Last reviewed:October 2019
Last updated:October  2019

Summary

Definition

History and exam

Key diagnostic factors

  • coronary artery disease
  • tachycardia
  • hypotension

Other diagnostic factors

  • weak pulse
  • syncope
  • presyncope
  • airway compromise
  • impaired consciousness
  • lightheadedness
  • dizziness
  • diminished responsiveness
  • chest discomfort
  • dyspnea
  • asymptomatic

Risk factors

  • coronary artery disease
  • acute myocardial infarction
  • left ventricular systolic dysfunction
  • hypertrophic cardiomyopathy
  • long QT syndrome
  • short QT syndrome
  • Brugada syndrome
  • family history of sudden death
  • mental or physical stress
  • ventricular pre-excitation
  • arrhythmogenic right ventricular cardiomyopathy
  • electrolyte imbalance
  • drug toxicity
  • Chagas disease and other cardiomyopathies

Diagnostic investigations

1st investigations to order

  • ECG
  • electrolytes
  • troponin I
  • creatine kinase-MB
Full details

Investigations to consider

  • transthoracic echocardiogram
  • cardiac catheterization
  • cardiac MRI
  • electrophysiologic study
  • genetic screening
Full details

Treatment algorithm

Contributors

Professor of Clinical Medicine

New York Medical College

Director, Cardiac Electrophysiology

Westchester Medical Center Health Network

Valhalla

NY

Disclosures

SI is on the Biosense-Webster speakers' bureau. He receives honoraria from Biotronik, Boston Scientific, and Medtronic 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 topic.

Peer reviewersVIEW 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.

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