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Coronary heart disease overview

2026-04-16T12:01:21Z

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	__NOTOC__		__NOTOC__
	{{Coronary heart disease}} {{CMG}}		{{Coronary heart disease}} {{CMG}} {{AE}} {{MSD}}

	==Overview==		==Overview==
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	==Treatment==		==Treatment==
	===Medical Therapy===		===Medical Therapy===
	Goals for treating coronary artery disease include lowering [[blood pressure]], ~~maintaining [[~~HbA1c~~]] levels to less than~~ 7%, and lowering [[LDL]] cholesterol. Long-term treatment will generally depend on the symptoms and severity of disease, and include [[aspirin]], [[ACE inhibitors]], and other ani-coagulant and anti-platelet regimens. The mainstay of treatment for [[chronic stable angina\|stable angina]] which occurs with exertion, includes [[nitroglycerin]]. When unstable angina causes symptoms at rest, or in the setting of an acute [[myocardial infarction]], the immediate therapy is [[morphine]], [[oxygen]], [[nitrate]] and [[aspirin]]. [[Angioplasty]] may also be required in cases of [[acute coronary syndrome]].		Goals for treating coronary artery disease include lowering [[blood pressure]], managing diabetes with cardiovascular-risk-reducing agents such as SGLT2 inhibitors and GLP-1 receptor agonists, independent of HbA1c target<ref name="pmid39289001">{{cite journal \|vauthors=Galli M, Gragnano F, Vrints C, Andreotti F \|title=2024 ESC guidelines on chronic coronary syndromes: what is new in pharmacotherapy? \|journal=Eur Heart J Cardiovasc Pharmacother \|volume=10 \|issue=7 \|pages=572–574 \|date=November 2024 \|pmid=39289001 \|doi=10.1093/ehjcvp/pvae069 \|url=}}</ref>, and lowering [[LDL]] cholesterol. Long-term treatment will generally depend on the symptoms and severity of disease, and include [[aspirin]], [[ACE inhibitors]], and other ani-coagulant and anti-platelet regimens.Low-dose colchicine (0.5 mg daily) should also be considered as an adjunctive anti-inflammatory therapy for long-term management. <ref name="pmid37558377">{{cite journal \|vauthors=Nelson K, Fuster V, Ridker PM \|title=Low-Dose Colchicine for Secondary Prevention of Coronary Artery Disease: JACC Review Topic of the Week \|journal=J Am Coll Cardiol \|volume=82 \|issue=7 \|pages=648–660 \|date=August 2023 \|pmid=37558377 \|doi=10.1016/j.jacc.2023.05.055 \|url=}}</ref> The mainstay of treatment for [[chronic stable angina\|stable angina]] which occurs with exertion, includes [[nitroglycerin]]. When unstable angina causes symptoms at rest, or in the setting of an acute [[myocardial infarction]], the immediate therapy is [[morphine]], supplemental oxygen (only if SpO₂ <90%), nitrate, and aspirin. [[Angioplasty]] may also be required in cases of [[acute coronary syndrome]].Beta-blockers should be used selectively: they are indicated when LVEF is <50%, or in the presence of angina, arrhythmias, or hypertension, but are no longer routinely recommended for all patients with chronic coronary disease.<ref name="pmid38766996">{{cite journal \|vauthors=Khorsandi M, Blumenthal RS, Blaha MJ, Kohli P \|title=The ABCs of the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease \|journal=Clin Cardiol \|volume=47 \|issue=5 \|pages=e24284 \|date=May 2024 \|pmid=38766996 \|pmc=11103637 \|doi=10.1002/clc.24284 \|url=}}</ref>

	===Primary Prevention===		===Primary Prevention===
	The [[LDL]] target in primary prevention depends upon the patient's [[risk factors]]. If the ~~patient has CHD or its equivalent~~, ~~then the LDL goal is under 100 mg~~/dl. ~~If the patient has 2~~ risk ~~factors~~, the LDL ~~goal is 130 mg~~/dl. ~~If the patient has~~ < ~~2 risk factors~~, ~~the LDL goal~~ is < ~~160 mg~~/dl. Attempts should be made to reduce [[triglyceride]] levels and to increase [[HDL]] levels. The underlying causes for existing [[dyslipidemia]]s should be identified and appropriately managed. Drugs that cause dyslipidemias should be avoided. Patients should be evaluated reguarly for the presence of risk factors for coronary heart disease, and those with increased risk should be counseled on the beneficial effects of daily [[aspirin]] therapy. Patients should also regularly be counseled about modifying risk factors such as [[obesity]], [[hypertension]], [[smoking]], and the benefits of an [[exercise]] plan.		The [[LDL]] target in primary prevention depends upon the patient's [[risk factors]]. LDL targets in primary prevention should be guided by estimated 10-year ASCVD risk using the PREVENT™ equations<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref>. Statin therapy is recommended for those with intermediate risk (5–<10%) and reasonable for those with borderline risk (3–<5%) after shared decision-making, with the goal of achieving at least a 50% LDL-C reduction from baseline<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref>.Non-statin therapies — including ezetimibe, bempedoic acid, and PCSK9 inhibitors should be considered when statin therapy alone is insufficient.<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref> Attempts should be made to reduce [[triglyceride]] levels and to increase [[HDL]] levels.Coronary artery calcium (CAC) scoring and Lp(a) measurement should be considered to further refine cardiovascular risk and guide treatment intensity.<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref> The underlying causes for existing [[dyslipidemia]]s should be identified and appropriately managed. Drugs that cause dyslipidemias should be avoided. Patients should be evaluated reguarly for the presence of risk factors for coronary heart disease, and those with increased risk should be counseled on the beneficial effects of daily [[aspirin]] therapy. Patients should also regularly be counseled about modifying risk factors such as [[obesity]], [[hypertension]], [[smoking]], and the benefits of an [[exercise]] plan.

