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Open Access Publications from the University of California

When the Female Heart Stops: Sex and Gender Differences in Out-of-hospital Cardiac Arrest Epidemiology and Resuscitation.

  • Author(s): Jarman, Angela F
  • Mumma, Bryn E
  • Perman, Sarah M
  • Kotini-Shah, Pavitra
  • McGregor, Alyson J
  • et al.

Sex- and gender-based differences are emerging as clinically significant in the epidemiology and resuscitation of patients with out-of-hospital cardiac arrest (OHCA). Female patients tend to be older, experience arrest in private locations, and have fewer initial shockable rhythms (ventricular fibrillation/ventricular tachycardia). Despite standardized algorithms for the management of OHCA, women are less likely to receive evidence-based interventions, including advanced cardiac life support medications, percutaneous coronary intervention, and targeted temperature management. While some data suggest a protective mechanism of estrogen in the heart, brain, and kidney, its role is incompletely understood. Female patients experience higher mortality from OHCA, prompting the need for sex-specific research.

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