B P7 C70 Cardiac Arrest and Sudden Cardiac Death Flashcards

1
Q

SCD is natural death from cardiac causes heralded by abrupt loss of consciousness within _____ hour of the onset of an acute change in cardiovascular status.

A

1 hour

As such detailed information is often lacking, various definitions of SCD include up to a 24 hour period and death during sleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

To satisfy clinical, scientific, legal, and social considerations, four temporal elements must be considered:

A

(1) Prodromes
(2) Onset
(3) Cardiac arrest
(4) Biologic death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The 1-hour definition primarily refers to the duration of the “_____,” which defines the interval between the onset of symptoms signaling the pathophysiologic disturbance leading to cardiac arrest and the onset of the cardiac arrest itself

A

Terminal event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

_____, occurring weeks or months before an event, are generally predictors of an impending cardiac event, but not specific for SCA itself.

The same premonitory signs and symptoms may be more specific for imminent cardiac arrest when they begin abruptly.

A

Prodromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sudden onset of chest pain, dyspnea, or palpitations and other symptoms of arrhythmias often precede the onset of _____ and define the onset of the 1-hour terminal event period that brackets the cardiac arrest.

A

Cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The fourth element, _____, is an immediate consequence of cardiac arrest, unless there is a successful intervention, and usually occurs within minutes

A

Biologic death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Examples of substrate-based risk

A

Coronary heart disease
State of epicardial and intramyocardial vessels Myocardial infarction
Myopathy, infiltration, inflammation, valvulopathy Hypertrophy; myocardial fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examples of expression-based risk

A

Left ventricular dysfunction and heart failure Metabolic abnormalities
Autonomic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of mechanism-based risk

A

VF/pulseless VT
PEA
Asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Three factors are of primary importance for identification of populations at risk and consideration of strategies for prevention of SCD:

A

(1) the Absolute numbers and event rates (incidence) among population subgroups
(2) the Clinical subgroups in which SCDs occur
(3) Competing risks
(4) the time dependence of risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Genetic Contributors to Risk for Sudden Cardiac Death

Genetically Based Primary Arrhythmia Disorders

A

Congenital long-QT syndrome, short-QT syndrome Brugada syndrome
Catecholaminergic polymorphic VT/VF
J wave syndromes
Nonsyndromic VT/VF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Genetic Contributors to Risk for Sudden Cardiac Death

Inherited Structural Disorders with Risk for Arrhythmic SCD

A

Hypertrophic cardiomyopathy
Right ventricular dysplasia/cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Genetic Contributors to Risk for Sudden Cardiac Death

Genetic Predisposition to Induced Arrhythmias and SCD

A

Drug-induced “acquired” long-QT syndrome (drugs, electrolytes)

Electrolyte and metabolic arrhythmogenic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Genetic Contributors to Risk for Sudden Cardiac Death

Genetic Modulation of Complex Acquired Diseases

A

Coronary artery disease, acute coronary syndromes Congestive heart failure, dilated cardiomyopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Although the pathologic anatomy associated with SCD caused by coronary artery disease often reflects the changes associated with acute myocardial injury,<_____% of survivors of OHCA have clinical evidence of a new transmural MI

A

<20%