Sudden cardiac death

"Cardiac death" redirects here. For the legal definition, see organ donation § Brain death versus cardiac death.
Sudden cardiac death
Classification and external resources
ICD-10 I46.1
eMedicine article/151907
MeSH D016757

Sudden cardiac death (SCD) is usually from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms.[1]

Signs and symptoms

Signs of sudden cardiac death include the following:[2]

Causes

Cardiac myofiber break-up(MFB) is a marker of ventricular fibrillation in SCD.
Coronary artery disease

The most common cause of sudden cardiac death in adults is ventricular fibrillation (v-fib), brought on by acute coronary ischemia.[3] Cases have shown that the most common finding at postmortem examination of SCD is chronic high-grade stenosis of at least one segment of a major coronary artery,[4] the arteries that supply the heart muscle with its blood supply. Left ventricular hypertrophy is thought to be the leading cause of sudden cardiac death in the adult population.[5] This is most commonly the result of longstanding high blood pressure which has caused secondary damage to the wall of the main pumping chamber of the heart, the left ventricle.[6]

Although the most frequent cause of sudden cardiac death is ventricular fibrillation, other causes include the following:[7]

Mechanism

Ventricular fibrillation

The mechanism of death in the majority of patients dying of sudden cardiac death is ventricular fibrillation.[8] Structural changes in the diseased heart as a result of inherited factors (mutations in ion-channel coding genes for example) cannot explain the suddenness of SCD.[9] Also, sudden cardiac death could be the consequence of electric-mechanical disjunction and bradyarrhythmias.[10][11]

Diagnosis

Sudden cardiac death by definition cannot be diagnosed as it has already happened. However, the risk factors for sudden cardiac arrest and subsequent death can be diagnosed in a variety of ways via an EKG, echocardiogram, MUGA test, cardiac catheterization, and blood tests.[12]

Treatment

Coronary artery bypass graft

Should coronary heart disease be diagnosed, percutaneous coronary intervention or coronary artery bypass grafting (procedures performed to help restore blood flow via narrowed arteries) may be the procedures of choice.[13] Treatment with marine-derived omega-3 polyunsaturated fatty acids (PUFAs) has been promoted for the prevention of sudden cardiac death due to its postulated ability to lower triglyceride levels, prevent serious arrhythmias, decrease platelet aggregation, and lower blood pressure.[14] However, according to a recent systematic review and meta-analysis, omega-3 PUFA supplementation has not been associated with a lower risk of sudden cardiac death based on absolute measures of association (RD, −0.01; 95% CI, −0.02 to 0.00; P = .09; I2 = 78%).[15]

Epidemiology

Sudden cardiac death accounts for more than half of all cardiac deaths. In the United States, it claims the lives of 250,000 to 310,000 people annually. It is also the first manifestation of heart disease for the majority of individuals. Consequently, better management of heart disease through lifestyle factors is recommended.[16]

See also

References

  1. ↑ Myerburg, Robert J. "Cardiac Arrest and Sudden Cardiac Death" in Heart Disease: A Textbook of Cardiovascular Medicine, 7th edition. Philadelphia: WB Saunders, 2005.
  2. ↑ "What Are the Signs and Symptoms of Sudden Cardiac Arrest?". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  3. ↑ Koplan, Bruce A.; Stevenson, William G. (2009). "Ventricular Tachycardia and Sudden Cardiac Death". Mayo Clinic Proceedings 84 (3): 289–297. doi:10.4065/84.3.289. ISSN 0025-6196. PMC 2664600. PMID 19252119.
  4. ↑ Fuster, Valentin; Topol, Eric J.; Nabel, Elizabeth G. (2005). Atherothrombosis and Coronary Artery Disease. Lippincott Williams & Wilkins. ISBN 9780781735834.
  5. ↑ Stevens, Steven M.; Reinier, Kyndaron; Chugh, Sumeet S. (2013). "Increased Left Ventricular Mass as a Predictor of Sudden Cardiac Death Is it Time to Put it to The Test?". Circulation: Arrhythmia and Electrophysiology 6 (1): 212–217. doi:10.1161/CIRCEP.112.974931. ISSN 1941-3149. PMID 23424223.
  6. ↑ Katholi RE, Couri DM (2011). "Left Ventricular Hypertrophy: Major Risk Factor in Patients with Hypertension: Update and Practical Clinical Applications". Int J Hypertens.: 495349. doi:10.4061/2011/495349. PMC 3132610. PMID 21755036.
  7. ↑ "What Causes Sudden Cardiac Arrest?". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  8. ↑ "What Is Sudden Cardiac Arrest?". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  9. ↑ Rubart, Michael; Zipes, Douglas P. (2005). "Mechanisms of sudden cardiac death". Journal of Clinical Investigation 115 (9): 2305–2315. doi:10.1172/JCI26381. ISSN 0021-9738. PMC 1193893. PMID 16138184.
  10. ↑ Bunch, T. Jared; Hohnloser, Stefan H.; Gersh, Bernard J. (2007). "Mechanisms of Sudden Cardiac Death in Myocardial Infarction Survivors Insights From the Randomized Trials of Implantable Cardioverter-Defibrillators". Circulation 115 (18): 2451–2457. doi:10.1161/CIRCULATIONAHA.106.683235. ISSN 0009-7322. PMID 17485594.
  11. ↑ "Types of Arrhythmia". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  12. ↑ "How Is Sudden Cardiac Arrest Diagnosed?". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  13. ↑ "How Is Sudden Cardiac Arrest Treated?". National Heart, Lung and Blood Institute. 1 April 2011. Retrieved 2015-06-21.
  14. ↑ Neil K. Kaneshiro (2 August 2011). "Omega-3 fatty acids". MedlinePlus Medical Encyclopedia. Retrieved 2015-06-21.
  15. ↑ Evangelos C. Rizos, Evangelia E. Ntzani, Eftychia Bika, Michael S. Kostapanos, Moses S. Elisaf (September 2012). "Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events A Systematic Review and Meta-analysis". JAMA 308 (10): 1024–1033. doi:10.1001/2012.jama.11374. PMID 22968891.
  16. ↑ Chiuve, Stephanie E.; Fung, Teresa T.; Rexrode, Kathryn M.; Spiegelman, Donna; Manson, JoAnn E.; Stampfer, Meir J.; Albert, Christine M. (2011-07-06). "Adherence to a low-risk, healthy lifestyle and risk of sudden cardiac death among women". JAMA 306 (1): 62–69. doi:10.1001/jama.2011.907. ISSN 1538-3598. PMC 3210472. PMID 21730242.

External links

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