sudden cardiac death
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04/12/2023 1
Sudden Cardiac Death
By: Dr. Ismah, Medical Department HKK
Reference: ACC/AHA/ESC 2006 guidelines for management of patients with
ventricular arrhythmias and the prevention of sudden cardiac death
‘Death from an unexpected circulatory arrest, usually due to a cardiac arrhythmia occurring
within an hour of the onset of symptoms’
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• ¾ caused by CHD cardiac arrest (commonest VF, 80%)
• Important symptoms: palpitation, pre & syncope
• Ix: ecg, echo, ambulatory ecg, intracardiac electrophysiology testing, MRI, angiogram
• Rx: drugs (type I: fast sodium channel blockers, type II: beta blockers, type III: repolarization potassium current blockers e.g. amiodarone, type IV: calcium channel antagonists), drugs for cardiac remodelling, ASA, statin, cardioverter-defibrillator, ablation
*ICD therapy should be used for treatment in patients who have sustained VT and/or VF and who are receiving chronic optimal medical therapy and who have reasonable expectation of survival with a good functional status for more than 1 year
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Right ventricular cardiomyopathy• Autosomal dominant, young age group• ECG:
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Hypertrophic obstructive cardiomyopathy
• Autosomal dominant• Young, athlete • Family history sudden death• ECG – VT, AF, VF• Echo – asymmetrical septal hypertrophy
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Takotsuba cardiomyopathy
• Surge of stress hormone mimic MI arrhythmias cardiac death
• Ecg mimic ant MI• Echo: hyperkinetic/normal at basal LV while
other region of LV hypokinetic• If survive, LV fx improves in 2 months
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Congenital long QT syndrome
• Commonly autosomal dominant• Prolonged ventricle repolarization• Elicit by stress or may occurred at rest• Lifestyle changes, beta blocker, ICD
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Brugada like ECG• Autosomal dominant• Cardiac sodium channel gene• >Male
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THANK YOU
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