Golden hour for emergency treatment of cardiogenic sudden death

Written by Chen Guang Yin

Cardiology

Updated on September 04, 2024

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Cardiac arrest is now also a very frequent event. We have seen some reports of it occurring frequently at airports, train stations, and on public transport, involving middle-aged, elderly, or even young individuals. The golden window for emergency aid is 4 to 6 minutes, with shorter times being preferable. We say time is life because after 4 to 6 minutes, if effective circulation isn't restored, brain cells begin to die. Even if later resuscitation restores breathing and heartbeat, the individual may end up in a vegetative state. Therefore, within the shortest time frame of 4 to 6 minutes, external chest compressions, including opening the airway and artificial respiration, must be administered. The optimal window is 4 minutes, but no more than 6 minutes.

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Written by Chen Guang Yin

Cardiology

38sec

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Will there be any sequelae from cardiogenic sudden death?

So, sudden cardiac death is firstly a sudden event. Whether there are sequelae depends greatly on whether timely rescue was administered at the time of the cardiac arrest. If effective cardiopulmonary resuscitation is given within a short time, generally within 4-6 minutes, then the patient's vital signs including consciousness might gradually recover, and it's possible that no severe sequelae will remain. However, if the rescue is not timely, it's possible for the heartbeat and breathing to be restored but not consciousness, leading to brain death and a vegetative state. This is a possibility.

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Written by Chen Guang Yin

Cardiology

42sec

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The difference between sudden cardiac death and myocardial infarction.

Sudden cardiac death and myocardial infarction are both types of coronary heart disease; they are classified under coronary heart disease. Sudden cardiac death is mostly caused by extensive myocardial infarction, with some patients experiencing it due to severe arrhythmias leading to sudden death. The primary clinical symptoms of myocardial infarction are typically those of coronary heart disease, including chest tightness, chest pain, and sweating. Sudden cardiac death can be triggered by myocardial infarction, but the two are not the same. Having a myocardial infarction does not necessarily result in sudden death, and myocardial infarction can be alleviated with treatment.

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Written by Chen Guang Yin

Cardiology

42sec

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What causes cyanosis of the face and lips in sudden cardiac death?

In patients with cardiogenic sudden death, we can see that their lips turn purple, commonly referred to as cyanosis of the lips. Similarly, their faces also turn purple. This primarily results from cardiac arrest caused by cardiogenic sudden death. Once the heart stops beating, the blood supply to the entire body, including the heart, brain, kidneys, peripheral vessels, face, skin, and fingers, is halted. This leads to a state of hypoxia. The purple discoloration (cyanosis) occurs because, after the heart stops, there is no blood flow and no oxygen exchange in the blood, ultimately leading to hypoxia.

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Written by Xie Zhi Hong

Cardiology

44sec

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The main cause of sudden cardiogenic cardiac arrest

70% of sudden cardiac deaths are caused by arrhythmias, often referred to as malignant arrhythmias, with the most common ones being ventricular tachycardia and ventricular fibrillation. A small portion is caused by severe bradycardia. This condition is generally seen in patients with structural heart diseases, such as acute myocardial infarction, severe dilated cardiomyopathy, hypertrophic cardiomyopathy, or patients in the late stages of valvular insufficiency or stenosis. It can also occur in patients with severe electrolyte disturbances, who are prone to malignant arrhythmias.

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Written by Chen Guang Yin

Cardiology

57sec

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The difference between cardiogenic sudden death and cerebrogenic sudden death.

The concept of sudden cardiac death exists, but there doesn't seem to be an equivalent term for "sudden brain death." For instance, if a large cerebral hemorrhage occurs and the patient dies within a very short time, this is referred to as death due to cerebral hemorrhage, not sudden death. Sudden death is characterized by death occurring unexpectedly within just a few minutes. The main difference between these, I think, is time. Sudden cardiac death happens very quickly and unexpectedly, which is why it's termed sudden death. In the case of brain-related issues, such as a significant cerebral hemorrhage, especially in the brainstem, it can compress the vital centers, leading to rapid respiratory and circulatory failure, and eventually death. Compared to sudden cardiac death, there is a slight delay in brain-related deaths; they don't occur as swiftly, and I believe the major difference lies in the timing.