wikidoc - Changes related to "Sudden cardiac death post arrest care and prevention" [en]

Sudden cardiac death risk factors

2026-04-06T16:54:56Z

Risk Factors

← Older revision		Revision as of 16:54, 6 April 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}}

	==Overview==		==Overview==
	Common [[risk factors]] related to underlying [[coronary artery disease]] ([[CAD]]) and [[inherited]] causes in the development of [[ sudden cardiac arrest]] ([[SCA]]) are [[hypertension]], [[male]] [[gender]]		Common [[risk factors]] related to underlying [[coronary artery disease]] ([[CAD]]) and [[inherited]] causes in the development of [[ sudden cardiac arrest]] ([[SCA]]) are [[hypertension]], [[male]] [[gender]]
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	:*[[Early repolarization]] patten in early phase of [[MI]]<ref name="NaruseTada2012">{{cite journal\|last1=Naruse\|first1=Yoshihisa\|last2=Tada\|first2=Hiroshi\|last3=Harimura\|first3=Yoshie\|last4=Hayashi\|first4=Mayu\|last5=Noguchi\|first5=Yuichi\|last6=Sato\|first6=Akira\|last7=Yoshida\|first7=Kentaro\|last8=Sekiguchi\|first8=Yukio\|last9=Aonuma\|first9=Kazutaka\|title=Early Repolarization Is an Independent Predictor of Occurrences of Ventricular Fibrillation in the Very Early Phase of Acute Myocardial Infarction\|journal=Circulation: Arrhythmia and Electrophysiology\|volume=5\|issue=3\|year=2012\|pages=506–513\|issn=1941-3149\|doi=10.1161/CIRCEP.111.966952}}</ref>		:*[[Early repolarization]] patten in early phase of [[MI]]<ref name="NaruseTada2012">{{cite journal\|last1=Naruse\|first1=Yoshihisa\|last2=Tada\|first2=Hiroshi\|last3=Harimura\|first3=Yoshie\|last4=Hayashi\|first4=Mayu\|last5=Noguchi\|first5=Yuichi\|last6=Sato\|first6=Akira\|last7=Yoshida\|first7=Kentaro\|last8=Sekiguchi\|first8=Yukio\|last9=Aonuma\|first9=Kazutaka\|title=Early Repolarization Is an Independent Predictor of Occurrences of Ventricular Fibrillation in the Very Early Phase of Acute Myocardial Infarction\|journal=Circulation: Arrhythmia and Electrophysiology\|volume=5\|issue=3\|year=2012\|pages=506–513\|issn=1941-3149\|doi=10.1161/CIRCEP.111.966952}}</ref>
	:*Family history of premature death (sudden and unexpected) before age 50 attributed to [[heart]] disease in > 1 relative, presence of [[heart]] disease in close relative less than age 50, presence of ion [[channelopathies]] in family members		:*Family history of premature death (sudden and unexpected) before age 50 attributed to [[heart]] disease in > 1 relative, presence of [[heart]] disease in close relative less than age 50, presence of ion [[channelopathies]] in family members

			=== Sudden Cardiac Arrest in Young Athletes: ===
			Generally, athletes are considered healthier than young adults in the general population. In studies of children and young adults, incidence of sudden death in athletes was reported to be low at approximately 1 per 100000 person-years.<ref name=":0">Maron BJ, Haas TS, Murphy CJ, Ahluwalia A, Rutten-RamosS. Incidence and causes of sudden death in U.S. college athletes. J Am Coll Cardiol. 2014;63(16):1636-1643. doi:10.1016/j.jacc.2014.01. 041</ref>,<ref>Risgaard B, Winkel BG, Jabbari R, et al. Sports-related sudden cardiac death in a competitive and a non competitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark.Heart Rhythm.2014;11(10):1673-1681. doi:10.1016/j.hrthm. 2014.05.026</ref> However in a prospective study of 11168 adolescent soccer players (mean age, 16.4 years, 95% male) in the English Football Association cardiac screening program from 1996 through 2016, the incidence of sudden death was 6.8 per 100000 person-years.<ref>Malhotra A, Dhutia H, Finocchiaro G, et al. Outcomes of cardiac screening in adolescent soccer players. N Engl J Med.2018;379(6):524-534. doi: 10.1056/NEJMoa1714719</ref> Most common cause of cardiac arrests in young athletes are:

			# Sudden arrhythmic death syndrome
			# Coronary anomalies
			# Myocarditis
			# Valvular disease.<ref name=":0" />,<ref>Finocchiaro G, Papadakis M, Robertus JL, et al. Etiology of sudden death in sports: insights from a United Kingdom regional registry. J AmColl Cardiol. 2016;67(18):2108-2115. doi:10.1016/j.jacc.2016.02. 062</ref>

			A meta-analysis evaluating sudden cardiac death etiology in individuals younger than 35 years from 2010 through 2020 demonstrated that the following cardiac conditions were more common among athletes than nonathletes: hypertrophic cardiomyopathy(11.9%vs3.9%;P = .002),dilated cardiomyopathy (3.6% vs 0.8%; P = .047), and anomalous coronary arteries (7.2% vs 1.9%; P = .009).<ref>D’Ascenzi F, Valentini F, Pistoresi S, et al. Causes of sudden cardiac death in young athletes and non-athletes: systematic review and meta-analysis: sudden cardiac death in the young. Trends Cardiovasc Med. 2022;32(5):299-308. doi:10.1016/j.tcm.2021.06.001</ref>

	==References==		==References==

Sudden cardiac death screening

2026-04-06T14:53:42Z

← Older revision		Revision as of 14:53, 6 April 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}}

