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 Li Hai Wen
Cardiology
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What does sudden cardiac death mean?

Sudden cardiac death refers to the sudden mortality caused by heart diseases, and the reasons for sudden cardiac death primarily include the following aspects: First, structural heart diseases, such as coronary heart disease and acute myocardial infarction; acute myocardial infarction is currently the most common cause of sudden cardiac death. Second, certain ion channel diseases, such as Brugada syndrome, or long QT syndrome. These types of ion channel diseases often coincide with malignant ventricular arrhythmias, such as torsade de pointes ventricular tachycardia or ventricular fibrillation, thus leading to the occurrence of these fatal phenomena. Third, severe arrhythmias, such as severe bradycardia or ventricular tachycardia related to structural heart disease, often trigger malignant ventricular arrhythmias, leading to death.

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Written by Chen Guang Yin
Cardiology
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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
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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, but they are different from each other. Firstly, having a myocardial infarction does not necessarily result in sudden death. Myocardial damage involves a large area of necrosis in the heart, and the patient may experience symptoms such as chest tightness, shortness of breath, chest pain, and sweating. The main symptom of sudden cardiac death is the abrupt cessation of vital signs, with breathing and pulse disappearing. This condition can be caused by a large and extensive acute myocardial infarction, but it can also be caused by other reasons such as electrolyte disturbances or malignant arrhythmias, which are different causes.

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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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Precursors of cardiogenic sudden death during sleep

Before the onset of cardiac arrest during sleep, patients often exhibit symptoms of coronary heart disease such as chest tightness, shortness of breath, and palpitations. Often, these individuals do not pay enough attention to the symptoms, do not undergo timely medical examinations at a hospital, and consequently, there is a delay in the treatment of the condition. It is very unfortunate that sudden deaths occur during sleep, possibly due to fatigue, poor rest, and underlying heart disease, which then leads to cardiac arrest. The precursors of such events can vary from person to person; symptoms may include chest tightness and palpitations, among others. Therefore, it is important that we pay attention to these signs.