of dying suddenly,” Dr. Ajijola says. “The truth is that for most people, there is nothing you can do to prepare except to be aware. The only way to protect yourself is if you know you have a heart condition.”

To learn more about your risk for sudden cardiac arrest, talk to your primary care provider.