	==Overview==		==Overview==
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	==Screening==		==Screening==
	*~~[[Screening]]~~ in the ~~first relative~~ of [[patients]] with [[sudden cardiac arrest~~]] should be done if there is concern about inherited causes~~ of [[cardiac arrest]].		*If the phenotype in a patient resuscitated after sudden cardiac arrest is established, a recent expert consensus statement<ref name=":0">Stiles MK, Wilde AAM, Abrams DJ, et al. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. Heart Rhythm. 2021;18(1):e1-e50. doi:10.1016/j.hrthm.2020.10.010</ref> recommends genetic testing focused on potential candidate genes and clinical evaluation of family members to identify relatives who have or are at risk of developing a clinical condition.
			*If the cause of sudden cardiac arrest is not determined, first-degree relatives may undergo clinical evaluation, including ECG, cardiac imaging, ambulatory monitoring, and provocative testing.
			*Psychological evaluation and treatment of grief and post traumatic stress in survivors and their immediate family members by trained mental health professionals is recommended.<ref name=":0" />
	*Several [[SCD]] [[risk calculators]] are available for all age groups <ref name="pmid31155932">{{cite journal\| author=Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK \| display-authors=etal\| title=Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. \| journal=Circulation \| year= 2019 \| volume= 140 \| issue= 4 \| pages= 293-302 \| pmid=31155932 \| doi=10.1161/CIRCULATIONAHA.118.039410 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31155932 }} </ref> <ref name="pmid30915475">{{cite journal\| author=Cadrin-Tourigny J, Bosman LP, Nozza A, Wang W, Tadros R, Bhonsale A \| display-authors=etal\| title=A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 23 \| pages= 1850-1858 \| pmid=30915475 \| doi=10.1093/eurheartj/ehz103 \| pmc=6568197 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30915475 }} </ref> <ref name="pmid32418493">{{cite journal\| author=Miron A, Lafreniere-Roula M, Steve Fan CP, Armstrong KR, Dragulescu A, Papaz T \| display-authors=etal\| title=A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 3 \| pages= 217-229 \| pmid=32418493 \| doi=10.1161/CIRCULATIONAHA.120.047235 \| pmc=7365676 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32418493 }} </ref> <ref name="pmid31411652">{{cite journal\| author=Norrish G, Ding T, Field E, Ziólkowska L, Olivotto I, Limongelli G \| display-authors=etal\| title=Development of a Novel Risk Prediction Model for Sudden Cardiac Death in Childhood Hypertrophic Cardiomyopathy (HCM Risk-Kids). \| journal=JAMA Cardiol \| year= 2019 \| volume= 4 \| issue= 9 \| pages= 918-927 \| pmid=31411652 \| doi=10.1001/jamacardio.2019.2861 \| pmc=6694401 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31411652 }} </ref> <ref name="pmid24126876">{{cite journal\| author=O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C \| display-authors=etal\| title=A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). \| journal=Eur Heart J \| year= 2014 \| volume= 35 \| issue= 30 \| pages= 2010-20 \| pmid=24126876 \| doi=10.1093/eurheartj/eht439 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24126876 }} </ref>		*Several [[SCD]] [[risk calculators]] are available for all age groups <ref name="pmid31155932">{{cite journal\| author=Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK \| display-authors=etal\| title=Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. \| journal=Circulation \| year= 2019 \| volume= 140 \| issue= 4 \| pages= 293-302 \| pmid=31155932 \| doi=10.1161/CIRCULATIONAHA.118.039410 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31155932 }} </ref> <ref name="pmid30915475">{{cite journal\| author=Cadrin-Tourigny J, Bosman LP, Nozza A, Wang W, Tadros R, Bhonsale A \| display-authors=etal\| title=A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 23 \| pages= 1850-1858 \| pmid=30915475 \| doi=10.1093/eurheartj/ehz103 \| pmc=6568197 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30915475 }} </ref> <ref name="pmid32418493">{{cite journal\| author=Miron A, Lafreniere-Roula M, Steve Fan CP, Armstrong KR, Dragulescu A, Papaz T \| display-authors=etal\| title=A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 3 \| pages= 217-229 \| pmid=32418493 \| doi=10.1161/CIRCULATIONAHA.120.047235 \| pmc=7365676 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32418493 }} </ref> <ref name="pmid31411652">{{cite journal\| author=Norrish G, Ding T, Field E, Ziólkowska L, Olivotto I, Limongelli G \| display-authors=etal\| title=Development of a Novel Risk Prediction Model for Sudden Cardiac Death in Childhood Hypertrophic Cardiomyopathy (HCM Risk-Kids). \| journal=JAMA Cardiol \| year= 2019 \| volume= 4 \| issue= 9 \| pages= 918-927 \| pmid=31411652 \| doi=10.1001/jamacardio.2019.2861 \| pmc=6694401 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31411652 }} </ref> <ref name="pmid24126876">{{cite journal\| author=O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C \| display-authors=etal\| title=A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). \| journal=Eur Heart J \| year= 2014 \| volume= 35 \| issue= 30 \| pages= 2010-20 \| pmid=24126876 \| doi=10.1093/eurheartj/eht439 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24126876 }} </ref>
	**[[HCM Risk-Kids Score]] is a validated [[risk calculator]] used for [[patients]] with [[hypertrophic cardiomyopathy]] ([[HCM]]) who are up to 16 years of [[age]].		**[[HCM Risk-Kids Score]] is a validated [[risk calculator]] used for [[patients]] with [[hypertrophic cardiomyopathy]] ([[HCM]]) who are up to 16 years of [[age]].

