Sudden cardiac death causes

Sudden cardiac death Microchapters
Home
Patient Information
Sudden Cardiac versus Non-Cardiac Death
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Definitions and Diagnosis
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Urgent Treatment
Post Arrest Care and Prevention
Ethical Issues
Sudden cardiac death causes On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Sudden cardiac death causes All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Sudden cardiac death causes
CDC on Sudden cardiac death causes
Sudden cardiac death causes in the news
Blogs on Sudden cardiac death causes
Directions to Hospitals Treating Sudden cardiac death
Risk calculators and risk factors for Sudden cardiac death causes

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

Overview

Cardiac arrest is synonymous with Clinical death. All disease processes leading to death have a period of (potentially) reversible cardiac arrest. The causes of arrest are, therefore, numerous. However, many of these conditions, rather than causing an arrest themselves, promote one of the reversible causes, which then triggers the arrest (e.g. Choking leads to Hypoxia which in turn leads to an arrest). In some cases, the underlying mechanism cannot be overcome, leading to an unsuccessful resuscitation. Among adults, ischemic heart disease is the predominant cause of arrest. At autopsy 30% of victims show signs of recent myocardial infarction. Other cardiac conditions potentially leading to arrest include structural abnormalities, arrhythmias, and cardiomyopathies. Non-cardiac causes include infections, overdoses, trauma and cancer, in addition to many others.

Causes

Sudden cardiac arrest may be caused by :

• Coronary artery abnormality such as coronary atherosclerosis, acute MI, coronary artery embolism, coronary arteritis

• 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 of Sudden Death Including Sudden Cardiac Death by Organ System

Cardiovascular	Amyloid cardiopathy, Congestive heart failure, Ventricular rupture,
Ischemic	Hypoxia, Coronary thrombosis, Coronary vasospasm, Coronary artery aneurysm, Prinzmetal's variant angina ,
Pericardial	Cardiac tamponade,
Myocardial	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,
Endocardial/Valvular	Mitral valve prolapse, Valvular aortic stenosis/insufficiency, Mitral valve disruption, Endocarditis, Prosthetic valve dysfunction,
Conduction/Arrhythmia	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,
Vascular	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,
Congenital/Developmental	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
Chemical / poisoning	Snake bite
Dermatologic	No underlying causes
Drug Side Effect	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
Ear, Nose, Throat	No underlying causes
Endocrine	Diabetic ketoacidosis - typically from undiagnosed diabetes, Thyrotoxicosis,
Environmental	Hypothermia,
Gastroenterologic	Appendicitis, Gastrointestinal bleeding, Retroperitoneal bleed,
Genetic	Brugada syndrome, 3-methylglutaconic aciduria, type 1, Familial dilated cardiomyopathy , Familial hypertrophic cardiomyopathy 1, Hyperbilirubinemia transient, familial neonatal, Marfan syndrome , Timothy syndrome
Hematologic	No underlying causes
Iatrogenic	Transfusion reaction
Infectious Disease	Flu mainly in the elderly, infants, infirm or chronically ill, Neurocysticercosis , Lyme disease
Musculoskeletal / Ortho	No underlying causes
Neurologic	Apoplexy, Encephalitis, Intracranial hemmorhage, Meningitis, Stroke, Subarachnoid hemorrhage,
Nutritional / Metabolic	3-methylglutaconic aciduria, type 1, Alpha-ketoglutarate dehydrogenase deficiency , Food allergy
Obstetric/Gynecologic	Amniotic fluid syndrome , Childbirth hemorrhage,
Oncologic	Atrial myxoma, familial
Opthalmologic	No underlying causes
Overdose / Toxicity	Opioid overdose , Oxycontin overdose, Pain killer overdose , Sleeping pill overdose
Psychiatric	No underlying causes
Pulmonary	Hypercapnia, Pickwickian Syndrome, Pulmonary embolism, Tension pneumothorax, Status asthmaticus
Renal /Electrolyte	Hypercalcemia, Hypokalemia, Hyperkalemia,
Rheumatology / Immune / Allergy	Amyloidosis, Anaphylaxis, Myasthenia gravis, Sarcoidosis,
Sexual	No underlying causes
Trauma	Commotio cordis, Homicide, Motor Vehicle accident
Urologic	No underlying causes
Miscellaneous	Shock, Asphyxia, Insect bite Sepsis syndrome, Shock

Differentiating sudden cardiac death from non-cardiac causes

Cardiac causes of sudden death

Non cardiac causes of sudden death:

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 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

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

Complete Differential Diagnosis for Sudden Cardiac Death

Cardiac causes of sudden cardiac death

Non cardiac causes of sudden cardiac death:

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 Kugel-Stoloff syndrome Long QT syndrome, both congenital and acquired Lyme disease Mitral valve prolapse Myocarditis Naxos disease Noncompaction Cardiomyopathy Papillary muscle rupture Prolonged Q-T Interval Syndrome Pulmonary embolism Romano-Ward syndrome Ruptured abdominal aortic aneurysm 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

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

Complete Differential Diagnosis for Sudden Non-Cardiac Death

• 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
• Flu mainly in the elderly, infants, infirm or chronically ill
• 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