	===Secondary Prevention===		===Secondary Prevention===
	Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery		Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a 10-year ASCVD risk >20% by contemporary risk calculators (e.g., PREVENT™ equations or SCORE2).<ref name="url2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \| Circulation">{{cite web \|url=https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 \|title=2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \| Circulation \|format= \|work= \|accessdate=}}</ref> There are 13 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control; antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation, influenza vaccine and low-dose colchicine (0.5 mg/day) for anti-inflammatory residual risk reduction.<ref>SEC Working Group for the 2024 ESC guidelines for the management of chronic coronary syndromes and SEC Guidelines Committee. (2025). Comments on the ESC 2024 guidelines for the management of chronic coronary syndromes. ''Revista Espanola de Cardiologia (English Ed.)'', ''78''(3), 170–175. <nowiki>https://doi.org/10.1016/j.rec.2024.10.007</nowiki></ref> Please note that secondary prevention guidelines, especially, those involving medication, may differ between [[Unstable Angina\|UA/NSTEMI]]; [[STEMI]]; and [[Chronic Stable Angina]].
	disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a ~~Framingham Risk Score of~~ > 20%.
	There are 12 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control; antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation ~~and~~ influenza vaccine. Please note that secondary prevention guidelines, especially, those involving medication, may differ between [[Unstable Angina\|UA/NSTEMI]]; [[STEMI]]; and [[Chronic Stable Angina]].

	==References==		==References==

Sudden cardiac death prognosis

2026-04-07T15:45:12Z

Prognosis of cardiac arrest in young athletes:

← Older revision		Revision as of 15:45, 7 April 2026
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	:* Women between 15-45 years old<ref name="pmid20228684">{{cite journal \|vauthors=Topjian AA, Localio AR, Berg RA, Alessandrini EA, Meaney PA, Pepe PE, Larkin GL, Peberdy MA, Becker LB, Nadkarni VM \|title=Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men \|journal=Crit Care Med \|volume=38 \|issue=5 \|pages=1254–60 \|date=May 2010 \|pmid=20228684 \|pmc=3934212 \|doi=10.1097/CCM.0b013e3181d8ca43 \|url=}}</ref>		:* Women between 15-45 years old<ref name="pmid20228684">{{cite journal \|vauthors=Topjian AA, Localio AR, Berg RA, Alessandrini EA, Meaney PA, Pepe PE, Larkin GL, Peberdy MA, Becker LB, Nadkarni VM \|title=Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men \|journal=Crit Care Med \|volume=38 \|issue=5 \|pages=1254–60 \|date=May 2010 \|pmid=20228684 \|pmc=3934212 \|doi=10.1097/CCM.0b013e3181d8ca43 \|url=}}</ref>
	:*Rapid intervention with a [[defibrillator]] increases [[survival rates]].<ref>{{cite journal \|author=Eisenberg MS, Mengert TJ \|title=Cardiac resuscitation \|journal=N. Engl. J. Med. \|volume=344 \|issue=17 \|pages=1304–13 \|year=2001 \|month=April \|pmid=11320390 \|doi= \|url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11320390&promo=ONFLNS19}}</ref><ref name="pmid12826637">{{cite journal \|author=Bunch TJ, White RD, Gersh BJ, ''et al'' \|title=Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation \|journal=N. Engl. J. Med. \|volume=348 \|issue=26 \|pages=2626–33 \|year=2003 \|month=June \|pmid=12826637 \|doi=10.1056/NEJMoa023053 \|url=}}</ref>		:*Rapid intervention with a [[defibrillator]] increases [[survival rates]].<ref>{{cite journal \|author=Eisenberg MS, Mengert TJ \|title=Cardiac resuscitation \|journal=N. Engl. J. Med. \|volume=344 \|issue=17 \|pages=1304–13 \|year=2001 \|month=April \|pmid=11320390 \|doi= \|url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=11320390&promo=ONFLNS19}}</ref><ref name="pmid12826637">{{cite journal \|author=Bunch TJ, White RD, Gersh BJ, ''et al'' \|title=Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation \|journal=N. Engl. J. Med. \|volume=348 \|issue=26 \|pages=2626–33 \|year=2003 \|month=June \|pmid=12826637 \|doi=10.1056/NEJMoa023053 \|url=}}</ref>

