• Definitions
• Synonyms and related keyword: sudden arrest
• Background
• Pathophysiologic
• Frequency
• Mortality/Morbidity
• Race
• Sex
• Age
• Epidemiology
• Prevalence
• Incidence
• The causes of sudden death
  view subtopics The causes of sudden death
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  • Ischemic heart disease
  • Ischemic heart disease
  • Hypertension
  • Heart failure
  • Pulmonar embolism
  • Dilated cardiomyopathy (DCM)
  • Hypertrophic cardiomyopathy (HCM)
  • Restrictive cardiomyopathy (RCM)
  • Arrhythmogenic right ventricular dysplasia(ARVD);
  • Infiltrative cardiomyopathy
  • Glycogen storage disease
  • Isolated ventricular noncompaction (IVNC)
  • Cardiomyopathies due to defective energy metabolism: Mitochondrial disease: Key Sayre, medium chain acyl-coenzyme A dehydrogenase (MCAD) deficiency.
  • Carnitine deficiency
  • Endocardial Fibroelastosis
  • Chagas' disease
  • Myocarditis
  • Valvular disease:
    (a) Aortic stenosis.
    (b) Aortic insufficiency /Aortic dissection or aneurysmal rupture is the other major cause of out-of-hospital nonarrhythmic cardiovascular death. Predisposing factors for aortic dissection: genetic deficiencies of collagen Marfan syndrome, Ehlers-Danlos syndrome, and aortic cystic medial necrosis.
    (c) Mitral valve prolapse (MVP).
  • Congenital heart disease: Congenital Coronary artery anomalies, congenital aortic stenosis, cystic medial necrosis, and sinus node artery obstruction. Tetralogy of Fallot after surgery, Transposition of the great arteries, Fontan operation, Marfan syndrome, Eisenmenger syndrome, congenital heart block, Ebstein anomaly,
  • Congenital Left Ventricular Aneurysms and diverticula’s
  • Kawasaki syndrome
  • Long QT syndrome:
    (a) Hereditary, idiopathic or congenital long QT syndrome
    (b) Acquired long QT syndrome
  • Primary pulmonary hypertension
  • Commotio cordis (traumatic blow to the chest wall causing VT/VF)
  • Congenital short QT syndrome (SQTS)
  • Wolff-Parkinson-White syndrome(WPWS)
  • Primary VT
  • Brugada syndrome
  • Sudden unexpected nocturnal death syndrome (SUNDS)
  • Mixed forms or overlapping clinical phenotypes:
    (a) Brugada syndrome and LQTS variant LQT3
    (b) Brugada syndrome and Lenègre disease
    (c) Brugada syndrome and sinus node dysfunction
  • Progressive cardiac conduction defect (PCCD)
    (a) Lenègre syndrome
    (b) Lev syndrome
  • Idiopathic ventricular fibrillation
  • Sudden infant death syndrome (SIDS)
  • Catecholaminergic polymorphic ventricular tachycardia( CPVT)
  • Short coupled variant of torsade de pointes, polymorphic ventricular tachycardia or truly torsade de pointe without long QT
  • Bi-directional ventricular tachycardia
  • Beta2-adrenergic receptor genetic variants: Right ventricular outflow tract ventricular tachycardia
  • Lown-Ganong-Levine syndrome( LGLS)
  • Cardiac sarcoidosis
  • Recreational drug abuse
  • Sudden death in hemodialysis patients
  • Cardiac tumors
  • Giant cell coronary arteritis
  • Beta2-adrenergic receptor polymorphisms and sudden cardiac death
  • After butane gas inhalation
  • Neurological meningo-cerebral causes: Brain infarction
  • Acute leukemias
  • Obesity and the metabolic syndrome.
