Cardiovascular disease
Sally Robinson in Priorities for Health Promotion and Public Health, 2021
Song and colleagues (2019) researched 136,637 patients with diagnosed stress disorders, such as post-traumatic stress disorder and acute stress reaction, from 1987 to 2013, to see who subsequently developed cardiovascular disease. The sample was compared to their siblings, who did not have a stress disorder. The authors found a stress-related disorder increased heart failure, cerebrovascular disease, heart conduction disorders and cardiac arrest within the first year of the diagnoses of the stress-related disorders. The patients were four times more likely to have a cardiac arrest, where the heart stops beating, within six months of the stress diagnosis compared to their sibling. The British Heart foundation explain: A cardiac arrest usually happens without warning. If someone is in cardiac arrest, they collapse suddenly. [They] will be unconscious … unresponsive and won’t be breathing or breathing normally … making gasping noises. Without immediate treatment …, the person will die.(British Heart Foundation, 2019)
Cardiopulmonary Resuscitation
Anthony FT Brown, Michael D Cadogan in Emergency Medicine, 2020
The decision to cease further attempts at resuscitation is difficult. Only the senior ED doctor should take this. Survival from out-of-hospital cardiac arrest is greatest when: The event is witnessed and help is called early.A bystander starts resuscitation, even if only chest compressions (doubles or triples survival rate).The heart arrests in VF or VT (20% or higher survival).Defibrillation is carried out at an early stage, with successful cardioversion achieved within 3–5 min (50–75% survival), and not more than 8 min: each minute of delay before defibrillation reduces survival to discharge by 10–12%survival after more than 12 min of VF in adults without ROSC is less than 5%.
The electrophysiology laboratory
John Edward Boland, David W. M. Muller in Interventional Cardiology and Cardiac Catheterisation, 2019
Patients with heart rhythm disturbances are studied and treated in the electrophysiology (EP) laboratory. The usual symptoms caused by cardiac arrhythmias include palpitations, chest pain, exertional dyspnoea, dizziness and syncope. Cardiac arrest may relate to a rapid arrhythmia usually ventricular in origin, or to a profound bradycardia. If an arrhythmia is suspected, diagnostic tests including measurement of conduction intervals in response to pacing and programmed electrical stimulation of the heart may be performed to determine the source of symptoms. Therapeutic procedures performed in the electrophysiology laboratory include transcatheter radiofrequency ablations, implantations of permanent pacemakers and defibrillators, overdrive pacing and electrical cardioversions.
Ventricular Fibrillation Simulated Electrocardiogram Artifact by a Deep Brain Stimulator
Published in Prehospital Emergency Care, 2023
Ryan P. Strum, Ian R. Drennan, Morgan Hillier, Sheldon Cheskes
An important tangent from this case study concerns ECG interpretation in cardiac arrest. It is not known how DBSs could influence ECG artifact in cardiac arrest, or interpretation of such rhythms. We hypothesize two scenarios are conceivable: artifact presents as VF when the underlying rhythm is not VF, or artifact is present that distorts all cardiac rhythm interpretation when VF or ventricular tachycardia could be present. Misdiagnosing a cardiac rhythm that requires defibrillation could negatively affect patient outcomes and survival. Additionally, the ability of defibrillator pads to detect ECG artifact instead of cardiac leads in circumstances of cardiac arrest has not been studied. We contend the natural progression of VF from coarse to fine complexes will not occur when the rhythm is an artifact, which could be a pertinent finding to classify a VF as artifact. As the prevalence of DBSs increases to manage a plethora of chronic diseases, future research is warranted to identify methods paramedics and emergency clinicians can incorporate to reduce ECG artifact (1, 9).
Association between Mode of Transport and Patient Outcomes in the Emergency Department following Out-of-Hospital Cardiac Arrest: A Single-Center Retrospective Study
Published in Prehospital Emergency Care, 2023
Pitsucha Sanguanwit, Kanthicha Sutthisuwan, Phatthranit Phattharapornjaroen, Malivan Phontabtim, Yahya Mankong
All patients who presented with OHCA to Ramathibodi Hospital's ED were included. The patients were divided into two groups according to transportation mode. The first, the EMS group, comprised patients transported by all types of EMS: first responders, BLS, and ALS; the second group comprised non-EMS patients, transported by any non-EMS means, for example, a personal relative or colleague. In the non-EMS group, there were no prehospital procedures. Cardiac arrest was identified as an absence of pulse or no spontaneous breathing and unresponsive by a health care provider. OHCA patients who visited the Ramathibodi ED between January 1, 2008 and May 31, 2020, and were at least 18 years old, met the inclusion criteria. Patients with traumatic cardiac arrests, obvious signs of death prior to resuscitation such as rigor mortis, do-not-resuscitate (DNR) patients, and patients whose data were destroyed or missing from the Ramathibodi Hospital database and electronic medical records were excluded. Patients whose resuscitation efforts were terminated by EMS personnel with the consent of on-site family members were also excluded.
Prevalence, clinical characteristics and outcomes of hypoxic hepatitis in critically ill patients
Published in Scandinavian Journal of Gastroenterology, 2022
Sigrún Jonsdottir, Margrét B. Arnardottir, Jóhannes A. Andresson, Helgi K. Bjornsson, Sigrun H. Lund, Einar S. Bjornsson
Shock was defined by persistent arterial hypotension leading to inadequate tissue perfusion with oliguria and poor peripheral perfusion in the clinical setting of hypovolemic (hypovolemic shock), sepsis (septic shock), cardiogenic events (cardiogenic shock) and extracardiac obstruction (obstructive shock). Heart failure was defined by a history of heart failure, clinical features or impaired left and/or right ventricular function on echocardiogram. Prolonged hypotension was defined as blood pressure <75 mmHg for 15 min or use of inotropes, massive fluid resuscitation, pericardiocentesis or intra-aortic balloon pump to sustain a higher blood pressure [9]. Cardiac arrest was defined as a sudden loss of blood flow due to failure of the heart to pump effectively [13]. Cardiac arrest can occur secondary to various disease states including cardiac arrhythmia, hypoxemia and decreased cardiac perfusion caused by cardiogenic, septic or hypovolemic shock. Cardiac arrest is a major etiology of HH and its cause can be difficult to determine. Therefore, cardiac arrest was categorized as a separate entity. Hypoxic respiratory failure was defined by a partial pressure of oxygen (PaO2) of <8.0 kPa (60 mmHg) in the appropriate clinical setting.
Related Knowledge Centers
- Arrhythmia
- Bleeding
- Cardiopulmonary Resuscitation
- Consciousness
- Defibrillation
- Respiratory Arrest
- Hypoxia
- Ventricular Fibrillation
- Circulatory System
- Ventricular Tachycardia