1
|
van Dijk JG, van Rossum IA, van Waning JI, Westra SW, Thijs RD. Clinical signs of the transition of syncope into hypoxic coma: a case report. Clin Auton Res 2023; 33:915-918. [PMID: 37668819 DOI: 10.1007/s10286-023-00978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Affiliation(s)
- J Gert van Dijk
- Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300RC, Leiden, The Netherlands.
| | - Ineke A van Rossum
- Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300RC, Leiden, The Netherlands
| | - Jaap I van Waning
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sjoerd W Westra
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Roland D Thijs
- Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300RC, Leiden, The Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| |
Collapse
|
2
|
Morton S, Goonetilleke C, Taylor M, Beach N. Out-of-Hospital Cardiac Arrests during Mass-Participation Endurance Events: A Case Series. Wilderness Environ Med 2023; 34:318-321. [PMID: 37357052 DOI: 10.1016/j.wem.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Mass-participation endurance events take place throughout the United Kingdom. Although out-of-hospital cardiac arrests (OHCAs) occur during these events, little is known about them. This case series aims to describe the number, type, etiology, and outcome of OHCAs treated by a UK-based specialist sports medicine provider over a period of 8 y. METHODS The medical records of a UK-based sports medicine provider were reviewed from 2014 to 2022. Anonymized information from OHCAs during this time was recorded. This included type of event, patient demographics, details of OHCA, and patient outcomes. RESULTS Ten OHCAs were identified during the course of 110 sporting events. These included the cases of 9 participants and 1 spectator. Return of spontaneous circulation (ROSC) was achieved on-site in all patients. Eight survived beyond 24 h and achieved a full neurological recovery. Seventy percent of these patients achieved ROSC within 4 min of cardiopulmonary resuscitation being initiated. The 2 patients who died both presented with a nonshockable rhythm. CONCLUSIONS OHCAs during mass-participation endurance events are rare. However, medical providers must be prepared to respond promptly. Quick interventions can result in a full neurological recovery.
Collapse
Affiliation(s)
- Sarah Morton
- SportMedics Ltd, Ramsay House, Grange Park, London, UK; Department of Surgery and Cancer, Imperial College, London, UK.
| | | | - Mark Taylor
- SportMedics Ltd, Ramsay House, Grange Park, London, UK
| | - Natasha Beach
- SportMedics Ltd, Ramsay House, Grange Park, London, UK
| |
Collapse
|
3
|
Colbenson K, Raukar NP. A Structured Approach to the Collapsed Athlete: The First Minute Matters. Curr Sports Med Rep 2023; 22:273-275. [PMID: 37549210 DOI: 10.1249/jsr.0000000000001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
|
4
|
Corrado D, Cipriani A, Zorzi A. Shocking insights on resuscitation after sports-related cardiac arrest. Eur Heart J 2023; 44:193-195. [PMID: 36419208 DOI: 10.1093/eurheartj/ehac659] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121 Padova, Italy
| |
Collapse
|
5
|
Thannhauser J, Nas J, Waalewijn RA, van Royen N, Bonnes JL, Brouwer MA, de Boer MJ. Towards individualised treatment of out-of-hospital cardiac arrest patients: an update on technical innovations in the prehospital chain of survival. Neth Heart J 2021; 30:345-349. [PMID: 34373998 PMCID: PMC9270531 DOI: 10.1007/s12471-021-01602-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) is a major healthcare problem, with approximately 200 weekly cases in the Netherlands. Its critical, time-dependent nature makes it a unique medical situation, of which outcomes strongly rely on infrastructural factors and on-scene care by emergency medical services (EMS). Survival to hospital discharge is poor, although it has substantially improved, to roughly 25% over the last years. Recognised key factors, such as bystander resuscitation and automated external defibrillator use at the scene, have been markedly optimised with the introduction of technological innovations. In an era with ubiquitous smartphone use, the Dutch digital text message alert platform HartslagNu (www.hartslagnu.nl) increasingly contributes to timely care for OHCA victims. Guidelines emphasise the role of cardiac arrest recognition and early high-quality bystander resuscitation, which calls for education and improved registration at HartslagNu. As for EMS care, new technological developments with future potential are the selective use of mechanical chest compression devices and extracorporeal life support. As a future innovation, ‘smart’ defibrillators are under investigation, guiding resuscitative interventions based on ventricular fibrillation waveform characteristics. Taken together, optimisation of available prehospital technologies is crucial to further improve OHCA outcomes, with particular focus on more available trained volunteers in the first phase and additional research on advanced EMS care in the second phase.
