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 Xie Zhi Hong
Cardiology
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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
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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.

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Written by Chen Guang Yin
Cardiology
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Is sudden cardiac death hereditary?

The majority of sudden cardiac deaths are caused by acute and extensive myocardial infarction, with some caused by malignant arrhythmias. Coronary atherosclerotic heart disease has a genetic history. Patients with such a family history, especially those with early-onset heart disease family history—that is, a family history of heart disease before the age of 50—should be given high attention. Heart disease has a genetic predisposition, and since sudden cardiac death is a type of heart disease, it also has a genetic predisposition.

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Written by Chen Guang Yin
Cardiology
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Does cardiogenic sudden death cause vomiting blood?

Of course, sudden cardiac death is now a very common cause of death. At places like airports and bus stations, we often see reports of such incidents, and many young people are also affected. However, patients experiencing sudden cardiac death generally do not present with symptoms of vomiting blood, as it is caused by cardiac arrest. Vomiting blood is usually associated with conditions such as gastric ulcers leading to severe bleeding, gastric cancer, or cirrhosis leading to rupture of varicose veins at the base of the stomach. The likelihood of vomiting blood occurring in cases of sudden cardiac death is very low, almost nonexistent.

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Written by Li Hai Wen
Cardiology
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Does sudden cardiac death have a relationship with hypertension?

Sudden cardiac death and hypertension are related, with the most common cause of sudden cardiac death being acute myocardial infarction, which leads to malignant arrhythmias, such as ventricular fibrillation, resulting in sudden cardiac death. In addition, severe aortic dissection can also cause sudden cardiac death, and hypertension is often an important cause of coronary heart disease, acute myocardial infarction, and aortic dissection. Long-term hypertension can lead to the occurrence of arteriosclerosis, resulting in the formation of arterial plaques or aneurysms, such as those occurring in the coronary arteries, causing coronary heart disease and myocardial infarction, or in the aorta, often leading to the formation of aortic aneurysms. When an aortic aneurysm ruptures, it can cause aortic dissection.