Sudden cardiac death causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3] Nehal Eid, M.D.[4]
Overview
Sudden cardiac arrest (SCA) may be caused by underlying cardiac abnormality including coronary artery abnormality , hypertrophy of myocardium, myocardial disease, valvular heart disease, congenital heart disease, abnormality in conducting system and electrical instability. The type of cardiac disease that is associated with sudden cardiac death (SCD) depends on the age of the individual [1] [2] [3] [4] [5] [6] [7] [8].
Causes
- Cardiac causes of sudden cardiac death (SCD) depend on the age of the individual [1] [2] [3] [4] [5] [6] [7] [8].
- In young people, cardiomyopathy, myocarditis, primary electric diseases and coronary abnormalities predominate [1] [2] [3] [4] [5] [6] [7] [8].
- 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. [9]
- In young adults, noncardiac causes of outside of hospital cardiac arrest may include drug overdose, pulmonary embolism, subarachnoid hemorrhage,seziure,anaphylaxis, and infection.[9]
- >50% of young adults with presumed sudeen cardiac death had identifiable cardiovascular risk factors such as hypertension and diabetes.[9]
- 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.[9]
- In people who are on their fourth decade of life, acute coronary syndrome (ACS) greatly predominates [10] [11].
- In elderly, structural diseases predominate [2].
Different etiologies in relation to geographical distribution:
- The number 1 cause of out-of-hospital cardiac arrest in the US among adults between 25 to 35 years is CAD (43%), followed by sudden unexplained death (14%).[12]
- According to a Canadian study, the most common etiologies of cardiac arrest among 131 individuals aged 25 through 34 years were structural heart disease (including cardiomyopathy and myocarditis) and sudden unexplained death, each accounting for 28%.[13]
- Among hospitalizations in the US for overdoses, opioid associated out-of-hospital cardiac arrest increased from 1% of hospitalizations in 2000 to 2% in 2013,47,48 although recent CDC data show a decrease in opioid overdose deaths from 84181 in 2022 to 81083 in 2023.[14]
- Positive drug toxicology was reported in 17.1% of out-of hospital cardiac arrests among persons aged 1 to 50 years(median,42.4years) in an Australian study from April 2019 to April 2021.[15]
References
- ↑ 1.0 1.1 1.2 Winkel BG, Holst AG, Theilade J, Kristensen IB, Thomsen JL, Ottesen GL; et al. (2011). "Nationwide study of sudden cardiac death in persons aged 1-35 years". Eur Heart J. 32 (8): 983–90. doi:10.1093/eurheartj/ehq428. PMID 21131293.
- ↑ 2.0 2.1 2.2 2.3 Risgaard B, Winkel BG, Jabbari R, Behr ER, Ingemann-Hansen O, Thomsen JL; et al. (2014). "Burden of sudden cardiac death in persons aged 1 to 49 years: nationwide study in Denmark". Circ Arrhythm Electrophysiol. 7 (2): 205–11. doi:10.1161/CIRCEP.113.001421. PMID 24604905.
- ↑ 3.0 3.1 3.2 Bagnall RD, Weintraub RG, Ingles J, Duflou J, Yeates L, Lam L; et al. (2016). "A Prospective Study of Sudden Cardiac Death among Children and Young Adults". N Engl J Med. 374 (25): 2441–52. doi:10.1056/NEJMoa1510687. PMID 27332903.
- ↑ 4.0 4.1 4.2 Wisten A, Forsberg H, Krantz P, Messner T (2002). "Sudden cardiac death in 15-35-year olds in Sweden during 1992-99". J Intern Med. 252 (6): 529–36. doi:10.1046/j.1365-2796.2002.01038.x. PMID 12472914.
- ↑ 5.0 5.1 5.2 Chugh SS, Jui J, Gunson K, Stecker EC, John BT, Thompson B; et al. (2004). "Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community". J Am Coll Cardiol. 44 (6): 1268–75. doi:10.1016/j.jacc.2004.06.029. PMID 15364331.
- ↑ 6.0 6.1 6.2 Winkel BG, Risgaard B, Sadjadieh G, Bundgaard H, Haunsø S, Tfelt-Hansen J (2014). "Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting". Eur Heart J. 35 (13): 868–75. doi:10.1093/eurheartj/eht509. PMID 24344190.
- ↑ 7.0 7.1 7.2 Byrne R, Constant O, Smyth Y, Callagy G, Nash P, Daly K; et al. (2008). "Multiple source surveillance incidence and aetiology of out-of-hospital sudden cardiac death in a rural population in the West of Ireland". Eur Heart J. 29 (11): 1418–23. doi:10.1093/eurheartj/ehn155. PMID 18424446.
- ↑ 8.0 8.1 8.2 Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM; et al. (2011). "Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance". J Am Coll Cardiol. 58 (12): 1254–61. doi:10.1016/j.jacc.2011.01.049. PMID 21903060.
- ↑ 9.0 9.1 9.2 9.3 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
- ↑ Waldmann V, Karam N, Bougouin W, Sharifzadehgan A, Dumas F, Narayanan K; et al. (2019). "Burden of Coronary Artery Disease as a Cause of Sudden Cardiac Arrest in the Young". J Am Coll Cardiol. 73 (16): 2118–2120. doi:10.1016/j.jacc.2019.01.064. PMID 31023437.
- ↑ Waldmann V, Karam N, Rischard J, Bougouin W, Sharifzadehgan A, Dumas F; et al. (2020). "Low rates of immediate coronary angiography among young adults resuscitated from sudden cardiac arrest". Resuscitation. 147: 34–42. doi:10.1016/j.resuscitation.2019.12.005. PMID 31857140.
- ↑ Meyer L,Stubbs B,Fahrenbruch C,et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review.Circulation. 2012;126(11):1363-1372. doi:10.1161/CIRCULATIONAHA.111.076810
- ↑ Allan KS, Morrison LJ,Pinter A,Tu JV, Dorian P; Rescu Investigators. Unexpected high prevalence of cardiovascular disease risk factors and psychiatric disease among young people with sudden cardiac arrest. J Am Heart Assoc.2019;8(2):e010330. doi:10.1161/JAHA.118.010330
- ↑ US Overdose deaths decrease in 2023, first time since 2018. CDC National Center for Health Statistics. Accessed December 3, 2024. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.htm
- ↑ Paratz ED, van Heusden A,Zentner D, et al. Causes, circumstances, and potential preventability of cardiac arrest in the young: insights from a state-wide clinical and forensic registry. Europace. 2022;24(12):1933-1941. doi:10.1093/europace/ euac141