Sudden cardiac death other diagnostic studies

2026-04-06T14:33:31Z

Postmortem Genetic Investigation:

Show changes

Sudden cardiac death diagnostic study of choice

2026-04-04T13:50:54Z

References

← Older revision		Revision as of 13:50, 4 April 2026
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	==Overview==		==Overview==
			Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>

	In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:		In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:

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	==Diagnosis Study Of Choice==		==Diagnosis Study Of Choice==
			*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
			*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />
	*According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.		*According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.
	* [[Autopsy]] investigates whether:		* [[Autopsy]] investigates whether:
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	** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations		** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations
	** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>		** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>
	*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>		*
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

	==References==		==References==

Sudden cardiac death echocardiography and ultrasound

2026-04-04T13:46:53Z

Echocardiography

← Older revision		Revision as of 13:46, 4 April 2026
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	* [[Tamponade]]		* [[Tamponade]]
	* [[ Aorta dissection]] <ref name="ParkerSalerno2018">{{cite journal\|last1=Parker\|first1=Brian K.\|last2=Salerno\|first2=Alexis\|last3=Euerle\|first3=Brian D.\|title=The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review\|journal=Journal of Ultrasound in Medicine\|volume=38\|issue=5\|year=2018\|pages=1141–1151\|issn=0278-4297\|doi=10.1002/jum.14794}}</ref>		* [[ Aorta dissection]] <ref name="ParkerSalerno2018">{{cite journal\|last1=Parker\|first1=Brian K.\|last2=Salerno\|first2=Alexis\|last3=Euerle\|first3=Brian D.\|title=The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review\|journal=Journal of Ultrasound in Medicine\|volume=38\|issue=5\|year=2018\|pages=1141–1151\|issn=0278-4297\|doi=10.1002/jum.14794}}</ref>
			* Mitral valve prolapse<ref>Han HC, Ha FJ, Teh AW, et al.Mitral valve prolapse and sudden cardiac death:a systematic review. JAmHeartAssoc.2018;7(23):e010584.doi: 10.1161/JAHA.118.010584</ref>

Sudden cardiac death diagnostic study of choice

2026-04-04T13:43:27Z

Diagnosis Study Of Choice

← Older revision		Revision as of 13:43, 4 April 2026
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	*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>		*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />		*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

	==References==		==References==

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 electrocardiogram

2026-04-04T13:38:49Z

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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}} {{Nehal}}

	==Overview==		==Overview==

Sudden cardiac death echocardiography and ultrasound

2026-04-04T12:32:24Z

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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==

Sudden cardiac death diagnostic study of choice

2026-04-04T12:16:33Z

Overview

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	** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations		** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations
	** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>		** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>
			*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />		*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

Sudden cardiac death electrocardiogram

2026-04-04T12:14:59Z

Brugada syndrome:

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	== Long QT syndrome: ==		== Long QT syndrome: ==
	Patients should be evaluated for LQTS, if the corrected QT interval remains at 460 milliseconds or longer for females or 450 milliseconds or longer for males 70 beyond 6 days after resuscitation,71. It is the most common arrhythmia syndrome causing sudden cardiac arrest.64 In patients with LQTS, a prolonged QT interval results in the end of ~~theT~~ wave often exceeding half of the RR interval,along ~~withbroad~~,biphasic,or notched T waves with beat-to-beat alternans (~~Figure 3A~~).72 In a study of 647 untreated patients older than 28 years with LQTS, 13% experienced out-of-hospital cardiac ~~ar rest~~ or sudden death before age 40 years.73 LQTS can be either congenital or acquired, most commonly due to drugs such as antiarrhythmics,antipsychotics,antidepressants,or antibiotics(a continuously updated list can be found at https://crediblemeds.org/). However, some acquired LQTS cases may have underlying congenital LQTS unmasked by drugs or other predisposing factors such as electrolyte abnormalities (hypokalemia, hypomagnesemia, and hypocalcemia) or bradyarrhythmias. Evaluation for acquired LQTS should be reassessed after resolution of these factors.~~74v~~		Patients should be evaluated for LQTS, if the corrected QT interval remains at 460 milliseconds or longer for females or 450 milliseconds or longer for males<ref>Vink AS, Neumann B, Lieve KVV, et al. Determination and interpretation of the QT interval. Circulation. 2018;138(21):2345-2358. doi:10.1161/CIRCULATIONAHA.118.033943</ref> beyond 6 days after resuscitation.<ref>Cohen RB, Dai M, Aizer A, et al. QT interval dynamics and triggers for QTprolongation immediately following cardiac arrest. Resuscitation. 2021;162:171-179. doi:10.1016/j.resuscitation.2021.02. 029</ref> It is the most common arrhythmia syndrome causing sudden cardiac arrest.<ref name=":0" /> In patients with LQTS, a prolonged QT interval results in the end of the T wave often exceeding half of the RR interval,along with broad,biphasic,or notched T waves with beat-to-beat alternans.<ref>Krahn AD, Laksman Z, Sy RW, et al.Congenital long QT syndrome.JACCClinElectrophysiol. 2022;8 (5):687-706. doi:10.1016/j.jacep.2022.02.017</ref> In a study of 647 untreated patients older than 28 years with LQTS, 13% experienced out-of-hospital cardiac arrest or sudden death before age 40 years.<ref>Priori SG, Schwartz PJ, Napolitano C, et al. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348(19):1866-1874. doi:10.1056/ NEJMoa022147</ref> LQTS can be either congenital or acquired, most commonly due to drugs such as antiarrhythmics,antipsychotics,antidepressants,or antibiotics (a continuously updated list can be found at https://crediblemeds.org/). However, some acquired LQTS cases may have underlying congenital LQTS unmasked by drugs or other predisposing factors such as electrolyte abnormalities (hypokalemia, hypomagnesemia, and hypocalcemia) or bradyarrhythmias. Evaluation for acquired LQTS should be reassessed after resolution of these factors.<ref>Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al; ESC Scientific Document Group. 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. EurHeartJ. 2022;43(40): 3997-4126. doi:10.1093/eurheartj/ehac262</ref>

