Sudden cardiac death causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Sudden cardiac death}}
{{Sudden cardiac death}}
{{CMG}} {{AE}} {{Sara.Zand}}
{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}


==Overview==
==Overview==
[[Sudden cardiac arrest]]  may be caused by [[coronary artery]] abnormality such as coronary [[atherosclerosis]], acute [[MI]], [[coronary artery embolism]], [[coronary arteritis]]
[[Sudden cardiac arrest]] ([[SCA]]) may be caused by underlying [[cardiac]] abnormality including [[coronary artery]] abnormality , [[hypertrophy]] of [[myocardium]], [[myocardial disease]], [[valvular heart disease]], [[congenital heart disease]], abnormality in [[conducting system]] and electrical instability. The type of [[cardiac disease]] that is associated with [[sudden cardiac death]] ([[SCD]]) depends on the [[age]] of the individual <ref name="pmid21131293">{{cite journal| author=Winkel BG, Holst AG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL | display-authors=etal| title=Nationwide study of sudden cardiac death in persons aged 1-35 years. | journal=Eur Heart J | year= 2011 | volume= 32 | issue= 8 | pages= 983-90 | pmid=21131293 | doi=10.1093/eurheartj/ehq428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21131293  }} </ref> <ref name="pmid24604905">{{cite journal| author=Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL | display-authors=etal| title=Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark. | journal=Circ Arrhythm Electrophysiol | year= 2014 | volume= 7 | issue= 2 | pages= 205-11 | pmid=24604905 | doi=10.1161/CIRCEP.113.001421 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24604905  }} </ref> <ref name="pmid27332903">{{cite journal| author=Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L | display-authors=etal| title=A Prospective Study of Sudden Cardiac Death among Children and Young Adults. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 25 | pages= 2441-52 | pmid=27332903 | doi=10.1056/NEJMoa1510687 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27332903  }} </ref> <ref name="pmid12472914">{{cite journal| author=Wisten A, Forsberg H, Krantz P, Messner T| title=Sudden cardiac death in 15-35-year olds in Sweden during 1992-99. | journal=J Intern Med | year= 2002 | volume= 252 | issue= 6 | pages= 529-36 | pmid=12472914 | doi=10.1046/j.1365-2796.2002.01038.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12472914  }} </ref> <ref name="pmid15364331">{{cite journal| author=Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B | display-authors=etal| title=Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 6 | pages= 1268-75 | pmid=15364331 | doi=10.1016/j.jacc.2004.06.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15364331  }} </ref> <ref name="pmid24344190">{{cite journal| author=Winkel BG, Risgaard B, Sadjadieh G, Bundgaard H, Haunsø S, Tfelt-Hansen J| title=Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting. | journal=Eur Heart J | year= 2014 | volume= 35 | issue= 13 | pages= 868-75 | pmid=24344190 | doi=10.1093/eurheartj/eht509 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24344190  }} </ref> <ref name="pmid18424446">{{cite journal| author=Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K | display-authors=etal| title=Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland. | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 11 | pages= 1418-23 | pmid=18424446 | doi=10.1093/eurheartj/ehn155 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18424446  }} </ref> <ref name="pmid21903060">{{cite journal| author=Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM | display-authors=etal| title=Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 12 | pages= 1254-61 | pmid=21903060 | doi=10.1016/j.jacc.2011.01.049 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21903060  }} </ref>.
, hypertrophy of [[myocardium]] such as [[HCM]], [[hypertensive heart disease]], primary or secondary [[pulmonary hypertension]]
, [[myocardial disease]] such as [[ischemic cardiomyopathy]], [[non-ischemic cardiomyopathy]], [[myocarditis]]
,[[valvular heart disease]] such as [[aortic stenosis]], [[aortic insufficiency]], [[mitral valve prolapse]], [[endocarditis]]
, [[congenital heart disease]] such as [[congenital septal defect]] with [[eisenmenger physiology]]
, abnormality in conducting system such as [[Wolf-Parkinson-White syndrome]]
, electrical instability such as ([[CPVT]], [[LQTS]])