			==== Prognosis of cardiac arrest in young athletes: ====

			* 58% survival rate was reported by the US Commotio Cordis Registry in 216 persons with sudden cardiac arrest due to commotio cordis (cardiac arrest due to VF triggered by blunt chest trauma) (age range, 0.2-51 years;mean,15years, 95% male) from 2006 through 2012.<ref name=":9">Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Estes NA III, Link MS. Increasing survival rate from commotio cordis.HeartRhythm.2013;10(2):219-223. doi:10.1016/j.hrthm.2012.10.034</ref>
			* Prompt resuscitation and participation in organized competitive sports was associated with higher survival rates. Multivariate analysis identified participation in recreational sports with lower survival (odds ratio [OR] compared with organized competitive sports, 0.33; 95%CI,0.16-0.67) and onsite automated external defibrillator with higher survival (OR, 4.61; 95% CI, 1.43-14.88).<ref name=":9" />
			* Individuals aged 18 to 35 years with sports-related sudden cardiac arrest in Germany and France showed improved survival to hospital discharge with public automated external defibrillator use prior to EMS arrival (OR, 6.25; 95% CI, 1.48 43.20); individuals with sudden cardiac arrest who received both immediate bystander CPR and automated external defibrillator had 91%survival.<ref>Bohm P, Meyer T, Narayanan K, et al. Sports-related sudden cardiac arrest in young adults. Europace. 2023;25(2):627-633. doi:10.1093/ europace/euac172</ref>
			* A recent meta-analysis demonstrated that in sports related sudden cardiac arrest, bystander presence (OR, 2.55; 95%CI, 1.48-4.37), bystander CPR (OR, 3.84; 95% CI, 2.36-6.25), and bystander automated external defibrillator use (OR, 5.25; 95%CI,3.58-7.70) were associated with improved survival.<ref>Michelland L, Murad MH, Bougouin W, et al. Association between basic life support and survival in sports-related sudden cardiac arrest: a meta-analysis. Eur Heart J. 2023;44(3):180-192. doi:10.1093/eurheartj/ehac586</ref>

