Michael Jackson RIP: Does Anyone Survive Sudden Cardiac Arrest?

Every twenty seconds, a heart attack strikes someone in America, killing five hundred thousand a year. That's fifty-seven deaths every hour, almost one per minute. In the United States and many nations, it's the leading cause of death among adults over age forty.

The most lethal kind of heart problem--called sudden cardiac arrest (SCA) --occurs when your ticker's electrical system goes haywire and stops pumping blood to the rest of your body. SCA accounts for an estimated 325,000 deaths every year in the US and -- according to news accounts -- it appears to have killed Michael Jackson.

It's important to note that a heart attack is different from cardiac arrest. A heart attack or myocardial infarction is a blockage of your heart's plumbing while cardiac arrest is an electrical problem with your heartbeat, according to the Heart Rhythm Foundation. The difference is critical: Cardiac arrest is typically much more dangerous than heart attack.

What are your odds of surviving cardiac arrest? In major cities in North America, your chances range between three to nine percent depending in large part on the quality of the emergency response system. In communities with the best emergency response like Seattle, the salvage rate tops out at 16 percent. Put bluntly, even in the best cities in America, 85 to 95 percent of cardiac arrest victims simply don't make it.

Consider the Jackson case: It took paramedics three minutes and 17 seconds to respond to the 9-1-1 call from Jackson's home. His personal physician was already in the house performing CPR, according to the Los Angeles Times. Jackson wasn't breathing and never regained consciousness. Paramedics treated Jackson for 42 minutes, transporting him to UCLA Medical Center, where he was pronounced dead.

So who actually survives cardiac arrest? People like Thurman Austin. The sixty-three-year-old textile worker from China Grove, North Carolina, was gambling at the Stardust Casino in Las Vegas when he collapsed, banged his head on a dollar slot machine, and hit the floor. He didn't even know his wife, Gwen, in the next seat had just won nearly three hundred dollars. Within minutes, security guards arrived with one of the casino's new defibrillators and shocked his heart back into normal rhythm. It was July 1, 1997. "I hit the jackpot that day," he says. Yes, he did.

Believe it or not, casinos are among the safest places in the world for a heart attack, according to the New England Journal of Medicine. The reason has nothing to do with Lady Luck, says Dr. Bryan Bledsoe, a former paramedic and emergency physician who teaches at the University of Nevada-Las Vegas and writes textbooks for emergency caregivers. Survival depends on how fast you're defibrillated and receive chest compressions. If you get the first jolt within one minute, your chances are around 90 percent, but they drop 10 percent every sixty seconds.

Incredibly, the salvage rate on the Vegas Strip is now 53 percent. Even in most hospitals, your odds aren't as good.

Why is Sin City the best place to survive cardiac arrest? It starts with the alarming fact that two to three times more people suffer cardiac arrest in Las Vegas than other cities of similar size. The reason: Vegas Syndrome. Older tourists keel over because of too much eating, drinking, partying, smoking, exhaustion, and stress from gambling. Indeed, paramedics in Clark County, Nevada, found themselves responding to so many fatal cardiac arrest calls in casinos that they urgently needed a solution. In 1997, they began persuading casino owners to buy automated external defibrillators (AEDs) and to install them like fire extinguishers in public places. They also started training casino workers in CPR and defibrillation. (Note: The story of cardiac arrest in Vegas is told wonderfully in a Wall Street Journal piece in January 2006 by Kevin Helliker.)

With security cameras and guards always on the lookout for cheaters and troublemakers, virtually everyone is under constant surveillance. That means if a visitor drops, someone notices quickly. If you keel over at the MGM Mirage, for instance, a trained staffer with a defibrillator will be standing over you in just 2.8 minutes. Even if you're in a hospital, the response rate isn't always so fast. And that can make the difference between hitting the jackpot and losing everything.

That's a big reason why airports, ball parks, libraries and other public places are installing more and more defibrillators. They save lives. Indeed, the AED program at O'Hare and Midway airports in Chicago has showed a salvage rate of 64 percent, good news for travelers and even better odds the Vegas strip.

Update: From news accounts Friday morning, it appears possible that Jackson suffered from respiratory arrest induced by drugs (or a drug overdose). Respiratory arrest means your breathing stops and it usually coincides with or triggers cardiac arrest. We'll know more after the autopsy today.