==Causes==
==Causes==
[[Sudden cardiac arrest]]  may be caused by :
*[[Cardiac]] causes of [[sudden cardiac death]] ([[SCD]]) depend on the [[age]] of the individual <ref name="pmid21131293">{{cite journal| author=Winkel BG, Holst AG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL | display-authors=etal| title=Nationwide study of sudden cardiac death in persons aged 1-35 years. | journal=Eur Heart J | year= 2011 | volume= 32 | issue= 8 | pages= 983-90 | pmid=21131293 | doi=10.1093/eurheartj/ehq428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21131293  }} </ref> <ref name="pmid24604905">{{cite journal| author=Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL | display-authors=etal| title=Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark. | journal=Circ Arrhythm Electrophysiol | year= 2014 | volume= 7 | issue= 2 | pages= 205-11 | pmid=24604905 | doi=10.1161/CIRCEP.113.001421 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24604905  }} </ref> <ref name="pmid27332903">{{cite journal| author=Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L | display-authors=etal| title=A Prospective Study of Sudden Cardiac Death among Children and Young Adults. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 25 | pages= 2441-52 | pmid=27332903 | doi=10.1056/NEJMoa1510687 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27332903 }} </ref> <ref name="pmid12472914">{{cite journal| author=Wisten A, Forsberg H, Krantz P, Messner T| title=Sudden cardiac death in 15-35-year olds in Sweden during 1992-99. | journal=J Intern Med | year= 2002 | volume= 252 | issue= 6 | pages= 529-36 | pmid=12472914 | doi=10.1046/j.1365-2796.2002.01038.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12472914  }} </ref> <ref name="pmid15364331">{{cite journal| author=Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B | display-authors=etal| title=Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 6 | pages= 1268-75 | pmid=15364331 | doi=10.1016/j.jacc.2004.06.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15364331  }} </ref> <ref name="pmid24344190">{{cite journal| author=Winkel BG, Risgaard B, Sadjadieh G, Bundgaard H, Haunsø S, Tfelt-Hansen J| title=Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting. | journal=Eur Heart J | year= 2014 | volume= 35 | issue= 13 | pages= 868-75 | pmid=24344190 | doi=10.1093/eurheartj/eht509 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24344190  }} </ref> <ref name="pmid18424446">{{cite journal| author=Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K | display-authors=etal| title=Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland. | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 11 | pages= 1418-23 | pmid=18424446 | doi=10.1093/eurheartj/ehn155 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18424446  }} </ref> <ref name="pmid21903060">{{cite journal| author=Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM | display-authors=etal| title=Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 12 | pages= 1254-61 | pmid=21903060 | doi=10.1016/j.jacc.2011.01.049 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21903060  }} </ref>.
*[[Coronary artery abnormality]] such as  [[coronary atherosclerosis]], [[acute MI]], coronary artery embolism, [[coronary arteritis]]<ref name="MehtaCurwin1997">{{cite journal|last1=Mehta|first1=Davendra|last2=Curwin|first2=Jay|last3=Gomes|first3=J. Anthony|last4=Fuster|first4=Valentin|title=Sudden Death in Coronary Artery Disease|journal=Circulation|volume=96|issue=9|year=1997|pages=3215–3223|issn=0009-7322|doi=10.1161/01.CIR.96.9.3215}}</ref><ref name="pmid11320390">{{cite journal |author=Eisenberg MS, Mengert TJ |title=Cardiac resuscitation |journal=N. Engl. J. Med. |volume=344 |issue=17 |pages=1304–13 |year=2001 |month=April |pmid=11320390 |doi= |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11320390&promo=ONFLNS19}}</ref>
* In young people, [[cardiomyopathy]], [[myocarditis]], [[primary electric diseases]] and [[coronary abnormalities]] predominate <ref name="pmid21131293">{{cite journal| author=Winkel BG, Holst AG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL | display-authors=etal| title=Nationwide study of sudden cardiac death in persons aged 1-35 years. | journal=Eur Heart J | year= 2011 | volume= 32 | issue= 8 | pages= 983-90 | pmid=21131293 | doi=10.1093/eurheartj/ehq428 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21131293  }} </ref> <ref name="pmid24604905">{{cite journal| author=Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL | display-authors=etal| title=Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark. | journal=Circ Arrhythm Electrophysiol | year= 2014 | volume= 7 | issue= 2 | pages= 205-11 | pmid=24604905 | doi=10.1161/CIRCEP.113.001421 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24604905  }} </ref> <ref name="pmid27332903">{{cite journal| author=Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L | display-authors=etal| title=A Prospective Study of Sudden Cardiac Death among Children and Young Adults. | journal=N Engl J Med | year= 2016 | volume= 374 | issue= 25 | pages= 2441-52 | pmid=27332903 | doi=10.1056/NEJMoa1510687 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27332903  }} </ref> <ref name="pmid12472914">{{cite journal| author=Wisten A, Forsberg H, Krantz P, Messner T| title=Sudden cardiac death in 15-35-year olds in Sweden during 1992-99. | journal=J Intern Med | year= 2002 | volume= 252 | issue= 6 | pages= 529-36 | pmid=12472914 | doi=10.1046/j.1365-2796.2002.01038.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12472914  }} </ref> <ref name="pmid15364331">{{cite journal| author=Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B | display-authors=etal| title=Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 6 | pages= 1268-75 | pmid=15364331 | doi=10.1016/j.jacc.2004.06.029 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15364331  }} </ref> <ref name="pmid24344190">{{cite journal| author=Winkel BG, Risgaard B, Sadjadieh G, Bundgaard H, Haunsø S, Tfelt-Hansen J| title=Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting. | journal=Eur Heart J | year= 2014 | volume= 35 | issue= 13 | pages= 868-75 | pmid=24344190 | doi=10.1093/eurheartj/eht509 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24344190  }} </ref> <ref name="pmid18424446">{{cite journal| author=Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K | display-authors=etal| title=Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland. | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 11 | pages= 1418-23 | pmid=18424446 | doi=10.1093/eurheartj/ehn155 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18424446  }} </ref> <ref name="pmid21903060">{{cite journal| author=Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM | display-authors=etal| title=Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. | journal=J Am Coll Cardiol | year= 2011 | volume= 58 | issue= 12 | pages= 1254-61 | pmid=21903060 | doi=10.1016/j.jacc.2011.01.049 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21903060  }} </ref>.
 