	==References==		==References==

Industrial and organizational psychology

2026-04-06T14:40:44Z

Self-determination theory

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	===Self-determination theory===		===Self-determination theory (SDT) ===
	[[Image:SelfDeterminationTheory.png\|right\|400px]]		[[Image:SelfDeterminationTheory.png\|right\|400px]]
	Self-determination theory was proposed in the early 1980s.<ref>Deci, Edward L., and Richard M. Ryan. "Self-determination theory: When mind mediates behavior." The Journal of Mind and Behavior (1980): 33-43. http://www.jstor.org/stable/43852807</ref> In this theory, autonomy, mastery (competence), and relatedness have been validated as components<ref>Reis, H. T., Sheldon, K. M., Gable, S. L., Roscoe, J., & Ryan, R. M. (2000). Daily well-being: The role of autonomy, competence, and relatedness. Personality and social psychology bulletin, 26(4), 419-435. {{doi\|10.1177/0146167200266002}}</ref><ref>Broeck A, Vansteenkiste M, Witte H, Soenens B, Lens W. Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work‐related Basic Need Satisfaction scale. Journal of Occupational and Organizational Psychology. 2010 Dec 1;83(4):981-1002. {{doi\|10.1348/096317909X481382}}</ref> and contains three factors:		Self-determination theory was proposed in the early 1980s.<ref>Deci, Edward L., and Richard M. Ryan. "Self-determination theory: When mind mediates behavior." The Journal of Mind and Behavior (1980): 33-43. http://www.jstor.org/stable/43852807</ref> In this theory, autonomy, mastery (competence), and relatedness have been validated as components<ref>Reis, H. T., Sheldon, K. M., Gable, S. L., Roscoe, J., & Ryan, R. M. (2000). Daily well-being: The role of autonomy, competence, and relatedness. Personality and social psychology bulletin, 26(4), 419-435. {{doi\|10.1177/0146167200266002}}</ref><ref>Broeck A, Vansteenkiste M, Witte H, Soenens B, Lens W. Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work‐related Basic Need Satisfaction scale. Journal of Occupational and Organizational Psychology. 2010 Dec 1;83(4):981-1002. {{doi\|10.1348/096317909X481382}}</ref> and contains three factors:
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	The SDT and Spreizter models were consolidated, with relatedness or membership included, by Ryff <ref name="pmid24281296">{{cite journal\| author=Ryff CD\| title=Psychological well-being revisited: advances in the science and practice of eudaimonia. \| journal=Psychother Psychosom \| year= 2014 \| volume= 83 \| issue= 1 \| pages= 10-28 \| pmid=24281296 \| doi=10.1159/000353263 \| pmc=4241300 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24281296 }} </ref> and Phipps-Taylor<ref name="pmid27995705">{{cite journal\| author=Phipps-Taylor M, Shortell SM\| title=More Than Money: Motivating Physician Behavior Change in Accountable Care Organizations. \| journal=Milbank Q \| year= 2016 \| volume= 94 \| issue= 4 \| pages= 832-861 \| pmid=27995705 \| doi=10.1111/1468-0009.12230 \| pmc=5192815 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27995705 }} </ref>:		The SDT and Spreizter models were consolidated, with relatedness or membership included, by Ryff <ref name="pmid24281296">{{cite journal\| author=Ryff CD\| title=Psychological well-being revisited: advances in the science and practice of eudaimonia. \| journal=Psychother Psychosom \| year= 2014 \| volume= 83 \| issue= 1 \| pages= 10-28 \| pmid=24281296 \| doi=10.1159/000353263 \| pmc=4241300 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24281296 }} </ref> and Phipps-Taylor<ref name="pmid27995705">{{cite journal\| author=Phipps-Taylor M, Shortell SM\| title=More Than Money: Motivating Physician Behavior Change in Accountable Care Organizations. \| journal=Milbank Q \| year= 2016 \| volume= 94 \| issue= 4 \| pages= 832-861 \| pmid=27995705 \| doi=10.1111/1468-0009.12230 \| pmc=5192815 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27995705 }} </ref>:
	* Ryff's six-factor model in 1989<ref name="Ryff1989">{{Citation \| vauthors=((Ryff, C. D.)) \| year=1989 \| title=Happiness is everything, or is it? Explorations on the meaning of psychological well-being. \| publisher=American Psychological Association (APA) \| url=http://dx.doi.org/10.1037/0022-3514.57.6.1069}}</ref> of 1) 'autonomy', 2) 'environmental mastery', 3) 'purpose in life', 4) 'positive relationships', and the addition of 'personal growth' and 'self-acceptance'. Interestingly, the addition of personal growth presaged ~~Spreitser~~'s inclusion of personal growth in her subsequent model of thriving later in 2011.		* Ryff's six-factor model in 1989<ref name="Ryff1989">{{Citation \| vauthors=((Ryff, C. D.)) \| year=1989 \| title=Happiness is everything, or is it? Explorations on the meaning of psychological well-being. \| publisher=American Psychological Association (APA) \| url=http://dx.doi.org/10.1037/0022-3514.57.6.1069}}</ref> of 1) 'autonomy', 2) 'environmental mastery', 3) 'purpose in life', 4) 'positive relationships', and the addition of 'personal growth' and 'self-acceptance'. Interestingly, the addition of personal growth presaged Spreitzer's inclusion of personal growth in her subsequent model of thriving later in 2011.

	SDT and JDR have been integrated<ref name="pmid27783240">{{cite journal\| author=Dreison KC, White DA, Bauer SM, Salyers MP, McGuire AB\| title=Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout. \| journal=Adm Policy Ment Health \| year= 2018 \| volume= 45 \| issue= 1 \| pages= 121-130 \| pmid=27783240 \| doi=10.1007/s10488-016-0772-z \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27783240 }} </ref>.		SDT and JDR have been integrated<ref name="pmid27783240">{{cite journal\| author=Dreison KC, White DA, Bauer SM, Salyers MP, McGuire AB\| title=Integrating Self-Determination and Job Demands-Resources Theory in Predicting Mental Health Provider Burnout. \| journal=Adm Policy Ment Health \| year= 2018 \| volume= 45 \| issue= 1 \| pages= 121-130 \| pmid=27783240 \| doi=10.1007/s10488-016-0772-z \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27783240 }} </ref>.

Sudden cardiac death prognosis

2026-04-05T12:42:38Z

Prognosis of Sudden Cardiac Death

← Older revision		Revision as of 12:42, 5 April 2026
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	==Prognosis of Sudden Cardiac ~~Death~~==		==Prognosis of Sudden Cardiac Arrest Survivors==
	*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.		*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.
	*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</ref>		*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</ref>
			*The 10-year survival rate of sudden cardiac arrest survivors aged 40 years or younger was 90% in an Australian registry.<ref>Andrew E, Nehme Z, Wolfe R, Bernard S, Smith K. Long-term survival following out-of-hospital cardiac arrest. Heart. 2017;103(14):1104-1110. doi: 10.1136/heartjnl-2016-310485</ref>The rate of recurrent arrest (both out of and in the hospital) or death in survivors aged 18 to 39 years in a Swedish registry was approximately 15% a year after the out-of-hospital cardiac arrest.<ref>Hellsén G, Rawshani A, Skoglund K, et al. Predicting recurrent cardiac arrest in individuals surviving out-of-hospital cardiac arrest. Resuscitation. 2023;184:109678. doi:10.1016/j.resuscitation.2022. 109678</ref>

