Sudden cardiac death

Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome

BACKGROUND

Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS.

METHODS

In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software.

RESULTS

The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission.

CONCLUSION

Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.

Cardiac risk factors and participation guidelines for youth sports

Accurate assessment of the cardiac system in pediatric and adolescent youth is important. The hemodynamic demands associated with exercise, training, and sport participation are usually positive and beneficial; however, when an underlying cardiac problem exists, it is imperative that such cardiac problems be identified. Safe sport-related cardiac participation guidelines should be provided for young athletes and their families and coaches. This chapter provides a physician perspective on the recognition and current cardiac management considerations for young athletes participating in both static and dynamic types of sports. The most recent guidelines for hypertension in youth are also provided.

Aborted sudden cardiac death: a clinical perspective

Sudden cardiac death in the community remains a major public health problem. The purpose of this article is to outline the epidemiology, pathophysiology, and immediate treatment of the cardiac arrest victim. The subsequent in-hospital diagnostic evaluation and management will then be discussed with an emphasis on the role of the implantable cardioverter-defibrillator. A systematic and evidence based approach should help to optimize patient care.

Evaluation and Management of Sudden Death Survivors

Only 20% of patients survive a cardiac arrest. Up to 80% of patients have a cardiac arrest secondary to a ventricular tachyarrhythmia. In the adult population, over 70% of the above patients have obstructive coronary artery disease; thus, coronary arteriography should be performed in all survivors of cardiac arrest. Once reversible causes have been treated, antiarrhythmic therapy is usually guided by Holter monitoring, electrophysiologic testing or both. Due to high recurrence rates on antiarrhythmic drugs, many patients are now treated with implantable cardioverter defibrillators. Although these devices appear to improve sudden death survival, long-term overall survival may not be superior to “best drug therapy.” This hypothesis is currently being tested in two prospective randomized, multicenter trials.