Sudden cardiac death diagnostic study of choice: Difference between revisions
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* Multiple [[premature ventricular contractions]] (9%) | * Multiple [[premature ventricular contractions]] (9%) | ||
* [[Normal ECG]] (9%) | * [[Normal ECG]] (9%) | ||
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Revision as of 08:19, 30 January 2021
Diagnostic Criteria
- The diagnosis of sudden cardiac arrest is made when the following diagnostic criteria are met:
- Absence of a palpable pulse of the heart[1]
- Absent carotid pulse
- Gasping respiration or NO respiration
- Loss of consciousness due to cerebral hypoperfusion
Symptoms
- Symptoms related to arrhythmia or underlying heart disease within one hour before cardiac arrest may include the following:[4]
- Palpitations
- lightheadedness
- syncope
- dyspnea
- chest pain
- cardiac arrest
- Dyspnea at rest or on exertion
- orthopnea
- paroxysmal nocturnal dyspnea
- chest pain, edema
Physical Examination
- Patients with cardiac arrest usually appear cyanotic.
- Physical examination may be remarkable for:
Laboratory Findings
- An elevated concentration of brain natriuretic peptide (BNP) predicts has been shown as the predictor of ventricular arrhythmia and sudden cardiac death.[5]
Electrocardiogram
An ECG may be helpful in the diagnosis of Sudden cardiac death. Findings on ECG associated with sudden cardiac arrest include:[6]
- Sinus tachycardia (39%)
- Abnormal T-wave inversions (30%)
- Prolonged QT interval (26%)
- Left/right atrial abnormality (22%)
- LVH (17%)
- Abnormal frontal QRS axis (17%)
- Delayed QRS-transition zone in precordial leads (13%)
- Pathological Q waves (13%)
- intraventricular conduction delays (9%)
- Multiple premature ventricular contractions (9%)
- Normal ECG (9%)
References
- ↑ Harrison's Principles of Internal Medicine 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7
- ↑ Zimetbaum, Peter; Josephson, Mark E. (1998). "Evaluation of Patients with Palpitations". New England Journal of Medicine. 338 (19): 1369–1373. doi:10.1056/NEJM199805073381907. ISSN 0028-4793.
- ↑ Noda, Takashi; Shimizu, Wataru; Taguchi, Atsushi; Aiba, Takeshi; Satomi, Kazuhiro; Suyama, Kazuhiro; Kurita, Takashi; Aihara, Naohiko; Kamakura, Shiro (2005). "Malignant Entity of Idiopathic Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Initiated by Premature Extrasystoles Originating From the Right Ventricular Outflow Tract". Journal of the American College of Cardiology. 46 (7): 1288–1294. doi:10.1016/j.jacc.2005.05.077. ISSN 0735-1097.
- ↑ Marijon E, Uy-Evanado A, Dumas F, Karam N, Reinier K, Teodorescu C, Narayanan K, Gunson K, Jui J, Jouven X, Chugh SS (January 2016). "Warning Symptoms Are Associated With Survival From Sudden Cardiac Arrest". Ann Intern Med. 164 (1): 23–9. doi:10.7326/M14-2342. PMC 5624713. PMID 26720493.
- ↑ Scott, Paul A.; Barry, James; Roberts, Paul R.; Morgan, John M. (2009). "Brain natriuretic peptide for the prediction of sudden cardiac death and ventricular arrhythmias: a meta-analysis". European Journal of Heart Failure. 11 (10): 958–966. doi:10.1093/eurjhf/hfp123. ISSN 1388-9842.
- ↑ Jayaraman, Reshmy; Reinier, Kyndaron; Nair, Sandeep; Aro, Aapo L.; Uy-Evanado, Audrey; Rusinaru, Carmen; Stecker, Eric C.; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S. (2018). "Risk Factors of Sudden Cardiac Death in the Young". Circulation. 137 (15): 1561–1570. doi:10.1161/CIRCULATIONAHA.117.031262. ISSN 0009-7322.