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Cardiac arrest is more fatal in women for this reason



Women with cardiac arrest outside hospital have a hospital less likely to receive resuscitation from viewers, according to new research published in the 'European Heart Journal'. The researchers, led by cardiologist Hanno Tan, from the University of Amsterdam (The Netherlands) found that t men and women they were not treated equally when they had a cardiac arrest in the community.

An important factor in this was that people who fell had not been recognized as having a heart attack, which caused delays in calling emergency services and delays in the provision of regeneration treatment. A cardiac arrest occurs when the heart enters an irregular rhythm and then stops completely, unlike a heart attack (or myocardial infarction).

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Dr Tan explains: "We found that the worst result in women is that women about half are as likely to suffer a sensitive rhythm to treatment compared to men."

The rhythm that tends to be treated is the recorded heart rate when a person with a cardiac arrest is connected to an electrocardiogram machine; It is very fast (often more than 300 beats per minute) and chaotic. This fast and irregular rhythm prevents the heart from beating in a cohesive manner so that there is no effective pumping function, and blood cannot circulate through the body and into the heart anymore, leading to cardiac arrest. Death occurs in minutes, unless the heart can receive an electric shock at a normal rate through an electric current of a defibrillator. If this does not happen, then the rhythm of the treatment that tends to get the disease melts into a “flat line,” noting the absence of any electrical activity in the heart.

At this point, it's too late for a defibrillator to work, and the only option that is left is to compress the chest to try to restore enough circulation to the heart to restore it. electrical and mechanical activity. The ability to recognize and treat cardiac arrest in minutes, therefore, is essential to be able to treat patients while they have an initial manipulative rhythm and before their heart stops.

He analyzed his team's data and all the resuscitation efforts made by the emergency services between 2006 and 2012 in a Dutch state. They reported that there were 5,717 heart arrests outside hospital treated in this period, 28 per cent of which occurred in women.

It was found that women were less likely than men to attempt to resuscitate from a viewer (68 against 73 per cent), even when someone was there to see the fall (69 compared to 74 per cent). Survival of the time when the heart was arrested to hospital admission was lower in women (34 against 37 per cent), and women were less likely to survive from admission to hospital. Hospital (37 against 55 per cent).

In general, the chances of women surviving in hospital are around half of men (12.5% ​​compared to 20%). The researchers believe that this is largely explained by the lowest starting rate of rhythm among women (33 against 52 per cent) and several reasons were found that could explain this difference.

Even when we adjusted our results to consider existing conditions and factors relating to how professionals provided resuscitation, for example, how long the ambulance took or the time of the defibrillator after cardiac arrest, it was t women are still half as likely as men to have a reversible rhythm, ”said Tan.

This suggests that the lowest proportion of women with reversible rhythm is not fully explained by the fact that women are more likely to suffer from preexisting diseases or different resuscitation factors, and that there are other factors, not found t again, also role play. However, when we saw only victims of cardiac arrests who had a reversible rhythm, we found that there were no differences in overall survival rates between men and women, "he said.


The researchers also found differences in the way women were treated in hospital. They were less likely to be diagnosed with acute myocardial infarction and were less likely to have coronary angiography or coronary intervention through the skin.

Scientists say that one possible reason why fewer women have a sensitive rhythm to treatment when they arrive at emergency services may be because fewer women than men tend to have cardiac arrest when others watch them: for reasons demographics, more elderly women living alone than men, and because the symptoms of a heart attack – one of the most common causes of cardiac arrest – are recognized as quickly in women.

People may be less aware that cardiac arrest can occur as often as women in men, and women themselves may not recognize the urgency of their symptoms, says Tan. Women can experience imminent heart attack symptoms less easily interpreted, such as fatigue, fainting, vomiting, and neck or jaw pain, while men are more likely to present typical complaints, such as pain in the chest. "

The researchers call for a series of measures to tackle the problem of survival between men and women, ranging from public awareness campaigns on heart attacks and cardiac arrests in women to reorganization. healthcare systems to provide more resuscitation. fast for women, especially those living alone, for example, through portable devices that control heart rate and circulation and this can send alerts to monitoring systems.

Because cardiac arrests occur more frequently outside the hospital setting in the general population, there is likely to be a lot of awareness gained in society that cardiac arrest is as common in women as it is in men. but may have different symptoms. Given the short window available to save the patient's life, every minute at this early stage counts; Support, even if only a call to the emergency number, is essential. Raising awareness through public campaigns could therefore have a major impact on women's survival. "It seems that the hospital treatment is also different, our perception is that it can be applied now and that may be easier to implement," he said.

Amongst the limitations of the study, data on existing diseases is missing in 27.5 per cent of heart attack patients, although in both cases the data was missing equally between the sexes. . The scientists had no knowledge of the symptoms that patients could have reported before their heart attacks, which may have influenced how quickly witnesses can make an emergency call.

You can read the original note

* This content is published with the permission of Europa Press.


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