*In people who are on their fourth decade of life, [[acute coronary syndrome]] ([[ACS]]) greatly predominates <ref name="pmid31023437">{{cite journal| author=Waldmann V, Karam N, Bougouin W, Sharifzadehgan A, Dumas F, Narayanan K | display-authors=etal| title=Burden of Coronary Artery Disease as a Cause of Sudden Cardiac Arrest in the Young. | journal=J Am Coll Cardiol | year= 2019 | volume= 73 | issue= 16 | pages= 2118-2120 | pmid=31023437 | doi=10.1016/j.jacc.2019.01.064 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31023437  }} </ref> <ref name="pmid31857140">{{cite journal| author=Waldmann V, Karam N, Rischard J, Bougouin W, Sharifzadehgan A, Dumas F | display-authors=etal| title=Low rates of immediate coronary angiography among young adults resuscitated from sudden cardiac arrest. | journal=Resuscitation | year= 2020 | volume= 147 | issue=  | pages= 34-42 | pmid=31857140 | doi=10.1016/j.resuscitation.2019.12.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31857140  }} </ref>.
*[[Hypertrophy]] of [[myocardium]] such as [[HCM]], [[hypertensive heart disease]], primary or secondary [[pulmonary hypertension]]
* In elderly, [[structural diseases]] predominate <ref name="pmid24604905">{{cite journal| author=Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL | display-authors=etal| title=Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark. | journal=Circ Arrhythm Electrophysiol | year= 2014 | volume= 7 | issue= 2 | pages= 205-11 | pmid=24604905 | doi=10.1161/CIRCEP.113.001421 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24604905  }} </ref>.
*[[Myocardial disease ]] such as [[ischemic cardiomyopathy]], non-ischemic [[cardiomyopathy]], [[myocarditis]]<ref>{{cite journal|doi=10.1080/2F20961790.2019.1595352}}</ref>
*[[Valvular heart disease]] such as [[aortic stenosis]],[[aortic insufficiency]], [[mitral valve prolapse]], [[endocarditis]] <ref name="BassoPerazzolo Marra2015">{{cite journal|last1=Basso|first1=Cristina|last2=Perazzolo Marra|first2=Martina|last3=Rizzo|first3=Stefania|last4=De Lazzari|first4=Manuel|last5=Giorgi|first5=Benedetta|last6=Cipriani|first6=Alberto|last7=Frigo|first7=Anna Chiara|last8=Rigato|first8=Ilaria|last9=Migliore|first9=Federico|last10=Pilichou|first10=Kalliopi|last11=Bertaglia|first11=Emanuele|last12=Cacciavillani|first12=Luisa|last13=Bauce|first13=Barbara|last14=Corrado|first14=Domenico|last15=Thiene|first15=Gaetano|last16=Iliceto|first16=Sabino|title=Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death|journal=Circulation|volume=132|issue=7|year=2015|pages=556–566|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.115.016291}}</ref>
 