			== Brugada syndrome: ==
			In Brugada syndrome, type 1 pattern (ie,coved shape of ST segment) in leads V1 and V2 can sometimes be recorded when these leads are moved to the second or third intercostal spaces instead of the typical fourth intercostal space.<ref>Zeppenfeld K,Tfelt-Hansen J, de Riva M, et al; ESC Scientific Document Group. 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. EurHeartJ. 2022;43(40): 3997-4126. doi:10.1093/eurheartj/ehac262</ref> In preexcitation syndromes (ie,Wolff-Parkinson-White), the observed delta waves are a marker for potential atrioventricular reentrant tachycardia or VF via preexcited atrial fibrillation.<ref>Pappone C, Vicedomini G, Manguso F, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130(10):811-819. doi:10.1161/CIRCULATIONAHA.114.011154</ref> In some cases of arrhythmogenic right ventricular cardiomyopathy, epsilon waves that represent delayed right ventricular conduction can be observed in the ST segment in the right precordial leads.<ref>Marcus FI, Fontaine GH, Guiraudon G, et al. Right ventricular dysplasia: a report of 24 adult cases. Circulation. 1982;65(2):384-398. doi:10.1161/ 01.CIR.65.2.384</ref>

	==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==		==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==

Sudden cardiac death causes

2026-04-04T11:42:57Z

Causes

Show changes

Sudden cardiac death electrocardiogram

2026-04-04T10:26:57Z

Electrocardiogram

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	===Electrocardiogram===		===Electrocardiogram===
	An [[electrocardiogram]] ([[ECG]]) may be helpful in the diagnosis of [[Sudden cardiac death]]. Findings on [[ECG]] associated with [[ sudden cardiac arrest]] ([[SCA]]) may 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>		An [[electrocardiogram]] ([[ECG]]) may be helpful in the diagnosis of [[Sudden cardiac death]].

			Findings on [[ECG]] associated with [[ sudden cardiac arrest]] ([[SCA]]) may 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>

	* [[Sinus tachycardia]] (39%)		* [[Sinus tachycardia]] (39%)
	* Abnormal [[T-wave inversions]] (30%)		* Abnormal [[T-wave inversions]] (30%)
	* Prolonged [[QT]] interval (26%)		* Prolonged [[QT]] interval
			* Long QT syndrome (26%) (present in 13% of young adults resuscitated from sudden cardiac arrest)<ref name=":0">Krahn AD, Healey JS, Chauhan V, et al. Systematic assessment of patients with unexplained cardiac arrest: Cardiac Arrest Survivors With Preserved Ejection Fraction Registry (CASPER). Circulation. 2009;120(4):278-285. doi:10.1161/CIRCULATIONAHA.109.853143</ref>
	* Left/[[right atrial]] abnormality (22%)		* Left/[[right atrial]] abnormality (22%)
	* [[ LVH]] (17%)		* [[ LVH]] (17%)
	* Abnormal frontal [[QRS axis]] (17%)		* Abnormal frontal [[QRS axis]] (17%)
	* Delayed [[QRS]]-transition zone in precordial leads (13%)		* Delayed [[QRS]]-transition zone in precordial leads (13%)
	* Pathological [[Q waves]] (13%)		* Pathological [[Q waves]] (13%)
	* [[intraventricular conduction delays]] (9%)		* [[intraventricular conduction delays]] (9%)
			* Wolff-Parkinson-White syndrome(5%-12% of young adults with cardiac arrest)<ref name=":0" />,<ref>van der Werf C, Hofman N, Tan HL, et al. Diagnostic yield in sudden unexplained death and aborted cardiac arrest in the young: the experience of a tertiary referral center in the Netherlands. Heart Rhythm.2010;7(10):1383-1389. doi:10.1016/j. hrthm.2010.05.036</ref>
			* Arrhythmogenic right ventricular cardiomyopathy(10% of young adults with cardiac arrest)<ref name=":0" />
			* Brugada syndrome (<1%).<ref>Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006.Circulation. 2009;119 (8):1085-1092. doi:10.1161/CIRCULATIONAHA.108.804617</ref>
	* Multiple [[premature ventricular contractions]] (9%)		* Multiple [[premature ventricular contractions]] (9%)
	* Normal [[ECG]] (9%)		* Normal [[ECG]] (9%)
			* If the ECG shows STEMI or unstable arrhythmia, the patient should be referred for emergency coronary angiography followed by revascularization in case of acute ischemia.

	A recently published case report demonstrated a [[cardiac arrest]] happening due to a very unusual cause. It was triggered by the increased [[parasympathethic tone]] during defecation. The successive changes that were observed on [[ECG]] were in this order: [[prolonged PR interval]], [[2:1 atrioventricular block]], [[sinus bradycardia]] and [[complete heart block]]. These findings supported the occurrence of a central mechanism in this cardiac arrest.<ref name="pmid33464284">{{cite journal\| author=Tsushima T, Patel TR, Sahadevan J\| title=Unusual Cause of Cardiac Arrest. \| journal=JAMA Intern Med \| year= 2021 \| volume= 181 \| issue= 4 \| pages= 542-543 \| pmid=33464284 \| doi=10.1001/jamainternmed.2020.8370 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33464284 }} </ref>		A recently published case report demonstrated a [[cardiac arrest]] happening due to a very unusual cause. It was triggered by the increased [[parasympathethic tone]] during defecation. The successive changes that were observed on [[ECG]] were in this order: [[prolonged PR interval]], [[2:1 atrioventricular block]], [[sinus bradycardia]] and [[complete heart block]]. These findings supported the occurrence of a central mechanism in this cardiac arrest.<ref name="pmid33464284">{{cite journal\| author=Tsushima T, Patel TR, Sahadevan J\| title=Unusual Cause of Cardiac Arrest. \| journal=JAMA Intern Med \| year= 2021 \| volume= 181 \| issue= 4 \| pages= 542-543 \| pmid=33464284 \| doi=10.1001/jamainternmed.2020.8370 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33464284 }} </ref>