Collapse
Affiliation(s)
- J Thannhauser
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands.
| | - J Nas
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands
| | - R A Waalewijn
- Department of Cardiology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - N van Royen
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands
| | - J L Bonnes
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands
| | - M A Brouwer
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands
| | - M J de Boer
- Department of Cardiology, Radboud university medical centre, Nijmegen, The Netherlands
| |
Collapse
|
6
|
Panhuyzen-Goedkoop NM, Wellens HJ, Verbeek ALM, Piek JJ, Peters RJG. Immediate Bystander Cardiopulmonary Resuscitation to Sudden Cardiac Arrest During Sports is Associated with Improved Survival-a Video Analysis. SPORTS MEDICINE-OPEN 2021; 7:50. [PMID: 34292409 PMCID: PMC8298728 DOI: 10.1186/s40798-021-00346-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/08/2021] [Indexed: 11/21/2022]
Abstract
Background Sudden cardiac arrest (SCA) during sports can be the first symptom of yet undetected cardiovascular conditions. Immediate chest compressions and early defibrillation offer SCA victims the best chance of survival, which requires prompt bystander cardiopulmonary resuscitation (CPR). Aims To determine the effect of rapid bystander CPR to SCA during sports by searching for and analyzing videos of these SCA/SCD events from the internet. Methods We searched images.google.com, video.google.com, and YouTube.com, and included any camera-witnessed non-traumatic SCA during sports. The rapidity of starting bystander chest compressions and defibrillation was classified as < 3, 3–5, or > 5 min. Results We identified and included 29 victims of average age 27.6 ± 8.5 years. Twenty-eight were males, 23 performed at an elite level, and 18 participated in soccer. Bystander CPR < 3 min (7/29) or 3–5 min (1/29) and defibrillation < 3 min was associated with 100% survival. Not performing chest compressions and defibrillation was associated with death (14/29), and > 5 min delay of intervention with worse outcome (death 4/29, severe neurologic dysfunction 1/29). Conclusions Analysis of internet videos showed that immediate bystander CPR to non-traumatic SCA during sports was associated with improved survival. This suggests that immediate chest compressions and early defibrillation are crucially important in SCA during sport, as they are in other settings. Optimal use of both will most likely result in survival. Most videos showing recent events did not show an improvement in the proportion of athletes who received early resuscitation, suggesting that the problem of cardiac arrest during sports activity is poorly recognized.
Collapse
Affiliation(s)
- Nicole M Panhuyzen-Goedkoop
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands. .,Sports Medical Centre Papendal, Arnhem, the Netherlands.
| | | | - André L M Verbeek
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Jan J Piek
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Ron J G Peters
- Heart Centre, Amsterdam University Medical Centre, AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| |
Collapse
|
7
|
van Dijk JG, van Rossum IA, Thijs RD. Timing of Circulatory and Neurological Events in Syncope. Front Cardiovasc Med 2020; 7:36. [PMID: 32232058 PMCID: PMC7082775 DOI: 10.3389/fcvm.2020.00036] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/24/2020] [Indexed: 11/13/2022] Open
Abstract
Syncope usually lasts less than a minute, in which short time arterial blood pressure temporarily falls enough to decrease brain perfusion so much that loss of consciousness ensues. Blood pressure decreases quickest when the heart suddenly stops pumping, which happens in arrhythmia and in severe cardioinhibitory reflex syncope. Loss of consciousness starts about 8 s after the last heart beat and circulatory standstill occurs after 10-15 s. A much slower blood pressure decrease can occur in syncope due to orthostatic hypotension Standing blood pressure can then stabilize at low values often causing more subtle signs (i.e., inability to act) but often not low enough to cause loss of consciousness. Cerebral autoregulation attempts to keep cerebral blood flow constant when blood pressure decreases. In reflex syncope both the quick blood pressure decrease and its low absolute value mean that cerebral autoregulation cannot prevent syncope. It has more protective value in orthostatic hypotension. Neurological signs are related to the severity and timing of cerebral hypoperfusion. Several unanswered pathophysiological questions with possible clinical implications are identified.
