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Paro cardíaco

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 24 Sep 2025
Last updated: 23 Apr 2025

Summary

Definition

History and exam

Principais fatores diagnósticos

  • paciente inconsciente
  • ausencia de respiración normal
  • ausencia de circulación
  • alteración del ritmo cardíaco
Detalhes completos

Fatores de risco

  • arteriopatía coronaria (AC)
  • disfunción ventricular izquierda
  • edad
  • cardiomiopatía hipertrófica (CMH)
  • displasia ventricular derecha arritmogénica (ARVD)
  • síndrome del segmento QT largo (SQTL)
  • medicamentos que prolongan el intervalo QT o que provocan alteraciones electrolíticas
  • emergencia médica o quirúrgica aguda
  • envenenamiento
  • síndrome de Brugada
  • cardiopatía valvular
  • tabaquismo
  • antecedentes de trastornos de la alimentación
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • monitorización cardíaca continua
  • hemograma completo (HC)
  • electrolitos séricos
  • GSA
  • biomarcadores cardíacos
  • ecografía en el punto de atención (POCUS)
Detalhes completos

Investigações a serem consideradas

  • electrocardiograma (ECG)
  • angiografía coronaria
  • ecocardiograma
  • pruebas de esfuerzo con ejercicio
  • radiografía de tórax
  • cribado toxicológico
  • resonancia magnética cardíaca
  • angiografía coronaria por tomografía computarizada
  • electrocardiograma de señal promediada (SAECG)
  • estudio electrofisiológico
Detalhes completos

Algoritmo de tratamento

Inicial

paro cardíaco no presenciado

AGUDA

ritmos que se pueden tratar con choque eléctrico (taquicardia ventricular sin pulso o fibrilación ventricular)

ritmos que no se pueden tratar con choque eléctrico (actividad eléctrica sin pulso o asistolia)

CONTÍNUA

regreso de la circulación espontánea

ausencia de regreso de la circulación espontánea

Contributors

Authors

John Wink, MD

Emergency Physician

Alberta Health Services

Alberta

Canada

Disclosures

JW declares that he has no competing interests.

Eddy Lang, MD

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.

Acknowledgements

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.

Disclosures

AK and ATA declare that they have no competing interests.

Peer reviewers

Vaikom Mahadevan, MD

Professor of Medicine

Division of Cardiology

University of California

San Francisco

CA

Divulgaciones

VM declares that he has no competing interests.

Anthony Aizer, MD, MS

Instructor

NYU Department of Medicine (Cardiology)

Leon H Charney Heart Rhythm Center and New York University

New York

NY

Divulgaciones

AA declares that he has no competing interests.

Massimo F. Piepoli, MD, PhD, FESC

Honorary Clinical Senior Lecturer/Consultant

Department of Cardiology

Imperial College London

London

UK

Раскрытие информации

MFP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-468.Полный текст  Аннотация

Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.Полный текст  Аннотация

Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct 21;43(40):3997-4126.Полный текст  Аннотация

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation. 2018 Sep 25;138(13):e272-391.Полный текст  Аннотация

Greif R, Bray JE, Djärv T, et al. 2024 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: summary from the basic life support; advanced life support; pediatric life support; neonatal life support; education, implementation, and teams; and first aid task forces. Resuscitation. 2024 Dec;205:110414.Полный текст  Аннотация

Nolan JP, Sandroni C, Böttiger BW, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Resuscitation. 2021 Apr;161:220-69.Полный текст  Аннотация

Статьи, указанные как источники

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