			Repeating 12 lead ECGs are important during evaluation because ECG wave forms, particularly type 1 waveform in Brugada syndrome<ref>Curcio A, Mazzanti A, Bloise R, et al.Clinical presentation and outcome of Brugada syndrome diagnosed with the new 2013 criteria. JCardiovasc Electrophysiol. 2016;27(8):937-943. doi:10.1111/jce. 12997</ref> and the QTinterval, may show day-to-day and circadian variation<ref>Jeyaraj D, Haldar SM, Wan X, et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis. Nature. 2012;483(7387):96-99. doi:10.1038/nature10852</ref> and variation after the initial resuscitation due to ischemia, autonomic fluctuations, and electrolyte derangements (eg, hypokalemia, hypomagnesemia) after sudden cardiac arrest.<ref>Salerno DM, Asinger RW, Elsperger J, Ruiz E, Hodges M. Frequency of hypokalemia after successfully resuscitated out-of-hospital cardiac arrest compared with that in transmural acute myocardial infarction. Am J Cardiol. 1987;59(1):84 88. doi:10.1016/S0002-9149(87)80075-9</ref>

			== Long QT syndrome: ==
			Patients should be evaluated for LQTS, if the corrected QT interval remains at 460 milliseconds or longer for females or 450 milliseconds or longer for males 70 beyond 6 days after resuscitation,71. It is the most common arrhythmia syndrome causing sudden cardiac arrest.64 In patients with LQTS, a prolonged QT interval results in the end of theT wave often exceeding half of the RR interval,along withbroad,biphasic,or notched T waves with beat-to-beat alternans (Figure 3A).72 In a study of 647 untreated patients older than 28 years with LQTS, 13% experienced out-of-hospital cardiac ar rest or sudden death before age 40 years.73 LQTS can be either congenital or acquired, most commonly due to drugs such as antiarrhythmics,antipsychotics,antidepressants,or antibiotics(a continuously updated list can be found at https://crediblemeds.org/). However, some acquired LQTS cases may have underlying congenital LQTS unmasked by drugs or other predisposing factors such as electrolyte abnormalities (hypokalemia, hypomagnesemia, and hypocalcemia) or bradyarrhythmias. Evaluation for acquired LQTS should be reassessed after resolution of these factors.74v

	==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==		==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==

Sudden cardiac death diagnostic study of choice

2026-04-04T10:00:39Z

Overview

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	==Overview==		==Overview==
			In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:

			# 12-lead electrocardiogram (ECG)
			# Toxicology testing
			# Bedside neurological assessment
			# Neuroimaging (eg, head computed tomography [CT]) after the patient has stabilized.

	According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.		According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.

Sudden cardiac death history and symptoms

2026-04-04T09:50:16Z

Overview

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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==
	[[Sudden cardiac death]] ([[SCD]]) often happens without warning and [[symptoms]]are usually drastic. History taking should be concise and be more focused on information very pertinent to [[SCD]] such as the presence of family history of [[SCD]], [[epilepsy]], [[deafness]] due to [[long QT syndrome]] ([[LQTS]]), [[sudden infant death syndrome]] ([[SIDS]]), or [[pacemaker]] [[implantation]] at 50 years old or younger <ref name="pmid29562304">{{cite journal\| author=Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A \| display-authors=etal\| title=2018 ESC Guidelines for the diagnosis and management of syncope. \| journal=Eur Heart J \| year= 2018 \| volume= 39 \| issue= 21 \| pages= 1883-1948 \| pmid=29562304 \| doi=10.1093/eurheartj/ehy037 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29562304 }} </ref> <ref name="pmid23150455">{{cite journal\| author=Ranthe MF, Winkel BG, Andersen EW, Risgaard B, Wohlfahrt J, Bundgaard H \| display-authors=etal\| title=Risk of cardiovascular disease in family members of young sudden cardiac death victims. \| journal=Eur Heart J \| year= 2013 \| volume= 34 \| issue= 7 \| pages= 503-11 \| pmid=23150455 \| doi=10.1093/eurheartj/ehs350 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23150455 }} </ref>.		[[Sudden cardiac death]] ([[SCD]]) often happens without warning and [[symptoms ]]are usually drastic. History taking should be concise and be more focused on information very pertinent to [[SCD]] such as the presence of family history of [[SCD]], [[epilepsy]], [[deafness]] due to [[long QT syndrome]] ([[LQTS]]), [[sudden infant death syndrome]] ([[SIDS]]), or [[pacemaker]] [[implantation]] at 50 years old or younger <ref name="pmid29562304">{{cite journal\| author=Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A \| display-authors=etal\| title=2018 ESC Guidelines for the diagnosis and management of syncope. \| journal=Eur Heart J \| year= 2018 \| volume= 39 \| issue= 21 \| pages= 1883-1948 \| pmid=29562304 \| doi=10.1093/eurheartj/ehy037 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29562304 }} </ref> <ref name="pmid23150455">{{cite journal\| author=Ranthe MF, Winkel BG, Andersen EW, Risgaard B, Wohlfahrt J, Bundgaard H \| display-authors=etal\| title=Risk of cardiovascular disease in family members of young sudden cardiac death victims. \| journal=Eur Heart J \| year= 2013 \| volume= 34 \| issue= 7 \| pages= 503-11 \| pmid=23150455 \| doi=10.1093/eurheartj/ehs350 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23150455 }} </ref>.


