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Prognosis and outcomes following sudden cardiac arrest in adults

Philip J Podrid, MD, FACC
Section Editors
Brian Olshansky, MD
Scott Manaker, MD, PhD
Deputy Editor
Brian C Downey, MD, FACC


Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) refer to the sudden cessation of cardiac mechanical activity with hemodynamic collapse, often due to sustained ventricular tachycardia/ventricular fibrillation. These events mostly occur in patients with evidence for ischemia due to coronary artery disease, disease of the myocardium (due to hypertrophy, fibrosis, scar replacement, or other myocardial abnormality that may or may not have been previously diagnosed), valvular abnormalities, or congenital channelopathies. (See "Pathophysiology and etiology of sudden cardiac arrest".)

The event is referred to as SCA (or aborted SCD) if an intervention (eg, defibrillation) or spontaneous reversion of the heart rhythm restores circulation. The event is called SCD if the patient dies. However, the use of SCD to describe both fatal and nonfatal cardiac arrest persists by convention. (See "Overview of sudden cardiac arrest and sudden cardiac death", section on 'Definitions'.)

The prognosis of patients who have SCA will be reviewed here. The issues related to acute therapy for SCA, including guidelines for advanced cardiovascular life support (ACLS), and issues related to prevention of recurrent sudden cardiac death, are discussed separately. (See "Supportive data for advanced cardiac life support in adults with sudden cardiac arrest" and "Advanced cardiac life support (ACLS) in adults" and "Pharmacologic therapy in survivors of sudden cardiac arrest".)


Despite advances in the treatment of heart disease, the outcome of patients experiencing SCA remains poor [1-5]. As examples:

A report analyzed outcomes for over 12,000 patients treated by emergency medical services (EMS) personnel in Seattle over 24 years [1]. Survival to hospital discharge for those treated between 1998 and 2001 was not significantly better than for those treated between 1977 and 1981 (15.7 versus 17.5 percent). In contrast, the long-term outcome among patients who survive until hospital discharge following SCA appears to be improving [2].

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Literature review current through: Nov 2017. | This topic last updated: Nov 15, 2017.
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