*[[Congenital heart disease]] such as [[congenital septal defect]] with [[Eisenmenger]] physiology<ref name="YapHarris2014">{{cite journal|last1=Yap|first1=Sing-Chien|last2=Harris|first2=Louise|title=Sudden cardiac death in adults with congenital heart disease|journal=Expert Review of Cardiovascular Therapy|volume=7|issue=12|year=2014|pages=1605–1620|issn=1477-9072|doi=10.1586/erc.09.153}}</ref>
*[[ Abnormality in conducting system]] such as [[Wolf-Parkinson-White syndrome]]
*Electrical instability such as  ([[CPVT]], [[LQTS]])
 
 
{| class="wikitable"
|+Multiplication table
|-
! Causes of [[sudden cardiac death]] !! [[Coronary Artery Disease]] !! [[Ideopathic dilated cardiomyopathy] !! [[Hypertrophic cardiomyopathy]]!![[Arrhythmogenic right ventricular cardiomyopathy]]!![[Valvular Heart Disease]]!! [[Congenital Heart Disease]]!![[Long QT syndrome]]!![[WPW]] syndrome!!Ideopathic monomorphic [[VT]!! Ideopathic polymorphic [[VT]]!! Primary [[VF]]!![[Sudden unexpected nocturnal death]]!!Drugs]]
|-
! Incidence of [[SCD]]
| 80%|| 10% || 2-4% per year in [[adult]], 4-6% in [[children]] and [[adolescence]]||2%||20% of post operative death after [[valvular replacement]]||
|-
! Mechanism
| [[Atherosclerosis]] in [[coronary arteries]] including: 40-86% of patients are 3 vessle disease with stenosis>75%,[[MI]]<50%, Qwave [[MI]]<25%, recent coronary thrombosis 15-64% (plaque, fissure, hemorrhage, thrombosis, healed infarct>50% in autopsy or survivors of [[SCD]], 000000Non atherosclerotic changes including [[coronary emboli]], [[coronary arthritis]], [[coronary dissection]]||[[Myocardial]] stretch, [[neuroendocrine factors]], [[electrolyte abnormality, [[proarrhythmic effect of antiarrhythmic drugs, excessive activation of [[sympathetic]] and [[renin angiotensin system]] || [[Arrhythmia]], abrupt hemodynamic deterioration, [[ischemia]]|| Fatty and fibrofaty myocardial infiltration, patchy [[myocarditis]], apoptosis of [[left ventricle]], [[left ventricular septum]] (50-67%), [[right ventricular]] inflow, outflow tract and apex( [[triangle of dysplasia]])|| [[Arrhythmia]], [[prosthetic valve dysfunction]],Coexisting [[CAD]]|| [[Tetralogy of fallout]], [[Transposition of the great arteries]], [[Aortic stenosis]], [[Pulmonary vascular obstruction]]. [[SCD]] is late presentation after surgical repair of complex [[congenital heart disease]]
|-
! Risk factors of [[SCD]]
| ||  Frequent episodes of non sustain [[VT]], [[syncope]] || Family history of [[SCD]], recurrent [[syncope]], [[sustained VT]], history of [[SCA]], massive [[LVH]], multiple episodes of non sustained [[VT]]|| ||Asymptomatic [[aotric valve disease]] is low risk for [[SCD].Risk factors of [[SCD]] in [[MVP]]: [[myxomatous]] degeneration of the [[valve]], coexisting [[mitral regurgitation]], [[LV dysfunction]]|| Risk factors of [[SCD]]  in [[TOF]]: [[QRS]] prolongation, dilated [[RV]]
|-
! Arrhythmia
| [[VT]], [[VF]] (75%), [[bradycardia]], [[asystole]](25%) || Mechanism of [[VT]]: [[bundle branch reentry tachycardia]], terminal event: [[asystole]], [[electromechanical dissociation in advanced [[LV]] dysfunction || 9|| [[ECG]] in [[normal sinus rhythm]]:inverted T waves in V1-V3, complete, incomplete [[RBBB]], epsilone wave ( terminal notch on [[QRS]] complex), [[VT]] is [[LBBB]] contour
|-
|}
 
 
 
 
 
 
 
 
 
 
::*Causes of acquired  [[Long QT]] syndrome include the following:
 
