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| ===Diagnostic Criteria=== | | ===Diagnostic Criteria=== |
| *The diagnosis of sudden cardiac arrest is made when the following diagnostic criteria are met:
| | ==Diagnosis Study Of Choice== |
| :*Absence of a [[palpable pulse]] of the [[heart]]<ref name="Harrison"> [http://books.mcgraw-hill.com/medical/harrisons/ Harrison's Principles of Internal Medicine] 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7</ref>
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| :*Absent [[carotid pulse]]
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| :*[[Gasping respiration]] or NO [[respiration]]
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| :*Loss of [[consciousness]] due to [[cerebral hypoperfusion]]
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| {| style="border: 2px solid #4479BA; align="left"
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| ! style="width: 200px; background: #4479BA;" | {{fontcolor|#FFF|Components}}
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| ! style="width: 300px; background: #4479BA;" | {{fontcolor|#FFF|Assessment and findings}}
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| | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Symptoms
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| | style="padding: 0 5px; background: #F5F5F5; text-align: left;" |
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| * Symptoms related to [[arrhythmia]]<ref name="ZimetbaumJosephson1998">{{cite journal|last1=Zimetbaum|first1=Peter|last2=Josephson|first2=Mark E.|title=Evaluation of Patients with Palpitations|journal=New England Journal of Medicine|volume=338|issue=19|year=1998|pages=1369–1373|issn=0028-4793|doi=10.1056/NEJM199805073381907}}</ref><ref name="NodaShimizu2005">{{cite journal|last1=Noda|first1=Takashi|last2=Shimizu|first2=Wataru|last3=Taguchi|first3=Atsushi|last4=Aiba|first4=Takeshi|last5=Satomi|first5=Kazuhiro|last6=Suyama|first6=Kazuhiro|last7=Kurita|first7=Takashi|last8=Aihara|first8=Naohiko|last9=Kamakura|first9=Shiro|title=Malignant Entity of Idiopathic Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Initiated by Premature Extrasystoles Originating From the Right Ventricular Outflow Tract|journal=Journal of the American College of Cardiology|volume=46|issue=7|year=2005|pages=1288–1294|issn=07351097|doi=10.1016/j.jacc.2005.05.077}}</ref>
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| : [[Palpitations]], [[lightheadedness]], [[syncope]], [[dyspnea]], [[chest pain]], [[cardiac arrest]]
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| * Symptoms related to underlying [[heart disease]]: [[Dyspnea]] at rest or on exertion, [[orthopnea]], [[paroxysmal nocturnal dyspnea]], [[chest pain]], [[edema]]
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| * Precipitating factors: [[Exercise]], [[emotional stress]]
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| | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Past medical history
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| * [[Heart disease]]: [[Coronary]], [[valvular]] ([[mitral valve prolapse]]), [[congenital heart disease]]
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| * [[Thyroid disease]]
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| * [[Acute kidney injury]]
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| * [[Chronic kidney disease]]
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| * [[Electrolyte abnormalities]]
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| * [[Stroke]],[[embolic events]]
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| * [[Lung disease]]
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| * [[Epilepsy]] ([[arrhythmic syncope]] can be misdiagnosed as [[epilepsy]])
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| * [[ Alcohol]], [[illicit drug]] use
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| * Use of over-the-counter medications caused [[QT prolongation]] and [[torsades de pointes]]
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| * [[ Unexplained motor vehicle accident]]
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| | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Medications
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| * [[Antiarrhythmic]] medications
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| * Medication with QT prolongation and torsades de pointes effect
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| * [[Cocaine]],[[amphetamines]]
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| * [[Anabolic steroids]]
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| * Medication-medication interaction that could cause [[QT prolongation]] and [[torsades de pointes]]
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| | style="padding: 0 5px; background: #F5F5F5; text-align: left;" | Family history
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| * [[SCD]], [[SCA]], [[unexplained drowning]] in a first-degree relative
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| * [[SIDS]], repetitive spontaneous [[pregnancy losses]] concerning [[cardiac channelopathies]]
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| * [[IHD]]
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| * [[Cardiomyopathy]]: [[Hypertrophic]],[[ dilated]], [[ARVC]]
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| * [[Congenital heart disease]]