			One-year overall mortality of subcutaneous ICD recipients aged 15 to 34 years was 4.3% in one cohort,90 whereas the VT or VF recurrence rate estimated by subcutaneous ICD recording in secondary prevention recipients (age not reported) in a separate study was 9.9% at 1year and15.8% at 3years.<ref>Boersma LV, Barr CS, Burke MC ,et al; EFFORTLESS and IDE Study Investigators. Performance of the subcutaneous implantable cardioverter-defibrillator in patients with a primary prevention indication with and without a reduced ejection fraction versus patients with a secondary prevention indication. Heart Rhythm. 2017;14(3): 367-375. doi:10.1016/j.hrthm.2016.11.025</ref>
	*<i><u>Factors associated poor [[prognosis]] after in-hospital [[cardiac arrest]] include</u></i>:<ref name="Chan2012">{{cite journal\|last1=Chan\|first1=Paul S.\|title=A Validated Prediction Tool for Initial Survivors of In-Hospital Cardiac Arrest\|journal=Archives of Internal Medicine\|volume=172\|issue=12\|year=2012\|pages=947\|issn=0003-9926\|doi=10.1001/archinternmed.2012.2050}}</ref><ref name="pmid21596693">{{cite journal \|vauthors=Ebell MH, Afonso AM \|title=Pre-arrest predictors of failure to survive after in-hospital cardiopulmonary resuscitation: a meta-analysis \|journal=Fam Pract \|volume=28 \|issue=5 \|pages=505–15 \|date=October 2011 \|pmid=21596693 \|doi=10.1093/fampra/cmr023 \|url=}}</ref>		*<i><u>Factors associated poor [[prognosis]] after in-hospital [[cardiac arrest]] include</u></i>:<ref name="Chan2012">{{cite journal\|last1=Chan\|first1=Paul S.\|title=A Validated Prediction Tool for Initial Survivors of In-Hospital Cardiac Arrest\|journal=Archives of Internal Medicine\|volume=172\|issue=12\|year=2012\|pages=947\|issn=0003-9926\|doi=10.1001/archinternmed.2012.2050}}</ref><ref name="pmid21596693">{{cite journal \|vauthors=Ebell MH, Afonso AM \|title=Pre-arrest predictors of failure to survive after in-hospital cardiopulmonary resuscitation: a meta-analysis \|journal=Fam Pract \|volume=28 \|issue=5 \|pages=505–15 \|date=October 2011 \|pmid=21596693 \|doi=10.1093/fampra/cmr023 \|url=}}</ref>
	:*Age > 70 years old		:*Age > 70 years old

Sudden cardiac death post arrest care and prevention

2026-04-05T12:33:04Z

2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death [2]

Show changes

Sudden cardiac death prognosis

2026-04-04T14:11:53Z

Prognosis of Sudden Cardiac Death

← Older revision		Revision as of 14:11, 4 April 2026
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	* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.		* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.
	* A retrospective cohort study from the CARES registry reported 101968 out-of-hospital cardiac arrests in the US between 2006 and 2013, approximately 6% of the incidents occurred among individuals between 20 through 39 years; survival rate to hospital discharge ranged from 11%(30-39years) to 16%(20-24years).<ref name=":0">Andersen LW, Bivens MJ,Giberson T,et al. The relationship between age and outcome in out-of-hospital cardiac arrest patients. Resuscitation. 2015;94:49-54. doi:10.1016/j.resuscitation.2015.05. 015</ref> Approximately 85% to 95% of out-of-hospital cardiac arrest survivors were discharged with good neurological outcome, as defined by a Cerebral Performance Categories scale of 1 or 2.<ref name=":0" /> <ref name=":1">Gustafsson L, Rawshani A,Råmunddal T, et al. Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden:a nationwide study. Resusc Plus. 2023;16:100503.doi:10.1016/j.resplu.2023.100503</ref>		* A retrospective cohort study from the CARES registry reported 101968 out-of-hospital cardiac arrests in the US between 2006 and 2013, approximately 6% of the incidents occurred among individuals between 20 through 39 years; survival rate to hospital discharge ranged from 11%(30-39years) to 16%(20-24years).<ref name=":0">Andersen LW, Bivens MJ,Giberson T,et al. The relationship between age and outcome in out-of-hospital cardiac arrest patients. Resuscitation. 2015;94:49-54. doi:10.1016/j.resuscitation.2015.05. 015</ref> Approximately 85% to 95% of out-of-hospital cardiac arrest survivors were discharged with good neurological outcome, as defined by a Cerebral Performance Categories scale of 1 or 2.<ref name=":0" /> <ref name=":1">Gustafsson L, Rawshani A,Råmunddal T, et al. Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden:a nationwide study. Resusc Plus. 2023;16:100503.doi:10.1016/j.resplu.2023.100503</ref>
	* The overall survival rate of young adults experiencing out-of-hospital cardiac arrest was 9% in a US study from 2005 through 2007 involving 665 persons aged 20 through 39 years, and increased to 34.8% for those with bystander-witnessed VT or VF who were more likely to receive prompt initial cardiopulmonary resus citation (CPR) or automated external defibrillator use.<ref>Rea TD, Cook AJ, Stiell IG, et al; Resuscitation Outcomes Consortium Investigators. Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements. AnnEmergMed.2010; 55(3):249-257. doi:10.1016/j.annemergmed.2009. 09.018</ref>		* The overall survival rate of young adults experiencing out-of-hospital cardiac arrest was 9% in a US study from 2005 through 2007 involving 665 persons aged 20 through 39 years, and increased to 34.8% for those with bystander-witnessed VT or VF who were more likely to receive prompt initial cardiopulmonary resus citation (CPR) or automated external defibrillator use.<ref name=":2">Rea TD, Cook AJ, Stiell IG, et al; Resuscitation Outcomes Consortium Investigators. Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements. AnnEmergMed.2010; 55(3):249-257. doi:10.1016/j.annemergmed.2009. 09.018</ref>
	* In an Australian registry conducted between 2000 and 2009 involving 3912 patients with ages between 16 and 39 years with out-of-hospital cardiac arrest,the survival rate was 8.8%.<ref name=":1" />		* In an Australian registry conducted between 2000 and 2009 involving 3912 patients with ages between 16 and 39 years with out-of-hospital cardiac arrest,the survival rate was 8.8%.<ref name=":1" />