*'''Antiarrhythmic agents'''
*Class IA: [[quinidine]], [[procainamide]], [[N-acetyl procainamide]], [[disopyramide]]
*Class III: [[amiodarone]], low risk of torsade de points
*Class IV: [[bepridil]],[[ mibefradil]]
*'''[[Antihistamines]]'''
*[[Terfenadine]]
*[[Astemizole]]
*'''[[Antimicrobials]]'''
*[[Erythromycin]]
*[[Trimethoprim-sulfamethoxazole]]
*[[Clarithromycin]]
*[[Cotzimoxazole]]
*[[Azithromycin]]
*[[Ketoconazole]]
*[[Pentamidine]]
*[[Chloroquine]]
*'''[[Gastrointestinal]]'''
*[[Cisapride]]
*[[Liquid protein diets]]
*[[Anorexia nervosa]]
*'''[[Lipid-lowering]]'''
*[[Probucol]]
*'''[[Psychotropic agents]]'''
*[[Tricyclic]] and [[tetracycline antidepressants]]
*[[Haloperidol]]
*[[Phenothiazines]]
*[[Risperidone]]
*[[Selective serotonin reuptake inhibitors]]
*'''Other agents'''
*[[Organophosphates]]
*[[Diuretics]] (reduced K+, Mg2+)
*[[Vasopressin]] (severe [[bradycardia]])
*[[Chloral hydrate amantadine]]
*[[Electrolyte abnormalities]]
*[[Hypokalemia]]
*[[Hypomagnesemia]]
*[[Hypocalcemia]]
 
 
 
 
 
===Causes of [[Sudden Death]] Including [[Sudden Cardiac Death]] by Organ System===
{|style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |  
[[Amyloid cardiopathy]],
[[Congestive heart failure]],
[[Ventricular rupture]],
 
|-
|-bgcolor="LightSteelBlue"
|
*''' [[Ischemic]]'''
|bgcolor="Beige"|  
[[Hypoxia]],
[[Coronary thrombosis]],
[[Coronary vasospasm]],
[[Coronary artery aneurysm]],
[[Prinzmetal's variant angina ]],
 
|-
|-bgcolor="LightSteelBlue"
|  
*''' Pericardial'''
|bgcolor="Beige"|  
[[Cardiac tamponade]],
 
|-
|-bgcolor="LightSteelBlue"
|  
*'''[[ Myocardial]]'''
|bgcolor="Beige"|  
[[Asymmetric septal hypertrophy ]],
[[ST Elevation Myocardial Infarction]],
[[Dilated cardiomyopathy]],
[[Giant cell myocarditis ]],
[[Hypertrophic cardiomyopathy]],
Kugel-Stoloff syndrome ,
[[Myocardial infarction]],
[[Myocarditis]],
[[Rupture of the papillary muscles]],
 
|-
|-bgcolor="LightSteelBlue"
|  
*''' Endocardial/Valvular'''
|bgcolor="Beige"|
[[Mitral valve prolapse]],
[[Valvular aortic stenosis]]/insufficiency,
[[Mitral valve disruption]],
[[Endocarditis]],
[[Prosthetic valve dysfunction]],
|-
|-bgcolor="LightSteelBlue"
|  
*''' Conduction/[[Arrhythmia]]'''
|bgcolor="Beige"|  
[[Arrhythmogenic right ventricular cardiomyopathy]],
[[Arrhythmogenic right ventricular dysplasia]],
[[Brugada syndrome]],
Jervell and Lange-Nielsen Syndrome,
[[Prolonged Q-T Interval Syndrome]],
[[Multifocal ventricular premature beats ]],
[[Naxos disease ]],
[[Romano-Ward syndrome ]],
[[Sick sinus syndrome]],
[[Short QT syndrome ]],
Sinus node disease,
[[Stokes-Adams Syndrome]],
Sudden Arrhythmia Death Syndrome,
[[Wolf-Parkinson-White syndrome]],
 
|-
|-bgcolor="LightSteelBlue"
|  
*'''[[Vascular]]'''
|bgcolor="Beige"|  
[[Acute aortic insufficiency]],
[[Acute coronary syndrome]],
[[Aortic dissection]],
[[Aortic stenosis]],
Aorto-ventricular tunnel,
[[Arteritis]],
[[Coronary artery disease]],
Coronary arteries - congenital malformation ,
[[Ruptured abdominal aortic aneurysm]],
 
