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SUDDEN CARDIAC DEATH@.pdf
- 1. SUDDEN CARDIAC ARREST AND DEATH DR. SOUMEN PRASAD BEHERA CONSULTANT CARDIOLOGIST APOLLO HOSPITALS, BBSR
- 2. 5 6 7 8 1 2 3 4 DEFINATION DATA ON SCD CAUSES PATHOPHYSIOLOGY ECG PREDICTORS MANAGEMENT PREVENTION SUDDEN CARDIAC DEATH RISK FACTORS
- 3. SUDDEN CARDIAC DEATH •Natural death from cardiac causes •Abrupt loss of consciousness within 1 hour of the onset of an acute change in cardiovascular status •Some definitions of SCD include up to a 24 hour period and death during sleep
- 4. SUDDEN CARDIAC DEATH SUDDEN IRREVERSIBLE CESSATION OF ALL BIOLOGIC FUNCTIONS AS A CONSEQUENCE OF CARDIAC ARREST CARDIAC ARREST
- 5. SUDDEN CARDIAC DEATH SUDDEN IRREVERSIBLE CESSATION OF ALL BIOLOGIC FUNCTIONS AS A CONSEQUENCE OF CARDIAC ARREST CARDIAC ARREST ABRUPT CESSATION OF CARDIAC MECHANICAL FUNCTION LEADING TO DEATH IN THE ABSENCE OF REVERSAL BY A PROMPT INTERVENTION
- 6. DATA ON SCD
- 7. 2 LAKHS/YEAR 3.8 LAKHS/YEAR 7 LAKHS/YEAR IN HOSPITAL SCA (US) OUT OF HOSPITAL SCD (US) SCD INDIA
- 9. 50 % RULE 50% of all cardiovascular deaths 50% of all SCDs are unexpected first expressions of a cardiac disorder 50% of years of potential life lost due to heart disease as it affects the productive years of one’s life
- 12. PERSONAL OR FAMILY HISTORY OF HEART DISEASE 04 03 02 01 SMOKING HYPERCHOLESTEROLEMIA RISK FACTORS FOR SUDDEN CARDIAC DEATH HYPERTENSION
- 13. OBESITY 08 07 06 05 DIABETES ALCOHOL CONSUMPTION RISK FACTORS FOR SUDDEN CARDIAC DEATH SEDENTARY LIFE STYLE
- 14. AGE : TWO PEAKS – 1ST YEAR OF LIFE & 45-75 YRS 12 11 10 09 GENDER :MALES > 2 TO 3 TIMES AS FEMALES PSYCHOLOGICAL STRESS RISK FACTORS FOR SUDDEN CARDIAC DEATH DRUG ABUSE OF COCAINE AND AMPHETAMINES
- 15. 14 13 VENTRICULAR ARRYTHYMMIAS (> 10 VPC/hr) RISK FACTORS FOR SUDDEN CARDIAC DEATH LOW LVEF IN CHRONIC IHD
- 16. A FIRST DEGREE RELATIVE OF A SUDDEN CARDIAC DEATH VICTIM PRIMARY CARDIAC ARREST
- 17. RISK FACTORS FOR SCD IN HCM YOUNG AGE OF ONSET STRONG FAMILY HISTORY OF SCD SEPTAL THICKNESS > 30 mm VENTRCULAR ARRYTHYMIAS
- 18. RISK FACTORS FOR SCD IN HCM FALL IN BP DURING EXERCISE SYNCOPE NON SUSTAINED VT ON AMBULATORY ECG RECORDING DEGREE OF CARDIAC FIBROSIS
- 20. ECG PREDICTORS OF SCD 1 2 4 3 PATHOLOGICAL Q WAVES OR DYNAMIC ST/T CHANGES PROLONGED QRS DURATION OR QT INTERVAL OR LBBB INCREASE R WAVE VOLTAGE FRAGMENTED QRS
- 21. • Any Q-wave in leads V2–V3 ≥ 2 mm or QS complex in leads V2 and V3 • Q-wave ≥ 0.03 s and > 1 mm deep or QS complex in leads I, II, aVL, aVF, or V4–V6 in any two leads of a contiguous lead grouping • I, aVL,V6; • V4–V6; • II, III, and aVF PATHOLOGICAL Q WAVE
- 22. PREDICTORS OF SCD TMT 24 HOURS HOLTER EPISODES OF NON SUSUTAINED VENTRCULAR TACHYCARDIA. REDUCED HR VARIABILITY. INCREASED VENTRCULAR ECTOPICS.
- 23. CAUSES OF SCA
- 24. CAD 18% NORMAL HEART 17% VIRAL MYOCARDITIS 12% ARRHYTHMOGENIC CARDIOMYOPATHY 10% HCM 9% MVP 8% CONDUCTION SYSTEM ABNORMALITIES 6% ALCAPA 5% AORTIC RUPTURE 3% OTHERS 12%
- 28. SCD IN ATHELETES < 35 YRS : HCM > 35 YRS : CAD
- 29. Ø DELTA WAVE Ø SHORT PR INTERVAL Ø DIRECTION OF ST AND T WAVE OPPOSITE TO THE DELTA WAVE WPW SYNDROME
- 30. EARLY REPOLARISATION SYNDROME •WIDESPREAD CONCAVE ST ELEVATION, MOST PROMINENT IN THE MID-TO-LEFT PRECORDIAL LEADS (V2-5) •NOTCHING OR SLURRING AT THE J POINT •NO RECIPROCAL ST DEPRESSION TO SUGGEST OCCLUSION MI
- 31. BRUGADA SYNDROME
- 32. TYPE 1 COVED ST SEGMENT ELEVATION >2MM IN >1 OF V1-V3 FOLLOWED BY A NEGATIVE T WAVE. IT IS OFTEN REFERRED TO AS BRUGADA SIGN
- 33. TYPE 2 >2 mm OF SADDLEBACK SHAPED ST ELEVATION.
- 34. TYPE 3 MORPHOLOGY OF EITHER TYPE 1 OR TYPE 2, BUT WITH <2MM OF ST SEGMENT ELEVATION
- 39. SUDDEN CARDIAC DEATH FOUR TEMPORAL PERSPECTIVES
- 46. A
- 47. ASSESS RHYTHM B
- 48. DC SHOCK AND CPR B
- 51. PREVENTION
- 52. 01 02 03 04 ANTI ARRHYTHMIC DRUGS ICD CATHETER ABLATION THERAPY SURGICAL INTERVENTIONAL STRATEGY