	==Symptoms==		==Symptoms==
	*[[Symptoms]] related to [[arrhythmia]] or underlying [[ heart disease]]may include the following:		*[[Symptoms]] related to [[arrhythmia]] or underlying [[ heart disease]]may include the following:
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	* [[Paroxysmal nocturnal dyspnea]] ([[PND]]), and		* [[Paroxysmal nocturnal dyspnea]] ([[PND]]), and
	* [[Edema]]<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>		* [[Edema]]<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>
	*

			In young adults, sudden cardiac arrest occurs more frequently at rest and during sleep than during exercise. In a study in which 153 persons aged 19 to 34 years, only 8 (5.2%) occurred during sports related activity.<ref>Jayaraman R, Reinier K, Nair S, et al. Risk factors of sudden cardiac death in the young: multiple-year community-wide assessment. Circulation. 2018;137(15):1561-1570. doi:10.1161/ CIRCULATIONAHA.117.031262</ref>

			Other studies have found that among young adults, the sudden cardiac death occurred during exercise in 7% to 15%, whereas 30% to 40% died during sleep.<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>,<ref>Wisten A, Krantz P, Stattin EL. Sudden cardiac death among the young in Sweden from 2000 to 2010:an autopsy-based study.Europace.2017;19 (8):1327-1334.</ref>,<ref>Ha FJ, Han HC, Sanders P, et al. Sudden cardiac death in the young:incidence, trends, and risk factors in a nationwide study. Circ Cardiovasc Qual Outcomes.2020;13(10):e006470.doi:10.1161/ CIRCOUTCOMES.119.006470</ref>,<ref>Rücklová K, Dobiáš M, Bílek M, et al.Burden of sudden cardiac death in persons aged 1-40 years in the CzechRepublic. CentEurJPublicHealth. 2022;30(1):58-64. doi:10.21101/cejph.a6793</ref>,<ref>Winkel BG, Holst AG, Theilade J, et al. Nationwide study of sudden cardiac death in persons aged1-35years. Eur HeartJ. 2011;32(8): 983-990.doi:10.1093/eurheartj/ehq428</ref>,<ref>Lynge TH, Nielsen JL, Risgaard B, van der Werf C, Winkel BG, Tfelt-Hansen J. Causes of sudden cardiac death according to age and sex in persons aged 1-49 years. HeartRhythm.2023;20(1):61-68. doi:10.1016/j.hrthm.2022.08.036</ref>

			Sudden cardiac death during sexual intercourse is rare. An autopsy-based study involving 6847 persons with sudden cardiac death in the UK reported that 17 (0.2%) occurred during or within an hour of sexual intercourse. The mean age of the17 who died suddenly was 38 years,11 (65%) of whom were men. The autopsy results showed that 9 cases (53%) had a structurally normal heart consistent with sudden arrhythmic death syndrome.<ref>Finocchiaro G, Westaby J, Behr ER, Papadakis M, Sharma S, Sheppard MN. Association of sexual intercourse with sudden cardiac death in young individuals in the United Kingdom. JAMACardiol. 2022;7(3):358-359. doi:10.1001/jamacardio.2021. 5532</ref>

	==References==		==References==

Sudden cardiac death epidemiology and demographics

2026-04-04T09:29:56Z

Age

← Older revision		Revision as of 09:29, 4 April 2026
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	* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.		* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.
	* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.		* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.
			* Among autopsy studies of persons younger than age 30 years who had sudden cardiac death, the most common cause was sudden arrhythmic death syndrome with normal heart on postmort emexamination (36%-49%).<ref name=":6">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><ref name=":7">Wisten A, Krantz P, Stattin EL. Sudden cardiac death among the young in Sweden from 2000 to 2010: an autopsy-based study. Europace.2017;19 (8):1327-1334.</ref>
			* The proportion of cases attributable to CAD increased with age, from 6% to 14% in persons younger than 30 years and to 19% to 46% in persons aged 30 years or older.<ref name=":6" />,<ref name=":7" />,<ref name="pmid21131293" />,<ref>Lynge TH, Nielsen JL, Risgaard B, van der Werf C, Winkel BG, Tfelt-Hansen J. Causes of sudden cardiac death according to age and sex in persons aged1-49 years. HeartRhythm.2023;20(1):61-68. doi:10.1016/j.hrthm.2022.08.036</ref>
			* Unexpected myocarditis is another relatively common underlying cause of sudden cardiac death in young adults.<ref name=":6" />,<ref name=":7" />,<ref name="pmid21131293" />
			* Autopsy-confirmed dilated cardiomyopathy was more frequently identified among individuals who were older than 30 years (10%) than individuals who were younger than 30 years (5%).<ref name=":6" />,<ref name=":7" />
			* Autopsy-based studies of individuals with sudden cardiac death aged 18 to 50 years reported that 65% to 78% had at least one known cardiovascular disease (CVD) risk factor (ie, hypertension, diabetes,dyslipidemia,obesity,smoking) before death.<ref name=":2" />,<ref>Vähätalo J, Holmström L, Pakanen L, et al. Coronary artery disease as the cause of sudden cardiac death among victims <50 years of age.Am J Cardiol. 2021;147:33-38. doi:10.1016/j.amjcard. 2021.02.012</ref> In these studies, compared with the reported prevalence of individual risk factors in the general US population among those aged 20 through 44 years,<ref>Aggarwal R, Yeh RW, Joynt Maddox KE, Wadhera RK. Cardiovascular risk factor prevalence, treatment, and control in us adults aged 20 to 44 years, 2009 to March 2020.JAMA.2023;329(11): 899-909.doi:10.1001/jama.2023.2307</ref> the reported prevalence of hypertension and diabetes was higher among those with sudden cardiac death (22%-24% vs 12% and 12% - 19% vs 4%, respectively).