|-
|-bgcolor="LightSteelBlue"
|  
*'''Congenital/Developmental'''
|bgcolor="Beige"|
Congenital aortic or pulmonary valve stenosis,
[[Congenital septal defect]] with eisenmenger physiology,
[[Congenital heart block ]],
Congenital Long QT syndrome,
[[Noncompaction Cardiomyopathy]],
[[Sudden Infant Death Syndrome]],
[[Uhl anomaly ]]
|-
|-bgcolor="LightSteelBlue"
|  
*'''Chemical / [[poisoning]]'''
|bgcolor="Beige"|  
[[Snake bite]]
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Dermatologic]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''Drug Side Effect'''
|bgcolor="Beige"| [[Agalsidase beta]], [[Articaine]], [[caspofungin acetate]], [[Clozapine]], [[cytomegalovirus immune globulin]], [[Drug allergy]], [[drug overdose]], [[Dornase Alfa]], [[ferumoxytol]], [[Flucytosine]], [[galsulfase]], [[Iodixanol]], [[laronidase]], [[Lincomycin Hydrochloride]], [[Polidocanol]], [[Potassium bicarbonate]], [[pramipexole]], [[prednisolone]], [[Ramucirumab]], [[Calcium gluconate]], [[Dextran]], [[Tiagabine]]
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Ear, Nose, Throat]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Endocrine]]'''
|bgcolor="Beige"|
 
[[Diabetic ketoacidosis]] - typically from undiagnosed [[diabetes]],
[[Thyrotoxicosis]],
|-
|-bgcolor="LightSteelBlue"
|
*'''Environmental'''
|bgcolor="Beige"| [[Hypothermia]],
|-
|-bgcolor="LightSteelBlue"
|
* '''Gastroenterologic'''
|bgcolor="Beige"|
[[Appendicitis]],
[[Gastrointestinal bleeding]],
[[Retroperitoneal bleed]],
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Genetic]]'''
|bgcolor="Beige"|
[[Brugada syndrome]],
3-methylglutaconic aciduria, type 1,
[[Familial dilated cardiomyopathy ]],
Familial hypertrophic cardiomyopathy 1,
Hyperbilirubinemia transient, familial neonatal,
[[Marfan syndrome ]],
[[Timothy syndrome ]]
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Hematologic]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''Iatrogenic'''
|bgcolor="Beige"| [[Transfusion reaction]]
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Infectious Disease]]'''
|bgcolor="Beige"|
[[Flu]] mainly in the elderly, infants, infirm or chronically ill,
[[Neurocysticercosis ]], [[Lyme disease]]
 
|-
|-bgcolor="LightSteelBlue"
|
* '''[[Musculoskeletal]] / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Neurologic]]'''
|bgcolor="Beige"|
[[Apoplexy]],
[[Encephalitis]],
[[Intracranial hemmorhage]],
[[Meningitis]],
[[Stroke]],
[[Subarachnoid hemorrhage]],
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Nutritional]] / Metabolic'''
|bgcolor="Beige"|
[[3-methylglutaconic aciduria]], type 1,
[[Alpha-ketoglutarate dehydrogenase deficiency]] ,
[[Food allergy]]
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Obstetric]]/[[Gynecologic]]'''
|bgcolor="Beige"|
[[Amniotic fluid syndrome]] ,
[[Childbirth hemorrhage]],
 
|-
|-bgcolor="LightSteelBlue"
|
* '''[[Oncologic]]'''
|bgcolor="Beige"|
[[Atrial myxoma]], familial
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Opthalmologic]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''Overdose / Toxicity'''
|bgcolor="Beige"|
[[Opioid overdose]]  ,
Oxycontin [[overdose]],
Pain killer [[overdose]] ,
Sleeping pill [[overdose]]
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Psychiatric]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| 
*'''[[Pulmonary]]'''
|bgcolor="Beige"|
[[Hypercapnia]],
[[Pickwickian Syndrome]],
[[Pulmonary embolism]],
[[Tension pneumothorax]],
[[Status asthmaticus]]
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Renal]] /[[ Electrolyte]]'''
|bgcolor="Beige"|
[[Hypercalcemia]],
[[Hypokalemia]],
[[Hyperkalemia]],
|-
|-bgcolor="LightSteelBlue"
|
*'''Rheumatology / Immune / [[Allergy]]'''
|bgcolor="Beige"|
[[Amyloidosis]],
[[Anaphylaxis]],
[[Myasthenia gravis]],
[[Sarcoidosis]],
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Sexual]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
* '''[[Trauma]]'''
|bgcolor="Beige"|
[[Commotio cordis]],
[[Homicide]],
[[Motor Vehicle accident]]
 
|-
|-bgcolor="LightSteelBlue"
|
*'''[[Urologic]]'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
|
*'''Miscellaneous'''
|bgcolor="Beige"|
[[Shock]],
[[Asphyxia]],
[[Insect bite]]
[[Sepsis syndrome]],
[[Shock]]
 
|-
|}
 
==Differentiating [[sudden cardiac death]] from non-cardiac causes==
 
 
{| class="wikitable"
|-
|-bgcolor="PeachPuff"
| '''Cardiac causes of [[sudden death]]'''
|bgcolor="PeachPuff"|
'''Non cardiac causes of [[sudden death]]:''' 
|-
 
|-bgcolor="PeachPuff"
|
*Acute [[aortic insufficiency]]
*[[Acute coronary syndrome]]
*[[Aortic dissection]]
*[[Aortic stenosis]]
 
