31_SCD

Question 1

Causes of SCD include:

Answer 1

Ventricular Fibrillation 
Bradycardia 
Pulmonary Emboli
Acute respiratory Failure
Intracranial/vascular catastrophe

Question 2

What two things are needed for SCD to occur?

Answer 2

Underlying Substrate that causes heterogeneity: myocardial scar/hypertrophy

+

A trigger: increase in sympathetic activation, ischemia, stress from environment (9/11)

Question 3

Greater proportion of CAD leading to SCD (M/F)

Answer 3

Male

Question 4

Greater proportion of normal hearts leading to SCD (M/F)

Answer 4

Female

Question 5

How does HCM lead to SCD?

Answer 5

Thickened myocardium has characteristic myocyte disarray leading to heterogeneity in conduction and thus sustained arrhythmias.

Question 6

What is Brugada Syndrome? And it’s characteristic EKG sign?

Answer 6

Mutation in Na channel (Scn5a)leads to channel dysfunction and dispersal of repolarization and essentially a reentrant loop resulting in sustained arrhythmia.

There is a non-MI ST elevation usually in V2

Question 7

Calvin hits Darnell in the chest at a precise time during repolarization. Darnell unfortunately develops VT/VF. What is the malfunction called?

Answer 7

Commotio Cordis

Question 8

Who is risk stratified for SCD?

Answer 8

SCD Survivors
Relatives of SCD victims
Hx of Vent Arrhythmia/or syncope
Ppl w/ Cardiomyopathy

Question 9

What is ARVC?

Answer 9

Arrhythmogenic Right Ventricular Cardiomyopathy
Replacement of myocardium with fibrofatty deposits–> heterogeneity

Notice T wave inversions on ECG

Question 10

What are some drawbacks to ICD use in SCD?

Answer 10

Infection 
Bleeding 
Perforation
Inappropriate Shock
Device Failure