Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • CAD
  • presence of other risk factors
  • tachycardia
  • hypotension

Other diagnostic factors

  • weak pulse
  • syncope
  • presyncope
  • airway compromise
  • impaired consciousness
  • light-headedness
  • dizziness
  • diminished responsiveness
  • chest discomfort
  • dyspnoea
  • asymptomatic

Risk factors

  • CAD
  • acute MI
  • left ventricular systolic dysfunction
  • hypertrophic cardiomyopathy (HCM)
  • long QT syndrome
  • short QT syndrome
  • Brugada syndrome
  • Family history of sudden death
  • mental or physical stress
  • ventricular pre-excitation
  • arrhythmogenic right ventricular cardiomyopathy (ARVC)
  • electrolyte imbalance
  • drug toxicity
  • Chagas disease, and other cardiomyopathies

Diagnostic investigations

1st investigations to order

  • ECG
  • electrolytes
  • troponin I
  • CK-MB
Full details

Investigations to consider

  • transthoracic echocardiogram
  • cardiac catheterisation
  • cardiac MRI
  • electrophysiological (EP) study
  • genetic screening
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Clinical Medicine

New York Medical College

Director, Cardiac Electrophysiology

Westchester Medical Center

Valhalla

NY

Disclosures

SI is on the Biosense-Webster speakers' bureau. He receives honoraria from Biotronik for lectures and research grant support from Boston Scientific.

Prof Sei Iwai would like to gratefully acknowledge Dr Kenneth Stein and Dr Richard Keating, previous contributors to this monograph. KS declares he is an employee of and shareholder in Boston Scientific, a manufacturer of implantable cardioverter defibrillators and ablation catheters. RK declares that he has no competing interests.

Peer reviewers VIEW ALL

Director

Electrophysiology Laboratory

The St. Luke's-Roosevelt Hospital Center

New York

NY

Disclosures

SM declares that he has no competing interests.

Kontos Professor of Cardiology

Medical College of Virginia

Richmond

VA

Disclosures

KAE declares that he has no competing interests.

Consultant Cardiologist and Electrophysiologist

Cardiac Department

John Radcliffe Hospital

Oxford

UK

Disclosures

KR declares that she has no competing interests.

Use of this content is subject to our disclaimer