Skip to Main Content


  • Most cardiac arrests in the community setting occur as a result of coronary artery disease and cardiac ischemia.
  • Given the high mortality of cardiac arrest, prevention is crucial.
  • Cardiopulmonary resuscitation and rapid defibrillation are the keys to successful resuscitation from cardiac arrest.
  • Advanced Cardiopulmonary Life Support (ACLS) guidelines provide treatment algorithms for the different cardiac rhythms of arrest.
  • Automatic external defibrillators provide a means for rapid defibrillation by the public.


Cardiac arrest, defined as the sudden complete loss of cardiac output and therefore blood pressure, is the leading cause of death in the United States and much of the developed world, claiming at least 300,000 lives each year in the United States alone.1 In the majority of cases, myocardial ischemia in the setting of coronary artery disease represents the underlying etiology of arrest. Conversely, cardiac arrest is the initial presentation of myocardial ischemia in approximately 20% of patients.2 A wide variety of other processes can lead to cardiac arrest, including septic shock, electrolyte abnormalities, hypothermia, pulmonary embolism, and massive trauma (Table 15-1).

Table Graphic Jump Location
Table 15–1. Etiologies of Cardiac Arrest

Survival from cardiac arrest remains dismal, even after the introduction of electrical defibrillation and cardiopulmonary resuscitation (CPR) over 50 years ago. In the best cases (witnessed ventricular fibrillation arrest with rapid defibrillation), survival to hospital discharge ranges from 30% to 46%,3,4 although overall out-of-hospital arrest survival is usually much lower, ranging from 2% to 26%.5 In large American cities, out-of-hospital arrest survival may be even worse—survival rates of 1.4% and 1.8% have been reported for New York and Chicago, respectively.6–8 Even after successful resuscitation from cardiac arrest, most patients die within 24 to 48 hours despite aggressive intensive care treatment. Reperfusion injury, a subject of much basic science investigation, is thought to be involved in this postarrest deterioration.9,10


Demographic data from multiple studies demonstrate that the mean age of patients who suffer out-of-hospital cardiac arrest is approximately 68 to 70 years, with a slightly higher incidence in men than in women.1,2,11 Over 70% of these patients experience arrest ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.