B4-015 Big Case: Cardiac Arrest Flashcards
sudden, irreversible cessation of all biologic functions
sudden cardiac death
abrupt cessation of cardiac activity such that victim becomes unresponsive
sudden cardiac arrest
sudden loss of effective blood flow because of cardiac/vascular factors that may reserve spontaneously or require interventions
cardiovascular collapse
prodrome of cardiac arrest
new/worsening cardiac symptoms:
* chest pain
* palpitations
* dyspnea
* fatigability
symptoms at onset of cardiac arrest
abrupt change in clinical status:
* arrhythmia
* hypotension
* chest pain
* dyspnea
* lightheadedness
symptoms of cardiac arrest
sudden collapse:
* loss of effective circulation
* loss of consciousness
biologic death
- failure of resuscitation OR
- failure of electrical, mechanical, or CNS function after intial resuscitation
arrhythmias preceding SCD
- monomorphic VT
- polymorphic VT
- birectional VT
- torsades de pointes
- ventricular flutter
- ventricular fibrillation
most common substrate of SCD
ischemic heart disease
cause up to 70% of SCD
CAD
development of artherosclerosis
adaptive intimal thickening
foam cells
lipid pools
fibrous cap
calcification
- comes on with activity
- brief in duration (minutes)
- relieved with nitrates
stable angina
- comes on at rest
- recent increase in frequency or duration)
unstable angina
- nonthrombotic plaque
- ST segment elevation absent
- no increase in biomarker level
unstable angina
demand related
- nonthrombotic plaque
- ST segment elevation absent
- increased biomarker level
non STEMI type 2
- partially occluding thrombus
- ST elevation absent
- no increase in biomarker level
unstable angina
thrombosis mediated
- partially occluding thrombus
- ST elevation absent
- increased biomarker level
Non-STEMI
type 1
- fully occluding thrombus
- ST elevation present
- increased biomarker level
STEMI type 1
non Q wave MI
non-STEMI
Q wave MI
STEMI
modifiers to MI survival
- ischemic burden
- hemodynamic fluctuations
- autonomic variations
- drugs/electrolytes
- genetic profile
MI pathology:
1 day
wavy fibers
MI pathology:
3-4 days
- extensive coagulation necrosis
- acute inflammation with neutrophils
MI pathology:
7-10 days
- macrophages
- granulation tissue
