Pulseless ventricular tachycardia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2] Avirup Guha, M.B.B.S.[3]; Mugilan Poongkunran M.B.B.S [4]

Overview

Structural heart disease is the most common cause of pulseless ventricular tachycardia. Other causes include but are not limited to, drugs/medications, congenital heart diseases, not to mention congenital and inherited channelopathies. It is important to note that QT interval lengthening medications, as well as electrolyte disturbances, can also result in pulseless ventricular tachycardia.

Causes

Life-threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. They are mainly due to acute conditions that promote rapid dysfunction of automaticity and include. but are not limited to;^[1]^[2]^[3]^[4]

Common Causes

Causes by Organ System

Cardiovascular	Acute coronary syndrome, Andersen cardiodysrhythmic periodic paralysis, arrhythmogenic right ventricular dysplasia, AV block, Brugada syndrome, cardiomyopathy, catecholaminergic polymorphic ventricular tachycardia, congenital heart disease, congestive heart failure, dilated cardiomyopathy, hypertensive heart disease, hypertrophic cardiomyopathy, ischemic heart disease, Jervell and Lange-Nielsen syndrome, long QT syndrome, mitral valve prolapse, myocardial infarction, myocarditis, noncompaction cardiomyopathy, NSTEMI, QT lengthening, right ventricular outflow tract tachycardia, Romano-Ward syndrome, 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, STEMI, Timothy syndrome, torsade de pointes, unstable angina, valvular heart disease, ventricular aneurysm, Wolff-Parkinson-White syndrome
Chemical / poisoning	Acetaminophen, arsenic trioxide, arsenicals, methanol, aconitine
Dermatologic	No underlying causes
Drug Side Effect	Acetaminophen, alimemazine, almokalant, amiodarone, amitriptyline, amphetamines, antiarrhythmics, asenapine, aspirin, astemizole, azimilide, azithromycin, bepridil, bretylium, bromocriptine, budipine, chloroquine, cibenzoline, cisapride, citalopram, claritin, clomipramine, clozapine, cocaine, crizotinib, desipramine, digitalis, diphenhydramine, disopyramide, dofetilide, dolasetron, doxepin, dronedarone, droperidol, Eletriptan, eribulin mesylate, erythromycin, fluconazole, fosphenytoin, grepafloxacin, halofantrine, haloperidol, ibutilide, imipramine, indapamide, inotropes, ketanserin, ketoconazole, lidoflazine, lubeluzole, methadone, methadyl acetate, methamphetamine, midodrine, mizolastine, moxifloxacin, naratriptan, nicardipine, nilotinib, Nizatidine, ondansetron, pasireotide, pazopanib, pentamidine, pergolide, phenothiazines, pimozide, piperaquine, prenylamine, probucol, procainamide, propoxyphene, quinidine, quinine, ranolazine, retigabine, ritodrine, ritonavir, saquinavir, sertindole, sotalol, sparfloxacin, sumatriptan, sympathomimetic agents, tedisamil, telithromycin, terfenadine, terodiline, tetrabenazine, theophylline, thioridazine, tricyclic antidepressants, vandetanib, vemurafenib, venlafaxine, vernakalant, voriconazole, vorinostat, ziprasidone, zotepine, zuclopenthixol
Ear Nose Throat	No underlying causes
Endocrine	Addisonian crisis, Cushing's syndrome, diabetic ketoacidosis, hyperthyroidism, hypothyroidism, myxedema, pheochromocytoma
Environmental	Heat stroke, hypothermia, zero gravity
Gastroenterologic	No underlying causes
Genetic	Andersen cardiodysrhythmic periodic paralysis, channelopathies, Fabry disease, Jervell and Lange-Nielsen syndrome, myotonic dystrophy, Romano-Ward 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, Timothy syndrome
Hematologic	No underlying causes
Iatrogenic	Cardioversion, defibrillation, heart surgery, post-anesthesia, pulmonary artery catheter, right heart catheterisation, runaway pacemaker syndrome, cardiac transplantation
Infectious Disease	Chagas heart disease, Lyme disease, myocarditis
Musculoskeletal / Ortho	Andersen cardiodysrhythmic periodic paralysis, Timothy syndrome, myotonic dystrophy
Neurologic	Acute stroke
Nutritional / Metabolic	Acid-base disturbances, acidosis, acute starvation, electrolyte imbalance, hyperkalaemia, hypocalcemia, hypoglycaemia, hypokalemia, hypomagnesemia
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	Alimemazine, almokalant, amiodarone, amitriptyline, amphetamines, antiarrhythmics, bretylium, budipine, chloroquine, cibenzoline, cisapride, clomipramine, clozapine, crizotinib, desipramine, digitalis, diphenhydramine, disopyramide, dofetilide, doxepin, dronedarone, droperidol, eribulin mesylate, halofantrine, haloperidol, ibutilide, lidoflazine, methadone, methadyl acetate, methamphetamine, midodrine, mizolastine, pentamidine, phenothiazines, pimozide, piperaquine, prenylamine, probucol, procainamide, propoxyphene, quinidine, quinine, ranolazine, retigabine, ritodrine, ritonavir, sertindole, tedisamil, telithromycin, terfenadine, terodiline, tetrabenazine, thioridazine, vandetanib, vemurafenib, venlafaxine, voriconazole, ziprasidone, zotepine, zuclopenthixol
Psychiatric	Anorexia nervosa, major depression, Takotsubo cardiomyopathy
Pulmonary	Chronic pulmonary artery hypertension, COPD, hypoxia, obstructive sleep apnea
Renal / Electrolyte	Acid-base disturbances, acidosis, electrolyte imbalance, hyperkalaemia, hypocalcemia, hypoglycaemia, hypokalemia, hypomagnesemia, renal failure, uremia
Rheum / Immune / Allergy	Amyloidosis, cardiac sarcoidosis, giant cell myocarditis, rheumatoid arthritis, systemic lupus erythematosus
Sexual	No underlying causes
Trauma	Blunt chest trauma, myocardial contusion
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Alcoholism, idiopathic