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	==Prognosis of Sudden Cardiac Death==		==Prognosis of Sudden Cardiac Death==
	*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.		*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.
			*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</ref>

Sudden cardiac death definitions and diagnosis

2026-04-04T13:40:25Z

← Older revision		Revision as of 13:40, 4 April 2026
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}
	==Overview==		==Overview==
	*The diagnosis of [[sudden cardiac arrest]] ([[SCA]]) is made when the following diagnostic criteria are met: the absence of a [[palpable pulse]] of the [[heart]] due to abrupt cessation of [[pump function]], absent [[carotid pulse]],[[gasping respiration]] or no [[respiration]], loss of [[consciousness]] due to [[cerebral hypoperfusion]].		*The diagnosis of [[sudden cardiac arrest]] ([[SCA]]) is made when the following diagnostic criteria are met: the absence of a [[palpable pulse]] of the [[heart]] due to abrupt cessation of [[pump function]], absent [[carotid pulse]],[[gasping respiration]] or no [[respiration]], loss of [[consciousness]] due to [[cerebral hypoperfusion]].

Sudden cardiac death prognosis

2026-03-29T05:33:11Z

Natural History of Sudden Cardiac Death

← Older revision		Revision as of 05:33, 29 March 2026
(One intermediate revision by the same user not shown)
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	{{Sudden cardiac death}}		{{Sudden cardiac death}}

	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}
	==Overview==		==Overview==
	* [[Sudden cardiac arrest]] ([[SCA]]) occurs due to sudden disturbance in [[cardiac electrical propagation]] or failure of the [[heart]] to pumping the [[blood]] into vital [[organs]].		* [[Sudden cardiac arrest]] ([[SCA]]) occurs due to sudden disturbance in [[cardiac electrical propagation]] or failure of the [[heart]] to pumping the [[blood]] into vital [[organs]].
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	* Prompt [[treatment]] is needed to prevent [[death]] which may occur within minutes to weeks, and prevent serious [[complications]].		* Prompt [[treatment]] is needed to prevent [[death]] which may occur within minutes to weeks, and prevent serious [[complications]].
	* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.		* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.
			* A retrospective cohort study from the CARES registry reported 101968 out-of-hospital cardiac arrests in the US between 2006 and 2013, approximately 6% of the incidents occurred among individuals between 20 through 39 years; survival rate to hospital discharge ranged from 11%(30-39years) to 16%(20-24years).<ref name=":0">Andersen LW, Bivens MJ,Giberson T,et al. The relationship between age and outcome in out-of-hospital cardiac arrest patients. Resuscitation. 2015;94:49-54. doi:10.1016/j.resuscitation.2015.05. 015</ref> Approximately 85% to 95% of out-of-hospital cardiac arrest survivors were discharged with good neurological outcome, as defined by a Cerebral Performance Categories scale of 1 or 2.<ref name=":0" /> <ref name=":1">Gustafsson L, Rawshani A,Råmunddal T, et al. Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden:a nationwide study. Resusc Plus. 2023;16:100503.doi:10.1016/j.resplu.2023.100503</ref>
			* The overall survival rate of young adults experiencing out-of-hospital cardiac arrest was 9% in a US study from 2005 through 2007 involving 665 persons aged 20 through 39 years, and increased to 34.8% for those with bystander-witnessed VT or VF who were more likely to receive prompt initial cardiopulmonary resus citation (CPR) or automated external defibrillator use.<ref>Rea TD, Cook AJ, Stiell IG, et al; Resuscitation Outcomes Consortium Investigators. Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements. AnnEmergMed.2010; 55(3):249-257. doi:10.1016/j.annemergmed.2009. 09.018</ref>
			* In an Australian registry conducted between 2000 and 2009 involving 3912 patients with ages between 16 and 39 years with out-of-hospital cardiac arrest,the survival rate was 8.8%.<ref name=":1" />