Follow Ben Sherwood on Twitter: www.twitter.com/survivorsclub

Comments

[CarolMajeshort]

Nice blog post Ben. The claim about MJ's addiction to pain medication is not unusual right ? It reminds me of the movie "Almost Famous" about 15 mins in as the kid (hero) goes to interview the rock band, his mum yells out "DON'T TAKE DRUGS". That scene has taken on a medical meaning in my head supplanting the recreational one and is prompted by events such as MJ’s death. The damage drugs can do and the lack of awareness distress’s me. We avoid them in our house and use one of those LLLT lasers (Low Level Laser Therapy) for musculoskeletal pains (back and neck pain, creaky arthritis joints and sports injuries). My partner is an osteopath and says it's is much safer and improves healing rather than making injuries worse like some pain relieving drugs do. Are you aware that NSAID's like Advil that slow healing, as well as upset stomachs? anything other than that has to be better, like ice packs and laser If you don’t know what I'm talking about you can look it up here http://www.thorlaser.com It's not improved my moon walking but it’s much safer. Anyways, MJ you ROCKED MY WORLD in this life, no doubt YOU WANNA BE STARTIN' SOMETHIN' in the next. and thanks Ben. Seems MJ wrote a song for you too.

[Fromageball]

Thank you for writing this and explaining the difference. My dad died in 2007 of cardiac arrest while he was out jogging, and since then from talking to various people, I have become alarmed at how often this sort of thing occurs with a seemingly healthy person simply dropping dead. My dad was 63 and in better shape than any other man we knew who was his age. I have heard stories of survivors, but it is only when there is a defibrillator close by and the person gets help immediatel­y(literall­y within minutes). For the victim, it seems like a very peaceful way to go, but it is very traumatic for those left behind. My dad simply went out for a jog and never returned. It really makes you realize how anyone can be taken from us at anytime. I hope that with such a high profile death as Michael Jackson, we will fund more research to find out what exactly causes this and what we can do.

[intelliwoman]

Less than 3 months ago a friend of mine in his early 50's in good health got up from a table at the end of a meeting, had SCA and went down. Local paramedics were on a call, and a paramedic unit from a neighboring town had to respond. It took them over 20 minutes.

Today, with a pacemaker, my friend is living a normal life, although he can not drive for several months, because someone else at the meeting had CPR training and immediately went into action.

Lesson learned, I hope.

[HeevenSteven]

So how do you know when it's time to hook up the jumper cables? How do you tell SCA from infarction? Pulse?

[MonkeyHah]

The AEDs test for an arrhythmia prior to prompting to administer a shock. Generally, people who experience sudden cardiac death quickly become unconscious. People who are having a myocardial infarction often are conscious and experiencing chest pain and other symptoms.

[Guitarsandmore]

I think what it all means is that after forty we should all start slowing down a little and after fifty we should slow down a lot. You shouldn't try to do at fifty what you did at twenty. The body just isn't built that way.

[NewIndy]

Although possible, it is unlikely that MJ died of SCA as you assert. Much more likely he suffered respiratory arrest (stopped breathing) due to an overdose of drugs that depressed his central nervous system. After a few minutes, his heart would have failed from lack of oxygen and excess of carbon dioxide. I suspect he was alone at the time and was discovered too late to be viable despite what I'm sure were heroic efforts by EMS and the hospital.

We'll know soon enough since they're rushing the autopsy.

[Ohioan730]

My dad died in 2005 of cardiac arrest. He was 6' 2", 300 lbs and doing drugs (he thought I didn't know about the drugs). He drank rum everyday and ate constantly. He also had chronic asthma and frequently used breathing machines. He used to be the star b-ball player in his school, a vegetarian, skinny, and he use to work out everyday. I don't know why he stopped doing those things but now he's dead. He was only 52.

My dad let himself go after he split up with my mother and moved out of state. Looking back, I think he saw no reason to prolong his life since his family split up. He was all about family and kids.

I have a feeling Michael wasn't doing enough to keep himself alive because he was punishing himself. He probably felt inhuman and wanted to die. How could he have looked at his face deteriorate for the next 20 years? Maybe it was best for him that didn't happen.

This should heighten everyone's heart health awareness not to mention general good health practices. MJ was like a relic of an by-gone era when big names lived on booze and pills, worked hard and died young. I'm glad the new generation is more health conscious although there is some serious anorexia going on in Hwood.

[nanniejo]

I survived a sudden cardiac arrest last year. I happened to be in the hospital recouperating from a hysterectomy and a nurse was at my bed removing a catheter. I would not have had time to even call out it happened so quickly. Had I been at home I would not be here writing this today.

