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
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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.

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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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Can an electrocardiogram be used to check for sudden cardiac death?

Can an electrocardiogram (ECG) detect the potential for sudden cardiac death in the future? Sudden cardiac death cannot be detected by an electrocardiogram. An ECG can only identify conditions such as myocardial infarction, arrhythmias, or premature beats occurring at the time of the test. Sudden cardiac death is a sudden cardiac event that definitely cannot be predicted by an ECG. There are some risk factors for sudden cardiac death, such as high blood pressure, diabetes, and underlying diseases like coronary heart disease, which make individuals more susceptible to sudden cardiac death. We cannot rely on an ECG to predict it.

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Written by Xie Zhi Hong
Cardiology
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Why does cardiogenic sudden death cause pallor throughout the body?

Sudden cardiac death occurs due to heart thrombosis or heart failure caused by various reasons whereby the heart cannot supply blood, leading to death. Most people experience hypotensive shock, insufficient blood and oxygen supply to the body before dying, thus appearing pale, with low blood pressure, and even cyanosis, with cessation of breathing and heartbeat. Some individuals suffer from heart thrombus dislodging into the brain, causing cerebral arterial infarction. Such extensive cerebral infarctions can also lead to the cessation of heartbeat, resulting in insufficient blood and oxygen supply throughout the body, manifesting as pallor and cyanosis.

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Written by Chen Guang Yin
Cardiology
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How to Self-Check for Precursors of Cardiogenic Sudden Death

The majority of cases of sudden cardiac death are due to coronary artery atherosclerotic heart disease, causing extensive myocardial infarction, hence these patients often have precursors. Some individuals experience acute coronary syndrome due to inflammatory changes, leading to thrombosis; others, such as young people without any underlying conditions, might also experience this, often due to poor lifestyle habits like high stress and lack of sleep among other triggers. Most patients exhibit warning signs, including chest tightness, chest pain, and palpitations – symptoms of heart disease. When these problems occur, it is crucial to promptly visit a hospital for examination to determine if there are issues with the coronary arteries, and if so, to receive timely treatment and intervention.