	==Natural History of Sudden Cardiac Death==		==Natural History of Sudden Cardiac Death==

Sudden cardiac death post arrest care and prevention

2026-03-29T00:25:26Z

Overview

← Older revision		Revision as of 00:25, 29 March 2026
(One intermediate revision by the same user not shown)
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}

	See also [[Post cardiac arrest syndrome care pathway]]		See also [[Post cardiac arrest syndrome care pathway]]
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	==Overview==		==Overview==
	*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.		*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.
	*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].		*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].
	*The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].		*The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].
	*In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].		*In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].
	*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.		*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.
			*In absence of noncardiac or reversible causes, an implantable cardioverter-defibrillator (ICD) is recommended because of the high risk of recurrent lethal ventricular arrhythmias. Adjunctive therapy (eg, amiodarone, catheter ablation) and lifestyle modifications for certain genetic arrhythmia syndromes may reduce ventricular arrhythmia recurrence after ICD placement.

	== Prevention ==		== Prevention ==

Sudden cardiac death definitions and diagnosis

2026-03-29T00:12:06Z

Definitions and Diagnosis

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	==Definitions and Diagnosis==		==Definitions and Diagnosis==

			* The case definitions of sudden cardiac death vary based on the use of death certificates,<ref>GillumRF.Sudden coronary death in the United States: 1980-1985. Circulation. 1989;79(4):756-765. doi:10.1161/01.CIR.79.4.756</ref> <ref>Escobedo LG, Zack MM. Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033</ref> <ref>Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States,1989 to 1998. Circulation. 2001;104(18):2158-2163. doi:10.1161/hc4301.098254</ref> <ref name=":0">Kitamura T, Iwami T, Nichol G, et al; Utstein OsakaProject. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010;31(11):1365-1372. doi:10.1093/eurheartj/ehq059</ref> reviews of EMS<ref name=":0" /> or hospital records<ref>Escobedo LG,Zack MM.Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033</ref>,<ref>Nichol G,Rumsfeld J,Eigel B,et al; American Heart Association Emergency Cardiovascular Care Committee;American Heart Association Council on Cardiopulmonary, Perioperative, and Critical Care; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; Quality of Care and Outcomes Research Interdisciplinary Working Group.Essential features of designating out-of-hospital cardiac arrest as a reportable event: a scientific statement from the American Heart Association Emergency Cardiovascular Care Committee;Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes ResearchInterdisciplinary Working Group. Circulation. 2008;117(17):2299-2308. doi:10.1161/ CIRCULATIONAHA.107.189472</ref> <ref>Bonny A,Tibazarwa K,Mbouh S,et al; Pan African Society of Cardiology (PASCAR) Task Force on Sudden Cardiac Death.Epidemiology of sudden cardiac death in Cameroon:the first population-based cohort survey in sub-Saharan Africa. Int J Epidemiol. 2017;46(4):1230-1238. doi:10.1093/ije/dyx043</ref><ref>Meyer L,Stubbs B,Fahrenbruch C,et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0to35 years of age: a30-year review. Circulation. 2012;126(11):1363-1372. doi:10.1161/CIRCULATIONAHA.111.076810</ref><ref>Zhang J,Zhou X,Xing Q,et al.Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomous region in Northwest China. BMC Public Health. 2019;19(1):116. doi:10. 1186/s12889-019-6435-8</ref> or whether the cases met the criteria of epidemiological definitions (eg, World Health Organization),<ref>Sudden cardiac death.Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1985;726:5-25.</ref>society definitions (eg, Cardiac Arrest Registry to EnhanceSurvival [CARES]),<ref>McNally B, Stokes A, Crouch A, Kellermann AL, Group CS; CARESSurveillanceGroup. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683.e2.doi:10.1016/j. annemergmed.2009.03.018</ref> outcomes of clinical trials,<ref>Chatterjee NA,Moorthy MV,Pester J,et al; PRE-DETERMINE Study Group.Sudden death in patients with coronary heart disease without severe systolic dysfunction. JAMA Cardiol. 2018;3 (7):591-600. doi:10.1001/jamacardio.2018.1049</ref><ref>Olgin JE, Pletcher MJ, Vittinghoff E, et al; VEST Investigators. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med. 2018;379 (13):1205-1215. doi:10.1056/NEJMoa1800781</ref> or the definition required in pathology-based studies.<ref>Tseng ZH,Olgin JE,Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCD study.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref><ref>Wu Q, Zhang L, Zheng J,et al.Forensic pathological study of 1656 cases of sudden cardiac death in southern China. Medicine (Baltimore). 2016;95(5):e2707. doi:10.1097/MD.0000000000002707</ref><ref>Bagnall RD,Weintraub RG,Ingles J,et al. A prospective study of sudden cardiac death among children and young adults. NEnglJMed.2016;374 (25):2441-2452. doi:10.1056/NEJMoa1510687</ref>
			* Sudden cardiac death is typically presumed to be of cardiac etiology because most individuals who died from sudden cardiac death do not have autopsies to confirm the underlying cause.<ref>Marijon E,Narayanan K,Smith K,et al.The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet. 2023;402(10405):883-936. doi:10.1016/S0140-6736(23)00875-9</ref>
			* A person resuscitated from an out-of-hospital cardiac arrest to hospitalization is classified as having resuscitated out-of-hospital cardiac arrest,regardless of subsequent in-hospital death or survival to discharge, the latter of whom are sudden cardiac arrest survivors.

