Sudden Cardiac Death and Sudden Cardiac Arrest

Question 1

What are the etiologies of SCD/SCA?

Answer 1

90% are from primary myocardial process and 10% from primary electrical process

Question 2

What are some channelmyopathies?

Answer 2

Long/Short QT Syndrome
Brugada Syndrome
Catecholaminergic polymorphic VT

Question 3

What are some primary electrical processes associated with SCA/SCD?

Answer 3

Channelmyopathies, acquired LQTS, WPW syndrome, Commotio Cordis

Question 4

Hypertrophic Cardiomyopathy etiology

Answer 4

Genetic disease that results in LVH

Question 5

HCM symptoms

Answer 5

Chest pain, dyspnea, syncope

Question 6

EKG signs of HCM

Answer 6

Deep and narrow Q waves in lateral (common) and inferior leads.
Signs of LVH
Apical variant shows deeply inverted T waves in precordial leads.

Question 7

Etiology of Arrhythmogenic Right Ventricular Dysplasia (ARVD)

Answer 7

Fibrofatty replacement of myocardium. Most common in RV and may result in reentrant paroxysmal VT. A fib common. Can lead to RV failure.

Question 8

EKG of ARVD

Answer 8

Epsilon wave
S wave upstroke of 55ms in V1-V3
QRS >110ms V1-V3
T wave inversion V1-V3

Question 9

Brugada Syndrome Etiology

Answer 9

Heart appears normal. Associated with polymorphic VT and VF. High chance of a-fib. Defective Na+ cardiac channels.

Question 10

Brugada Syndrome EKG

Answer 10

pseudo-RBBB and persistent ST elevation in V1-V2. There is type 1: ST elevation >2mm, downsloping ST segment, inverted T wave.
Type 2: ST elevation >2mm, “saddle-back” ST-T wave config. Upright/biphasic T wave.

Question 11

Catecholaminergic Polymorphic VT (CPVT) etiology

Answer 11

Recurrent PVT brought on by exercise or emotional stress in the absence of structural heart disease. Defective handling of Ca2+ channels by sarcoplasmic reticulum.