Each year in the United States, 400,000-460,000 persons die of unexpected sudden cardiac death (SCD) in an emergency department (ED) or before reaching a hospital (1). Based on the latest U.S. mortality data, this report summarizes and analyzes 1999 national and state-specific SCD data. Reducing the proportion of out-of-hospital* SCDs would decrease the overall incidence of premature death in the United States. Heart attacks are the major cause of SCD; approximately 70% of SCDs are caused by coronary heart disease. National efforts are needed to increase public awareness of heart attack symptoms and signs and to reduce delay time to treatment.