	===Gender===		===Gender===

	*commonly affected with [[sudden cardiac death]] than [[women]] in all age groups.<ref name="EckartShry2011">{{cite journal\|last1=Eckart\|first1=Robert E.\|last2=Shry\|first2=Eric A.\|last3=Burke\|first3=Allen P.\|last4=McNear\|first4=Jennifer A.\|last5=Appel\|first5=David A.\|last6=Castillo-Rojas\|first6=Laudino M.\|last7=Avedissian\|first7=Lena\|last8=Pearse\|first8=Lisa A.\|last9=Potter\|first9=Robert N.\|last10=Tremaine\|first10=Ladd\|last11=Gentlesk\|first11=Philip J.\|last12=Huffer\|first12=Linda\|last13=Reich\|first13=Stephen S.\|last14=Stevenson\|first14=William G.\|title=Sudden Death in Young Adults\|journal=Journal of the American College of Cardiology\|volume=58\|issue=12\|year=2011\|pages=1254–1261\|issn=07351097\|doi=10.1016/j.jacc.2011.01.049}}</ref>		*Men commonly affected with [[sudden cardiac death]] than [[women]] in all age groups.<ref name="EckartShry2011">{{cite journal\|last1=Eckart\|first1=Robert E.\|last2=Shry\|first2=Eric A.\|last3=Burke\|first3=Allen P.\|last4=McNear\|first4=Jennifer A.\|last5=Appel\|first5=David A.\|last6=Castillo-Rojas\|first6=Laudino M.\|last7=Avedissian\|first7=Lena\|last8=Pearse\|first8=Lisa A.\|last9=Potter\|first9=Robert N.\|last10=Tremaine\|first10=Ladd\|last11=Gentlesk\|first11=Philip J.\|last12=Huffer\|first12=Linda\|last13=Reich\|first13=Stephen S.\|last14=Stevenson\|first14=William G.\|title=Sudden Death in Young Adults\|journal=Journal of the American College of Cardiology\|volume=58\|issue=12\|year=2011\|pages=1254–1261\|issn=07351097\|doi=10.1016/j.jacc.2011.01.049}}</ref>
			*In a study of sudden cardiac death in young adults (n =2006,median age, 28 years), CAD was more common in males (44%) than in females (27%), whereas unspecified cardiomyopathy (5% males vs 7% females, P = .04), myocarditis (9% males vs 14% females,P < .001), and valvular heart disease (2% males vs 7% females,P < .001) were more common in young females.<ref>Ha FJ, Han HC, Sanders P, et al. Sudden cardiac death in the young:incidence, trends, and risk factors in a nationwide study. Circ Cardiovasc Qual Outcomes. 2020;13(10):e006470.doi:10.1161/ CIRCOUTCOMES.119.006470</ref>

	===Race===		===Race===

Sudden cardiac death causes

2026-04-04T08:59:22Z

Causes

← Older revision		Revision as of 08:59, 4 April 2026
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	* Autopsy-based studies demonstrate that 55% to 69% of young adults with sudden cardiac death have underlying cardiac causes, including sudden arrhythmic death syndrome (normal heart by autopsy, common in athletes) and structural heart disease such as coronary artery disease. <ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. ''JAMA.'' 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		* Autopsy-based studies demonstrate that 55% to 69% of young adults with sudden cardiac death have underlying cardiac causes, including sudden arrhythmic death syndrome (normal heart by autopsy, common in athletes) and structural heart disease such as coronary artery disease. <ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. ''JAMA.'' 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	* In young adults, noncardiac causes of outside of hospital cardiac arrest may include drug overdose, pulmonary embolism, subarachnoid hemorrhage,seziure,anaphylaxis, and infection.<ref name=":0" />		* In young adults, noncardiac causes of outside of hospital cardiac arrest may include drug overdose, pulmonary embolism, subarachnoid hemorrhage,seziure,anaphylaxis, and infection.<ref name=":0" />
			* Over a 3-year study period (2011-2014), autopsies of 32 persons aged 18 through 39 years with presumed sudden cardiac deaths in San Francisco demonstrated that 40% had a noncardiac cause.<ref name=":1">Tseng ZH, Olgin JE, Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCDstudy.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref> Even when a lethal rhythm is documented at the time of sudden death, including VT or VF <ref>Kim AS, Moffatt E, Ursell PC, Devinsky O, Olgin J, Tseng ZH.Sudden neurologic death masquerading as out-of-hospital sudden cardiac death. Neurology. 2016;87(16):1669-1673. doi:10. 1212/WNL.0000000000003238</ref>or complete heart block,<ref name=":1" /> be due to underlying noncardiac causes, such as intracranial hemorrhage or drug overdose.
			* Combined data from 4 autopsy-based studies worldwide that include 529 presumed sudden cardiac deaths among those aged 14 through 44 years, with autopsy rates ranging from 43% to 100%, demonstrated that cardiac causes accounted for 64% of sudden deaths.
			* The most frequent cardiac causes were coronary artery disease (22% of all presumed suddencardiac deaths), sudden arrhythmic death syndrome (16%),hypertrophic cardiomyopathy (12%), and cardiomyopathy (11%). The most frequent noncardiac causes were neu rological (9.3%), pulmonary (8.1%), overdose (4.7%), and infection (4.7%).<ref name=":1" />,<ref>Carrington M, de Gouveia RH, Teixeira R, Corte-Real F, Gonçalves L, Providência R. Sudden death in young South European population: a cross-sectional study of postmortem cases. SciRep. 2023;13(1):22734. doi:10.1038/s41598-023-47502-0</ref>,<ref>Margey R, Roy A, Tobin S, et al. Sudden cardiac death in 14- to 35-year olds in Ireland from 2005 to 2007: a retrospective registry. Europace. 2011;13 (10):1411-1418. doi:10.1093/europace/eur161</ref>,<ref>van der Werf C, Hendrix A, Birnie E, etal. Improving usual care after sudden death in the young with focus on inherited cardiac diseases (the CAREFULstudy): a community-based intervention study. Europace. 2016;18(4):592-601. doi:10.1093/europace/euv059</ref>
			* The distribution of underlying causes of sudden cardiac arrest in resuscitated patients differs from those who were not resuscitated (ie, sudden cardiac death) with significantly more noncardiac causes in the latter.<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>
	* >50% of young adults with presumed sudeen cardiac death had identifiable cardiovascular risk factors such as hypertension and diabetes.<ref name=":0" />		* >50% of young adults with presumed sudeen cardiac death had identifiable cardiovascular risk factors such as hypertension and diabetes.<ref name=":0" />
	* 2% to 22% of young adult survivors of outside hospital cardiac arrest had genetic cardiac disease such as long QT syndrome or dilated cardiomyopathy, which is a lower yield than for nonsurvivors (13%-34%) with autopsy-confirmed sudden cardiac death.<ref name=":0" />		* 2% to 22% of young adult survivors of outside hospital cardiac arrest had genetic cardiac disease such as long QT syndrome or dilated cardiomyopathy, which is a lower yield than for nonsurvivors (13%-34%) with autopsy-confirmed sudden cardiac death.<ref name=":0" />