*[[Arrhythmogenic right ventricular dysplasia]]
*[[Brugada syndrome]]
*[[Cardiac tamponade]]
*[[Cardiomyopathy]]
*[[Catecholaminergic polymorphic ventricular tachycardia]]
*[[Commotio cordis]]
*[[Complete heart block]]
*[[Congenital heart disease]]
*[[Congestive heart failure]]
*[[Coronary artery disease]]
*[[Dilated cardiomyopathy]]
*[[Hypertrophic cardiomyopathy]]
*[[Jervell and Lange-Nielsen syndrome]]
* [[Long QT syndrome]], both [[congenital]] and acquired
*[[Lyme disease]]
*[[Mitral valve prolapse]]<ref name="BassoPerazzolo Marra2015">{{cite journal|last1=Basso|first1=Cristina|last2=Perazzolo Marra|first2=Martina|last3=Rizzo|first3=Stefania|last4=De Lazzari|first4=Manuel|last5=Giorgi|first5=Benedetta|last6=Cipriani|first6=Alberto|last7=Frigo|first7=Anna Chiara|last8=Rigato|first8=Ilaria|last9=Migliore|first9=Federico|last10=Pilichou|first10=Kalliopi|last11=Bertaglia|first11=Emanuele|last12=Cacciavillani|first12=Luisa|last13=Bauce|first13=Barbara|last14=Corrado|first14=Domenico|last15=Thiene|first15=Gaetano|last16=Iliceto|first16=Sabino|title=Arrhythmic Mitral Valve Prolapse and Sudden Cardiac Death|journal=Circulation|volume=132|issue=7|year=2015|pages=556–566|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.115.016291}}</ref>
 
*[[Myocarditis]]
*[[Naxos disease]]
*[[Noncompaction Cardiomyopathy]]
*[[Papillary muscle rupture]]
*[[Prolonged Q-T Interval Syndrome]]
*[[Pulmonary embolism]]
*[[Romano-Ward syndrome ]]
*[[Ruptured abdominal aortic aneurysm]]
*[[Prosthetic valve dysfunction]]
*[[Short QT syndrome]]
*[[Short QT syndrome type 1]]
*[[Short QT syndrome type 2]]
*[[Short QT syndrome type 3]]
*[[Short QT syndrome type 4]]
*[[Short QT syndrome type 5]]
*[[Sick sinus syndrome]]
*[[ST Elevation Myocardial Infarction]]
*[[Stokes-Adams Syndrome]]
*[[Sudden Infant Death Syndrome]]
*[[Timothy syndrome ]]
*[[Uhl anomaly ]]
*[[Valvular Heart Disease]]
*[[Ventricular rupture]]
*[[Wolf-Parkinson-White syndrome]] with rapid conduction
*Commotio cordis-blunt [[chest trauma]]
*[[Sudden death]] during extreme physical activity
|bgcolor="PeachPuff"|
*3-methylglutaconic aciduria, type 1
*Alpha-ketoglutarate dehydrogenase deficiency
*Amniotic fluid syndrome
*Arterial dissections with lentiginosis
*[[Anaphylaxis]]
*[[Aneurysm]]
*[[Apoplexy]]
*[[Appendicitis]]
*[[Asphyxia]]
*Birth injury
*[[Bleeding]] excessive
*Childbirth hemorrhage
*Diabetic ketoacidosis - typically from undiagnosed diabetes
*[[Drug allergy]]
*[[Drug]] [[overdose]]
*[[Encephalitis]]
*[[Fetal death]]
*[[Food allergy]]
*[[Gastrointestinal bleeding]]
*Homicide
*Hyperbilirubinemia transient, familial, neonatal
*[[Hypercalcemia]]
*[[Hypercapnia]]
*[[Hyperkalemia]]
*[[Hypokalemia]]
*[[Hypoxia]]
*[[Injury]]
*[[Insect bite]]
*[[Intracranial hemmorhage]]
*[[Marfan syndrome ]]
*[[Meningitis]]
*[[Meningococcal disease]]
*Motor Vehicle accident
*Myasthenia Gravis
*[[Neurocysticercosis ]]
*Opioid [[overdose]] 
*[[Oxycontin]] [[overdose]]
*Pain killer [[overdose]]
*[[Pickwickian Syndrome]]
*[[Poisoning]]
*[[Pulmonary embolism]]
*[[Retroperitoneal bleed]]
*[[Sepsis syndrome]]
*[[Shock]]
*[[Sleep apnea ]]
*[[Snake bite]]
*[[Status asthmaticus]]
*[[Stillbirth]]
*[[Stroke]]
*[[Subarachnoid hemorrhage]]
*[[Sudden Infant Death Syndrome]]
*[[Suicide]]
*Sleeping pill [[overdose]]
*Toxic/metabolic disturbances
*Tranquilizer addiction
*[[Tension pneumothorax]]
* Toxic/metabolic disturbances
*[[Thyrotoxicosis]]
*[[Toxic shock syndrome]]
*[[Transfusion reaction]]
*[[Venom]]
|-
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Public health]]
[[Category:Public health]]
[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
{{WH}}
{{WS}}

