Last reviewed: March 2020
Last updated: January  2020

Summary

Definition

History and exam

Key diagnostic factors

  • patient unresponsive
  • absence of normal breathing
  • absence of circulation
  • cardiac rhythm disturbance

Risk factors

  • coronary artery disease (CAD)
  • left ventricular dysfunction
  • hypertrophic cardiomyopathy (HCM)
  • arrhythmogenic right ventricular dysplasia (ARVD)
  • long QT syndrome (LQTS)
  • medications that prolong the QT interval or cause electrolyte disturbances
  • acute medical or surgical emergency
  • illicit substances
  • Brugada syndrome
  • valvular heart disease
  • smoking
  • history of eating disorders

Diagnostic investigations

1st investigations to order

  • continuous cardiac monitoring
  • FBC
  • serum electrolytes
  • ABG
  • cardiac biomarkers
  • echocardiogram
More 1st investigations to order

Investigations to consider

  • ECG
  • coronary angiography
  • chest x-ray
  • toxicology screen
  • cardiac magnetic resonance imaging
  • signal-averaged electrocardiogram (SAECG)
  • electrophysiological study
More investigations to consider

Treatment algorithm

Contributors

Resident Physician

Department of Family Medicine

University of Calgary

Calgary

Canada 

Disclosures

JW declares that he has no competing interests.

Professor and Department Head of Emergency Medicine

Cumming School of Medicine

University of Calgary

Alberta Health Services

Calgary

Canada

Disclosures

EL declares that he has no competing interests.

Dr John Wink and Professor Eddy Lang would like to gratefully acknowledge Dr Amar Krishnaswamy and Dr Arman T. Askari, previous contributors to this topic.

Peer reviewersVIEW ALL

Professor of Medicine

Division of Cardiology

University of California

San Francisco

CA

Disclosures

VM declares that he has no competing interests.

Instructor

NYU Department of Medicine (Cardiology)

Leon H Charney Heart Rhythm Center and New York University

New York

NY

Disclosures

AA declares that he has no competing interests.

Honorary Clinical Senior Lecturer/Consultant

Department of Cardiology

Imperial College London

London

UK

Disclosures

MFP declares that he has no competing interests.

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