Collapse
Affiliation(s)
- J Gert van Dijk
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
| | - Ineke A van Rossum
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
| | - Roland D Thijs
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
- Stichting Epilepsie Instellingen Nederland, Heemstede, Netherlands
| |
Collapse
|
8
|
Ghorayeb N, Stein R, Daher DJ, Silveira ADD, Ritt LEF, Santos DFPD, Sierra APR, Herdy AH, Araújo CGSD, Colombo CSSDS, Kopiler DA, Lacerda FFRD, Lazzoli JK, Matos LDNJD, Leitão MB, Francisco RC, Alô ROB, Timerman S, Carvalho TD, Garcia TG. The Brazilian Society of Cardiology and Brazilian Society of Exercise and Sports Medicine Updated Guidelines for Sports and Exercise Cardiology - 2019. Arq Bras Cardiol 2019; 112:326-368. [PMID: 30916199 PMCID: PMC6424031 DOI: 10.5935/abc.20190048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Nabil Ghorayeb
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
- Hospital do Coração (HCor), Associação do Sanatório Sírio, São Paulo, SP - Brazil
- Programa de Pós-Graduação em Medicina do Esporte da Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brazil
- Instituto de Assistência Médica ao Servidor Público Estadual (IAMSPE), São Paulo, SP - Brazil
| | - Ricardo Stein
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (HCPA/UFRGS), Porto Alegre, RS - Brazil
- Vitta Centro de Bem Estar Físico, Porto Alegre, RS - Brazil
| | - Daniel Jogaib Daher
- Hospital do Coração (HCor), Associação do Sanatório Sírio, São Paulo, SP - Brazil
| | - Anderson Donelli da Silveira
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (HCPA/UFRGS), Porto Alegre, RS - Brazil
- Vitta Centro de Bem Estar Físico, Porto Alegre, RS - Brazil
| | - Luiz Eduardo Fonteles Ritt
- Hospital Cárdio Pulmonar, Salvador, BA - Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil
| | | | | | - Artur Haddad Herdy
- Instituto de Cardiologia de Santa Catarina, Florianópolis, SC - Brazil
- Clínica Cardiosport de Prevenção e Reabilitação, Florianópolis, SC - Brazil
| | | | - Cléa Simone Sabino de Souza Colombo
- Hospital do Coração (HCor), Associação do Sanatório Sírio, São Paulo, SP - Brazil
- Sports Cardiology, Cardiology Clinical Academic Group - St George's University of London,14 London - UK
| | - Daniel Arkader Kopiler
- Sociedade Brasileira de Medicina do Esporte e do Exercício (SBMEE), São Paulo, SP - Brazil
- Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ - Brazil
| | - Filipe Ferrari Ribeiro de Lacerda
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brazil
| | - José Kawazoe Lazzoli
- Sociedade Brasileira de Medicina do Esporte e do Exercício (SBMEE), São Paulo, SP - Brazil
- Federação Internacional de Medicina do Esporte (FIMS), Lausanne - Switzerland
| | | | - Marcelo Bichels Leitão
- Sociedade Brasileira de Medicina do Esporte e do Exercício (SBMEE), São Paulo, SP - Brazil
| | - Ricardo Contesini Francisco
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
- Hospital do Coração (HCor), Associação do Sanatório Sírio, São Paulo, SP - Brazil
| | - Rodrigo Otávio Bougleux Alô
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
- Hospital Geral de São Mateus, São Paulo, SP - Brazil
| | - Sérgio Timerman
- Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (InCor-FMUSP), São Paulo, SP - Brazil
- Universidade Anhembi Morumbi, Laureate International Universities, São Paulo, SP - Brazil
| | - Tales de Carvalho
- Clínica Cardiosport de Prevenção e Reabilitação, Florianópolis, SC - Brazil
- Departamento de Ergometria e Reabilitação Cardiovascular da Sociedade Brasileira de Cardiologia (DERC/SBC), Rio de Janeiro, RJ - Brazil
- Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC - Brazil
| | - Thiago Ghorayeb Garcia