  • Alergic causes
  • Hematologic causes
  • Endocrinological cause
• Clinical Testing
  view subtopics Clinical Testing
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  • Value of History Family history
  • Value of physical examination
  • Value of non invasive and invasive tests
  • Electrocardiography (ECG or EKG)
  • ECG with modified protocol
  • Vectorcardiography (VCG)
  • Signal-Averaged Electrocardiogram (SAECG) or High-Resolution Electrocardiography
  • Ambulatory monitoring Ambulatory Electrocardiography Recorders or Long-Term Electrocardiographic Recording
  • Intermitent Recorders
  • Memory-Looping Event Monitoring;
  • Heart Rate Variability from 24hours Holter Recording (HRV)
  • QT Dispersion
  • Microvolt T-Wave Alternans (TWA)
  • Heart rate turbulence
  • T peak-Tend and T peak-Tend dispersion
  • Ambulatory monitoring;
  • Exercise Stress Tests or Treadmill Exercise Test
  • Cardiopulmonary Metabolic Exercise Testing or Exercise Testing (CMET)
  • Body-Surface Potential Maps (BSPM)
  • Chest Roentgenogram or chest x-ray
  • Conventional Echocardiography or Trans-thoracic Echocardiography (TTE): M-mode and Two-Dimensional and Doppler Echocardiography
  • Trans-Esophageal Echocardiography or Biplanar transesophageal Echocardiography (TEE)
  • Three-Dimensional Echocardiography or Real-Time Three-Dimensional (3D) Echocardiography (RT3DE)
  • Intracardiac Ultrasound or Intracardiac Echocardiography (ICE)
  • Cardiac Magnetic Resonance Imaging or Nuclear Magnetic Resonance (CMRI, MRI or NMR) and Delayed-Enhancement Magnetic Resonance Imaging (gadodiamide MDE-MRI)
  • Ultrafast Computed Tomography (UFCT) or Electron-Bean Computed Tomography (EBCT);
  • Contrast Enhanced ECG gated Computed Tomography (CT)
  • Gallium-67 scintigraphy
  • Electrocardiographically (ECG)-gated multi-detector row computed tomography (CT);
  • Radionuclide Angiography or Radionuclide Ventriculography (RNV)
  • Genetic investigations
  • Plasma levels of brain natriuretic peptide (BNP)
  • Estimation of EF by echocardiogram or other non-invasive methods
  • Electrophysiologic study response to programmed electrical stimulation (PES) (INDUCTION)
  • Cardiac catheterization: ejection fraction
  • Endomyocardial biopsy (EMB)
  • Postmortem magnetic resonance imaging (PMMRI)
• Treatment
  view subtopics Treatment
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  • Drugs
  • Balloon angioplasty or PTCA
  • Antiarrhythmic medicine
  • Implantable cardioverter / defibrillator
  • Implantable pacemaker
  • Interventional procedures or surgery
  • Coronary artery bypass surgery
  • Left ventricular reconstruction surgery (surgical removal of the infarcted or dead area of heart tissue)
  • Heart transplantation
• Sudden death in athletes
  view subtopics Sudden death in athletes
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  • Causes:
    (a) In young (<35 years old)
    (b) In veterans(>35 years old)
  • Prevelence
  • Screening: Value of historic, physical examination, electrocardiographic features and others methodologies.
  • The athlete at heart characteristic.
  • Asthma deaths and the athlete.
  • Commotio cordis in athlete.
  • Trials
  • Guideline
• The risk factors of SCD
• Factors that can increase a person's risk of sudden cardiac arrest and SCD. The two leading risk factors include:
  view subtopics Factors that can increase a person's risk of sudden cardiac arrest and SCD. The two leading risk factors include:
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  • Previous heart attack (75 percent of SCD cases are linked to a previous heart attack) -- A person’s risk of SCD is higher during the first six months after a heart attack
  • Coronary artery disease (80 percent of SCD cases are linked with this disease) Risk factors for coronary artery disease include smoking, family history of cardiovascular disease, high cholesterol or an enlarged heart.
  • Ejection fraction of less than 40 percent, combined with ventricular tachycardia
  • Prior episode of sudden cardiac arrest
  • Family history of sudden cardiac arrest or SCD;
  • Personal or family history of certain abnormal heart rhythms including long QT syndrome, Wolff-Parkinson-White Syndrome, extremely low heart rates or heart block
  • Ventricular tachycardia or ventricular fibrillation after a heart attack
  • History of congenital heart defects or blood vessel abnormalities
  • History of syncope (fainting episodes of unknown cause)
  • Heart failure: a condition in which the heart’s pumping power is weaker than normal. Patients with heart failure are 6 to 9 times more likely than the general population to experience ventricular arrhythmias that can lead to sudden cardiac arrest.
  • Dilated cardiomyopathy (cause of SCD in about 10 percent of the cases): a decrease in the heart’s ability to pump blood due to an enlarged (dilated) and weakened left ventricle
  • Hypertrophic cardiomyopathy (a thickened heart muscle that especially affects the ventricles)
  • Significant changes in blood levels of potassium and magnesium (from using diuretics, for example), even if there is not organic heart disease
  • Obesity
  • Diabetes
  • Recreational drug abuse
  • Taking drugs that are “pro-arrhythmic” may increase the risk for life-threatening arrhythmias.
• The treatment for sudden cardiac death