I try as hard as I can to educate people about the use of defribrillators - most people who have them at their workplace do not know where they are located. Everyone should know where a defribrillator is - they are at the mall, in airports, etc. using this right away can save you - CPR doesn't do it. If you see someone who appears to have the symptoms of cardiac arrest, run and find a defribrillator. They are easy to use and directions are posted right on the unit. Tim Russert might have survived if someone had thought to get the defribrillator at NBC during the ten minutes it took for the paramedics to get there.

[Overd0g2]

The number one cause of death is the heart ceasing to beat.

[lisarcohen]

Fascinating statistics - much more interesting than reading about Michael Jackson's death. It came as no surprise. Just sadness.

[byebyechick]

i can't believe Michael Jackson is gone, and honestly i refuse to believe he is gone permanently. If we all believe I think that he can come back. In fact Lazarus was raised from the dead and a man in Korea recently. If we all pray and believe God will use Michael Jackson to catch the world's attention and raise him up unexpectedly, when all of the world is watching, imagine how many people would convert to Christianity. All of my friends think I am crazy, but I just believe God please just have a little faith and pray with me. Please and I honestly DO NOT mean to offend ANYONE who is not Christian, obviously seeing that Michael Jackson was not Christian himself and approved of all races. I really mean that and apologize in advance for ANYONE I've offended. Thank you for reading this extremely long comment. Long live the king of Pop Michael Jackson, there is NO other.
Rey Del Pop.
Roi De la Pop

[JWheels]

Your friends are right, I think you need to get over it. Death is final, no coming back.

[lovingly18]

i would really like to talk with you on behalf of that. I just wish i could have found this site sooner. get back to me as soon as you can girlie. quick!

[ewoman]

My dad had a cardiac arrest and lived. He remained so angry with my mother for reviving him that he didn't speak to her for almost six months. He said that's the way he wants to go - instantaneously and painlessly. Zap. Just like that.

[MonkeyHah]

Because Michael Jackson appears to have experienced his SCA at home, it is appropriate to review the literature on home AEDs. Approximately 75% of SCAs occur in the home (NEJM 2008;358:1­793-1804). In this recently published study, Bardy et al.(ibid) reported that home use of AEDs in post-MI patients did not significantly improve overall survival when compared to conventional resuscitation methods (calling 911 and then starting CPR). However, for those who were fortunate enough to have an attended SCA (someone present and willing to use the AED) and have had their lives saved by the use of a home AED, the availability of a home AED was surely priceless.

[xim5]

a well-established, long-term study well-regarded by the psychiatric community (ask your doc) has established that the single most common cause of death among those who have taken a psychotropic medication in their lifetime is sudden cardiac arrest (aka "sudden death").

If you take an antidepressant, you may take to heart knowing other studies have established vigorous exercise is just as effective.

[JoshAus]

Sounds like the word of Xenu to me.

[MonkeyHah]

Not terribly informative. You need to compare those who've taken antidepressants with those who have not and then see if there is a statistically significant difference between the groups. Since heart disease is the leading cause of death overall and SCA accounts for the majority of those deaths, it's not surprising that the antidepressant population would follow a similar pattern.

Additionally, depression is a risk factor for heart disease, so the antidepressant population is already confounded by that risk factor. See O'Connor et al. Arch Intern Med. 2008 Nov 10;168(20):2232-7, one study designed to look at whether mortality was associated with antidepressants or depression, after adjusting for confounding factors. While depression remained an independent risk factor for mortality, anti-depressant use did not.

If you don't cite your study, then it's rather difficult to assess what was actually measured and whether or not it is of any significance.

[billbb]

In Jackson's case, it is sadly likely that he had chemical help. We know he had his skin bleached with chemicals that are illegal in the US and Europe. Although he never admitted it, there is no way he could have lightened that many shades just from staying inside a lot.

There are two chemicals commonly found in skin lightening products, Hydroquinone or Mercury.
Hydroquinone (C6H6O2) is a severely toxic and very powerful chemical used mostly in photo processing, and Mercury in the form of Mercury Chloride & Ammoniated Mercury is carcinogenic. Hydroquinone or Mercury applied to the skin will react with ultra violet rays and re-oxidize, leading to more pigmentation. This may account for Jackson's vampirish dislike of even the slightest hint of sunlight when outside.

Prolonged use of Hydroquinone will thicken collagen fibres damaging the connective tissues. Mercury's toxicity is well-known, and will slowly accumulate. In the long term the chemical will damage vital organs and lead to neurological, liver and kidney problems and mercury poisoning.

After decades of this, Jackson may have been far enough gone on this that no measures of any kind would have revived him. All of this is speculative, of course, and the coroner's toxicological report will be the only facts about what really happened in this case.