Causes of Sudden Death Including Sudden Cardiac Death by Organ System

Cardiovascular	Amyloid cardiopathy, Congestive heart failure, Ventricular rupture,
* Ischemic	Hypoxia, Coronary thrombosis, Coronary vasospasm, Coronary artery aneurysm, Prinzmetal's variant angina ,
* Pericardial	Cardiac tamponade,
* Myocardial	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,
* Endocardial/Valvular	Mitral valve prolapse, [[Valvular aortic stenosis/insufficiency], Mitral valve disruption, Endocarditis, Prosthetic valve dysfunction,
* Conduction/Arrhythmia	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,
* Vascular	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,
Congenital/Developmental	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
Chemical / poisoning	Snake bite
Dermatologic	No underlying causes
Drug Side Effect	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
Ear Nose Throat	No underlying causes
Endocrine	Catecholaminergic polymorphic ventricular tachycardia, Diabetic ketoacidosis - typically from undiagnosed diabetes, Thyrotoxicosis,
Environmental	Hypothermia,
Gastroenterologic	Appendicitis, Gastrointestinal bleeding, Retroperitoneal bleed,
Genetic	Brugada syndrome, 3-methylglutaconic aciduria, type 1, Familial dilated cardiomyopathy , Familial hypertrophic cardiomyopathy 1, Hyperbilirubinemia transient, familial neonatal, Marfan syndrome , Timothy syndrome
Hematologic	No underlying causes
Iatrogenic	Transfusion reaction
Infectious Disease	Flu mainly in the elderly, infants, infirm or chronically ill, Neurocysticercosis , Lyme disease
Musculoskeletal / Ortho	No underlying causes
Neurologic	Apoplexy, Encephalitis, Intracranial hemmorhage, Meningitis, Stroke, Subarachnoid hemorrhage,
Nutritional / Metabolic	3-methylglutaconic aciduria, type 1, Alpha-ketoglutarate dehydrogenase deficiency , Food allergy
Obstetric/Gynecologic	Amniotic fluid syndrome , Childbirth hemorrhage,
Oncologic	Atrial myxoma, familial
Opthalmologic	No underlying causes
Overdose / Toxicity	Opioid overdose , Oxycontin overdose, Pain killer overdose , Sleeping pill overdose
Psychiatric	No underlying causes
Pulmonary	Hypercapnia, Pickwickian Syndrome, Pulmonary embolism, Tension pneumothorax, Status asthmaticus
Renal / Electrolyte	Hypercalcemia, Hypokalemia, Hyperkalemia,
Rheum / Immune / Allergy	Amyloidosis, Anaphylaxis, Myasthenia gravis, Sarcoidosis,
Sexual	No underlying causes
Trauma	Commotio cordis, Homicide, Motor Vehicle accident
Urologic	No underlying causes
Miscellaneous	Shock, Asphyxia, Insect bite Sepsis syndrome, Shock

Causes of Sudden Death Including Sudden Cardiac Death in Alphabetical Order

3-methylglutaconic aciduria, type 1 Acute aortic insufficiency Acute coronary syndrome Alpha-ketoglutarate dehydrogenase deficiency Amniotic fluid syndrome Amyloid cardiopathy Anaphylaxis Aneurysm Aortic dissection Aortic stenosis Aorto-ventricular tunnel Apoplexy Appendicitis Arrhythmogenic right ventricular dysplasia Arterial dissections with lentiginosis Asphyxia Asymmetric septal hypertrophy Atrial cardiomyopathy with heart block Atrial fibrillation, familial 1 Atrial myxoma, familial Bleeding excessive Brugada syndrome Cardiac tamponade Cardiomyopathy dilated with conduction defect Catecholaminergic polymorphic ventricular tachycardia Childbirth hemorrhage Commotio cordis Complete heart block Congenital heart block Congenital heart disease Congestive heart failure Coronary arteries - congenital malformation Coronary artery disease Cytomegalovirus immune globulin Diabetic ketoacidosis - typically from undiagnosed diabetes Drug allergy Drug overdose Encephalitis Familial dilated cardiomyopathy Familial hypertrophic cardiomyopathy 1 Flumainly in the elderly, infants, infirm or chronically ill Food allergy Gastrointestinal bleeding Giant cell myocarditis Heart attack Heart failure Homicide Hyperbilirubinemia transient, familial, neonatal Hypercalcemia Hypercapnia Hyperkalemia Hypokalemia Hypoxia Injury Insect bite Intracranial hemmorhage Iodixanol Jervell and Lange-Nielsen syndrome Kugel-Stoloff syndrome

Marfan syndrome Meningitis Meningococcal disease Mitral valve prolapse Multifocal ventricular premature beats Myasthenia gravis Myocarditis Naxos disease Neurocysticercosis Noncompaction Cardiomyopathy Opioid overdose Oxycontin overdose Pain killer overdose Papillary muscle rupture Paroxysmal ventricular fibrillation Pickwickian Syndrome Poisoning Polymorphic catecholergic ventricular tachycardia Prescribed medication addiction Prinzmetal's variant angina Prolonged Q-T Interval Syndrome Pulmonary embolism Retroperitoneal bleed Motor Vehicle accident Romano-Ward syndrome Ruptured abdominal aortic aneurysm Sepsis syndrome Shock Short QT syndrome Sick sinus syndrome Sinus node disease Sleep apnea Sleeping pill overdose Snake bite ST Elevation Myocardial Infarction Status asthmaticus Stillbirth Stokes-Adams Syndrome Stroke Subaortic stenosis - short stature syndrome Subarachnoid hemorrhage Sudden Arrhythmia Death Syndrome Sudden Infant Death Syndrome Suicide Tension pneumothorax Thyrotoxicosis Timothy syndrome Toxic shock syndrome Toxic/metabolic disturbances Tranquilizer addiction Transfusion reaction Uhl anomaly Valvular Heart Disease Venom Ventricular rupture Ventricular tachycardia, catecholaminergic polymorphic, 1 Wolf-Parkinson-White syndrome