Latest revision as of 19:51, 19 July 2023

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3]

Overview

Sudden cardiac arrest (SCA) may be caused by underlying cardiac abnormality including coronary artery abnormality , hypertrophy of myocardium, myocardial disease, valvular heart disease, congenital heart disease, abnormality in conducting system and electrical instability. The type of cardiac disease that is associated with sudden cardiac death (SCD) depends on the age of the individual [1] [2] [3] [4] [5] [6] [7] [8].

Causes

References

  1. ↑ 1.0 1.1 1.2 Winkel BG, Holst AG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL; et al. (2011). "Nationwide study of sudden cardiac death in persons aged 1-35 years". Eur Heart J. 32 (8): 983–90. doi:10.1093/eurheartj/ehq428. PMID 21131293.
  2. ↑ 2.0 2.1 2.2 2.3 Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL; et al. (2014). "Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark". Circ Arrhythm Electrophysiol. 7 (2): 205–11. doi:10.1161/CIRCEP.113.001421. PMID 24604905.
  3. ↑ 3.0 3.1 3.2 Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L; et al. (2016). "A Prospective Study of Sudden Cardiac Death among Children and Young Adults". N Engl J Med. 374 (25): 2441–52. doi:10.1056/NEJMoa1510687. PMID 27332903.
  4. ↑ 4.0 4.1 4.2 Wisten A, Forsberg H, Krantz P, Messner T (2002). "Sudden cardiac death in 15-35-year olds in Sweden during 1992-99". J Intern Med. 252 (6): 529–36. doi:10.1046/j.1365-2796.2002.01038.x. PMID 12472914.
  5. ↑ 5.0 5.1 5.2 Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B; et al. (2004). "Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community". J Am Coll Cardiol. 44 (6): 1268–75. doi:10.1016/j.jacc.2004.06.029. PMID 15364331.
  6. ↑ 6.0 6.1 6.2 Winkel BG, Risgaard B, Sadjadieh G, Bundgaard H, Haunsø S, Tfelt-Hansen J (2014). "Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting". Eur Heart J. 35 (13): 868–75. doi:10.1093/eurheartj/eht509. PMID 24344190.
  7. ↑ 7.0 7.1 7.2 Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K; et al. (2008). "Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland". Eur Heart J. 29 (11): 1418–23. doi:10.1093/eurheartj/ehn155. PMID 18424446.
  8. ↑ 8.0 8.1 8.2 Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM; et al. (2011). "Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance". J Am Coll Cardiol. 58 (12): 1254–61. doi:10.1016/j.jacc.2011.01.049. PMID 21903060.
  9. ↑ Waldmann V, Karam N, Bougouin W, Sharifzadehgan A, Dumas F, Narayanan K; et al. (2019). "Burden of Coronary Artery Disease as a Cause of Sudden Cardiac Arrest in the Young". J Am Coll Cardiol. 73 (16): 2118–2120. doi:10.1016/j.jacc.2019.01.064. PMID 31023437.
  10. ↑ Waldmann V, Karam N, Rischard J, Bougouin W, Sharifzadehgan A, Dumas F; et al. (2020). "Low rates of immediate coronary angiography among young adults resuscitated from sudden cardiac arrest". Resuscitation. 147: 34–42. doi:10.1016/j.resuscitation.2019.12.005. PMID 31857140.
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