Causes in Alphabetical Order

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↑ Ajijola, Olujimi A.; Tung, Roderick; Shivkumar, Kalyanam (2014). "Ventricular tachycardia in ischemic heart disease substrates". Indian Heart Journal. 66: S24–S34. doi:10.1016/j.ihj.2013.12.039. ISSN 0019-4832.
↑ Meja Lopez, Eliany; Malhotra, Rohit (2019). "Ventricular Tachycardia in Structural Heart Disease". Journal of Innovations in Cardiac Rhythm Management. 10 (8): 3762–3773. doi:10.19102/icrm.2019.100801. ISSN 2156-3977.
↑ Coughtrie, Abigail L; Behr, Elijah R; Layton, Deborah; Marshall, Vanessa; Camm, A John; Shakir, Saad A W (2017). "Drugs and life-threatening ventricular arrhythmia risk: results from the DARE study cohort". BMJ Open. 7 (10): e016627. doi:10.1136/bmjopen-2017-016627. ISSN 2044-6055.
↑ El-Sherif, Nabil (2001). "Mechanism of Ventricular Arrhythmias in the Long QT Syndrome: On Hermeneutics". Journal of Cardiovascular Electrophysiology. 12 (8): 973–976. doi:10.1046/j.1540-8167.2001.00973.x. ISSN 1045-3873.

[AjijolaTung2014-1] Ajijola, Olujimi A.; Tung, Roderick; Shivkumar, Kalyanam (2014). "Ventricular tachycardia in ischemic heart disease substrates". Indian Heart Journal. 66: S24–S34. doi:10.1016/j.ihj.2013.12.039. ISSN 0019-4832.

[Meja_LopezMalhotra2019-2] Meja Lopez, Eliany; Malhotra, Rohit (2019). "Ventricular Tachycardia in Structural Heart Disease". Journal of Innovations in Cardiac Rhythm Management. 10 (8): 3762–3773. doi:10.19102/icrm.2019.100801. ISSN 2156-3977.

[CoughtrieBehr2017-3] Coughtrie, Abigail L; Behr, Elijah R; Layton, Deborah; Marshall, Vanessa; Camm, A John; Shakir, Saad A W (2017). "Drugs and life-threatening ventricular arrhythmia risk: results from the DARE study cohort". BMJ Open. 7 (10): e016627. doi:10.1136/bmjopen-2017-016627. ISSN 2044-6055.

[El-Sherif2001-4] El-Sherif, Nabil (2001). "Mechanism of Ventricular Arrhythmias in the Long QT Syndrome: On Hermeneutics". Journal of Cardiovascular Electrophysiology. 12 (8): 973–976. doi:10.1046/j.1540-8167.2001.00973.x. ISSN 1045-3873.

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