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
- Hospital do Coração (HCor), Associação do Sanatório Sírio, São Paulo, SP - Brazil
| |
Collapse
|
9
|
Steinskog DM, Solberg EE. Sudden cardiac arrest in sports: a video analysis. Br J Sports Med 2018; 53:1293-1298. [DOI: 10.1136/bjsports-2018-099578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2018] [Indexed: 11/04/2022]
Abstract
ObjectivesInformation about sudden cardiac arrest (SCA) in sports arises from registries, insurance claims and various reports. Analysing video footage of SCA during sports for scientific purposes has scarcely been done. The objective of this study was to examine videotaped SCA in athletes to better understand the mechanisms of SCA.MethodsPublicly available online video databases were searched for videos displaying SCA in athletes.ResultsThirty-five online videos (26 from professional and 9 from amateur sport; 34 male victims) were obtained. Twenty-one events resulted in survival and 14 in sudden cardiac death. Level of physical activity prior to SCA was assessable in 28 videos; 19 events occurred during low-intensity, 6 during moderate-intensity and 3 during high-intensity activity. SCA predominately occurred during low-intensity compared with both moderate-intensity and high-intensity activities (p<0.01). In 26/35 videos, it was possible to observe if resuscitation was provided. Resuscitation was carried out in 20 cases; cardiopulmonary resuscitation (CPR) alone (8 cases), CPR+defibrillation (10), cardiac thump (1) or shock from an implantable cardioverter defibrillator (1). Thirteen of the 20 cases with resuscitation received an intervention within 1 min after collapse. Survival was high when intervention occurred within 1 min (12/13) compared with those who received delayed (3/5) or no intervention (1/6). Associated signs of SCA such as agonal respirations and seizure-like movements were observed in 66% of the cases.ConclusionsSCA during sport most often occurred during low-intensity activity. Prompt intervention within 1 min demonstrated a high survival rate and should be the standard expectation for witnessed SCA in athletes.
Collapse
|
10
|
Zorzi A, Cipriani A, Corrado D. Circumstances of cardiac arrest during sports activity recorded on video. Eur J Prev Cardiol 2018; 25:1452-1454. [DOI: 10.1177/2047487318791289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Alberto Cipriani
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| |
Collapse
|
11
|
Panhuyzen-Goedkoop NM, Piek JJ. Resuscitation on the pitch with cardiac massage and on-site AED. Neth Heart J 2018; 26:286. [PMID: 29619672 PMCID: PMC5910315 DOI: 10.1007/s12471-018-1109-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
12
|
Zorzi A, Corrado D. Cardiac arrest during sports activity is difficult to recognise? Let the AED do the job! Neth Heart J 2018. [PMID: 29520620 PMCID: PMC5876178 DOI: 10.1007/s12471-018-1097-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- A Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
| | - D Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| |
Collapse
|
13
|
Reply to the letter from A. Zorzi and D. Corrado. Rhythm analysis with an AED in an unconscious athlete. Neth Heart J 2018. [PMID: 29520621 PMCID: PMC5876179 DOI: 10.1007/s12471-018-1100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
14
|
Peters RJG. Preparticipation screening in athletes, the role of sports cardiology and the impact of the camera. Neth Heart J 2018; 26:109-110. [PMID: 29423770 PMCID: PMC5818384 DOI: 10.1007/s12471-018-1088-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- R J G Peters
- Department of Cardiology, F3-326, Academic Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|