Sudden cardiac death epidemiology and demographics

2026-04-02T03:31:49Z

Race

← Older revision		Revision as of 03:31, 2 April 2026
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	===Age===		===Age===
	* There is a low [[incidence]] of [[SCD]] in [[infants]] and [[children]] which is approximately 1 per 100,000 person-years.		* There is a low [[incidence]] of [[SCD]] in [[infants]] and [[children]] which is approximately 1 per 100,000 person-years.
			* In adults younger than 40 years, the worldwide incidence of presumed sudden cardiac death is 4.2 to 7.8 per 100000 person-years.<ref name=":1">Zhang J, Zhou X, Xing Q,et al.Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomousregion in Northwest China. BMCPublicHealth. 2019;19(1):116. doi:10. 1186/s12889-019-6435-8</ref><ref name=":2">Tseng ZH, Olgin JE, Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCDstudy.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref><ref name=":3">Empana JP, Lerner I, Valentin E, et al; ESCAPE-NET Investigators. Incidence of sudden cardiac death in the EuropeanUnion.JAmColl Cardiol. 2022;79(18):1818-1827. doi:10.1016/j.jacc. 2022.02.041</ref><ref name=":4">Hua W, Zhang LF, Wu YF, et al.Incidence of sudden cardiac death in China:analysis of 4 regional populations. J Am Coll Cardiol. 2009;54 (12):1110-1118. doi:10.1016/j.jacc.2009.06.016</ref><ref name=":5">Hendrix A, Vaartjes I, Mosterd A, et al. Regional differences in incidence of sudden cardiac death in the young.NethJMed.2010;68(6):274-279.</ref>
			* In adults aged 40 through 49 years, the worldwide incidence of presumed sudden cardiac death is 23 to 34 per 100000 person-years.<ref name=":1" /><ref name=":2" /><ref name=":3" /><ref name=":4" /><ref name=":5" />
	* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.		* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.
	* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.		* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.
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	===Race===		===Race===
	*[[Black]] individuals are more likely to develop [[cardiac arrest]].<ref name="BeckerHan1993">{{cite journal\|last1=Becker\|first1=Lance B.\|last2=Han\|first2=Ben H.\|last3=Meyer\|first3=Peter M.\|last4=Wright\|first4=Fred A.\|last5=Rhodes\|first5=Karin V.\|last6=Smith\|first6=David W.\|last7=Barrett\|first7=John\|title=Racial Differences in the Incidence of Cardiac Arrest and Subsequent Survival\|journal=New England Journal of Medicine\|volume=329\|issue=9\|year=1993\|pages=600–606\|issn=0028-4793\|doi=10.1056/NEJM199308263290902}}</ref>		*[[Black]] individuals are more likely to develop [[cardiac arrest]].<ref name="BeckerHan1993">{{cite journal\|last1=Becker\|first1=Lance B.\|last2=Han\|first2=Ben H.\|last3=Meyer\|first3=Peter M.\|last4=Wright\|first4=Fred A.\|last5=Rhodes\|first5=Karin V.\|last6=Smith\|first6=David W.\|last7=Barrett\|first7=John\|title=Racial Differences in the Incidence of Cardiac Arrest and Subsequent Survival\|journal=New England Journal of Medicine\|volume=329\|issue=9\|year=1993\|pages=600–606\|issn=0028-4793\|doi=10.1056/NEJM199308263290902}}</ref>
			*Incidence of presumed sudden cardiac death among adults younger than 40 years in Cameroon was higher at 12 to 42 per 100000 person-years.<ref>Bonny A,Tibazarwa K, Mbouh S, et al; PanAfrican 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>
			*In a US study from 1999 through 2015 (n = 31492), Black individuals younger than 34 years had a higher incidence of presumed sudden cardiac deaths (1.88 per 100000 person-years in 2015) than Hispanic individuals (0.66 per 100000 person-years),and White individuals (1.17 per 100000 person-years),<ref>El-AssaadI, Al-Kindi SG, Aziz PF. Trends of out-of-hospital sudden cardiac death among children and youngadults. Pediatrics. 2017;140(6): e20171438. doi:10.1542/peds.2017-1438</ref> which may be due to inequitable access to care <ref>Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12. doi:10. 1186/s40985-016-0025-4</ref> and racial disparities among out-of hospital resuscitation attempts.
			*White individuals were more likely to receive bystander CPR after a witnessed cardiac arrest and postresuscitation care than were Black and Hispanic persons in several US based studies.<ref>Toy J, Bosson N, Schlesinger S,Gausche-Hill M. Racial and ethnic disparities in the provision of bystander CPR after witnessed out-of-hospital cardiac arrest in the United States. Resuscitation. 2023;190:109901. doi:10.1016/j.resuscitation.2023. 109901</ref><ref>Casey SD, Mumma BE.Sex,race,and insurance status differences in hospital treatment and outcomes following out-of-hospital cardiac arrest. Resuscitation. 2018;126:125-129. doi:10.1016/j. resuscitation.2018.02.027</ref>

	==References==		==References==

Sudden cardiac versus non-cardiac death

2026-04-02T02:57:45Z

References

Show changes