	*The [[diagnosis]] of [[SCA]] is made when the following [[diagnostic criteria]] are satisfied:		*The [[diagnosis]] of [[SCA]] is made when the following [[diagnostic criteria]] are satisfied:

Industrial and organizational psychology

2026-03-28T17:39:31Z

Workforce well-being

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	Workforce wellbeing has been described as a combination states, "job satisfaction, work engagement, and lower burnout"<ref name="BroeckVansteenkisteWitte2010">{{cite journal \| last1 = Broeck \| first1 = Anja \| last2 = Vansteenkiste \| first2 = Maarten \| last3 = Witte \| first3 = Hans \| last4 = Soenens \| first4 = Bart \| last5 = Lens \| first5 = Willy \| title = Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work-related Basic Need Satisfaction scale \| journal = Journal of Occupational and Organizational Psychology \| date = December 2010 \| volume = 83 \| issue = 4 \| pages = 981–1002 \| issn = 0963-1798 \| doi = 10.1348/096317909X481382 \| pmid = \| url = }}</ref>.		Workforce wellbeing has been described as a combination states, "job satisfaction, work engagement, and lower burnout"<ref name="BroeckVansteenkisteWitte2010">{{cite journal \| last1 = Broeck \| first1 = Anja \| last2 = Vansteenkiste \| first2 = Maarten \| last3 = Witte \| first3 = Hans \| last4 = Soenens \| first4 = Bart \| last5 = Lens \| first5 = Willy \| title = Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work-related Basic Need Satisfaction scale \| journal = Journal of Occupational and Organizational Psychology \| date = December 2010 \| volume = 83 \| issue = 4 \| pages = 981–1002 \| issn = 0963-1798 \| doi = 10.1348/096317909X481382 \| pmid = \| url = }}</ref>.

			* [[Well-being\|Well-being]]
	* [[Flourishing(psychology)\|Flourishing]]		* [[Flourishing(psychology)\|Flourishing]]
	* [[Thriving (psychology)\|Thriving]]		* [[Thriving (psychology)\|Thriving]]
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	Outcomes of these states are discussed in the separate "Outcomes" section below this.		Outcomes of these states are discussed in the separate "Outcomes" section below this.

			===Workforce well-being ===
			The National Academies in 2019 and 2024 defined Professional well-being is a “function of being satisfied with one’s job, finding meaning in work, feeling engaged at work, having a high-quality working life, and finding professional fulfillment in work."<ref name = "NA2019">{{cite book \| vauthors=Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being, National Academy of Medicine, National Academies of Sciences, Engineering, and Medicine \| date=2 December 2019 \| title=Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being \| publisher=National Academies Press \| url=https://www.nationalacademies.org/publications/25521 \| doi=10.17226/25521 \| isbn=978-0-309-49547-9}}</ref><ref name="NA2024">{{cite book \| vauthors=Action Collaborative on Clinician Well-Being and Resilience, National Academy of Medicine \| veditors=((Dzau, V. J.)), ((Kirch, D.)), ((Murthy, V.)), ((Nasca, T.)) \| date=28 February 2024 \| title=National Plan for Health Workforce Well-Being \| publisher=National Academies Press \| url=https://www.nationalacademies.org/publications/26744 \| doi=10.17226/26744 \| isbn=978-0-309-69467-4}}
			</ref>

			Earlier, in 1999, Danna summarized literature to date but did not synthesize a final definition<ref name="i345">{{cite journal \| last1=Danna \| first1=Karen \| last2=Griffin \| first2=Ricky W. \| title=Health and Well-Being in the Workplace: A Review and Synthesis of the Literature \| journal=Journal of Management \| volume=25 \| issue=3 \| date=1999 \| issn=0149-2063 \| doi=10.1177/014920639902500305 \| pages=357–384 \| url=https://journals.sagepub.com/doi/10.1177/014920639902500305 \| access-date=2026-03-28}}</ref>

	===Flourishing===		===Flourishing===