Evaluation of the survivor of sudden cardiac arrest
- Philip J Podrid, MD, FACC
Philip J Podrid, MD, FACC
- Professor of Medicine, Professor of Pharmacology and Experimental Therapeutics
- Boston University School of Medicine
- Lecturer, Harvard Medical School
- Section Editors
- Brian Olshansky, MD
Brian Olshansky, MD
- Section Editor — Cardiac Arrhythmias
- Adjunct Professor of Medicine
- Des Moines University
- Scott Manaker, MD, PhD
Scott Manaker, MD, PhD
- Section Editor — Critical Care
- Professor of Medicine
- University of Pennsylvania School of Medicine
Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation. These events mostly occur in patients with structural heart disease (that may not have been previously diagnosed), particularly coronary heart disease. (See "Pathophysiology and etiology of sudden cardiac arrest".)
The event is referred to as SCA (or aborted SCD) if an intervention (eg, defibrillation) or spontaneous reversion restores circulation. The event is called SCD if the patient dies. However, the use of SCD to describe both fatal and nonfatal cardiac arrest persists by convention. (See "Overview of sudden cardiac arrest and sudden cardiac death", section on 'Definitions'.)
Evaluation of the survivor of SCD includes the following:
●Identification and treatment of acute reversible causes
●Evaluation for structural heart disease
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- ETIOLOGY OF SCD
- INITIAL EVALUATION
- History and physical examination
- Laboratory testing
- EVALUATION FOR STRUCTURAL HEART DISEASE
- Coronary angiography
- - Acute coronary syndrome
- - Diagnostic angiography
- Cardiac MR
- EVALUATION FOR PRIMARY ELECTRICAL DISEASES
- General issues
- EP study
- Exercise testing
- Ambulatory monitoring
- Pharmacologic challenge
- MINOR CARDIAC ABNORMALITIES NOT ASSOCIATED WITH SCD
- EVALUATION OF FAMILY MEMBERS
- NEUROLOGIC AND PSYCHOLOGIC ASSESSMENT
- SUMMARY AND RECOMMENDATIONS