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| * [[ Cardiac channelopathies]]: [[Long QT]], [[Brugada]], [[Short QT]], [[CPVT]]
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| * [[Arrhythmias]]: [[conduction disorders]], [[ pacemakers]]/[[ICDs]]
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| * [[Neuromuscular disease]] associated with [[cardiomyopathies]]
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| * [[Muscular dystrophy]]
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| * [[Epilepsy]]
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| |}
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| {{clear}}
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| === Symptoms ===
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| *[[Symptoms]] related to arrhythmia or underlying [[ heart disease]] within one hour before [[ cardiac arrest]] may include the following:<ref name="pmid26720493">{{cite journal |vauthors=Marijon E, Uy-Evanado A, Dumas F, Karam N, Reinier K, Teodorescu C, Narayanan K, Gunson K, Jui J, Jouven X, Chugh SS |title=Warning Symptoms Are Associated With Survival From Sudden Cardiac Arrest |journal=Ann Intern Med |volume=164 |issue=1 |pages=23–9 |date=January 2016 |pmid=26720493 |pmc=5624713 |doi=10.7326/M14-2342 |url=}}</ref>
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| :* [[Palpitations]]
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| :* [[lightheadedness]]
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| :* [[syncope]]
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| :* [[dyspnea]]
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| :* [[chest pain]]
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| :* [[cardiac arrest]]
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| :* [[Dyspnea]] at rest or on exertion
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| :* [[orthopnea]]
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| :* [[paroxysmal nocturnal dyspnea]]
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| :* [[chest pain]], [[edema]]
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| === Physical Examination ===
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| *Patients with [[cardiac arrest]] usually appear [[cyanotic]].
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| * [[Physical examination]] may be remarkable for:
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| :*[[Heart rate]] and [[regularity]], [[blood pressure]]
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| :*[[ Jugular venous pressure]]
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| :*[[Murmurs]]
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| :*[[ Pulses]], [[bruits]]
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| :*[[Edema]]
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| :*[[Sternotomy scars]]
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| === Laboratory Findings ===
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| *An elevated concentration of [[brain natriuretic peptide]] ([[BNP]]) predicts has been shown as the predictor of [[ventricular arrhythmia]] and [[sudden cardiac death]].<ref name="ScottBarry2009">{{cite journal|last1=Scott|first1=Paul A.|last2=Barry|first2=James|last3=Roberts|first3=Paul R.|last4=Morgan|first4=John M.|title=Brain natriuretic peptide for the prediction of sudden cardiac death and ventricular arrhythmias: a meta-analysis|journal=European Journal of Heart Failure|volume=11|issue=10|year=2009|pages=958–966|issn=13889842|doi=10.1093/eurjhf/hfp123}}</ref>
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| ===Electrocardiogram===
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| An [[ECG]] may be helpful in the diagnosis of [[Sudden cardiac death]]. Findings on [[ECG]] associated with [[ sudden cardiac arrest]] include:<ref name="JayaramanReinier2018">{{cite journal|last1=Jayaraman|first1=Reshmy|last2=Reinier|first2=Kyndaron|last3=Nair|first3=Sandeep|last4=Aro|first4=Aapo L.|last5=Uy-Evanado|first5=Audrey|last6=Rusinaru|first6=Carmen|last7=Stecker|first7=Eric C.|last8=Gunson|first8=Karen|last9=Jui|first9=Jonathan|last10=Chugh|first10=Sumeet S.|title=Risk Factors of Sudden Cardiac Death in the Young|journal=Circulation|volume=137|issue=15|year=2018|pages=1561–1570|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.117.031262}}</ref>
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| * [[Sinus tachycardia]] (39%)
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| * Abnormal [[T-wave inversions]] (30%)
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| * Prolonged [[QT]] interval (26%)
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| * Left/[[right atrial]] abnormality (22%)
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| * [[ LVH]] (17%)
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| * Abnormal frontal [[QRS axis]] (17%)
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| * Delayed [[QRS]]-transition zone in precordial leads (13%)
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| * Pathological [[Q waves]] (13%)
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| * [[intraventricular conduction delays]] (9%)
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| * Multiple [[premature ventricular contractions]] (9%)
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| * [[Normal ECG]] (9%)
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| ==References== | | ==References== |
| {{reflist|2}} | | {{reflist|2}} |