The difference between cardiogenic shock and sudden cardiac death

Written by Li Qiang
Intensive Care Unit
Updated on November 10, 2024
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Cardiogenic shock is caused by a decrease in cardiac contractile function, leading to reduced ejection, lowered blood pressure, and resulting in ischemia and hypoxia of tissue cells. It is due to the reduced contractile function of the heart, which may be caused by coronary issues such as coronary ischemia, or by severe arrhythmias such as severe ventricular tachycardia or fibrillation, or by acute heart failure. Cardiogenic sudden death occurs when cardiogenic shock progresses further, leading to the cessation of the heartbeat. The main difference between cardiogenic sudden death and cardiogenic shock is that during cardiogenic sudden death, the heartbeat has definitely stopped completely, or there is only ventricular fibrillation, at which point it is called cardiogenic sudden death. During cardiogenic shock, the heart still retains some contractile function, meaning the heart still has some autonomous beating capability. Compared to cardiogenic sudden death, it is still an early, reversible stage of cardiogenic sudden death. Once it progresses to cardiogenic sudden death, immediate cardiopulmonary resuscitation is necessary, and at this point, the mortality rate greatly increases.

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Golden hour for emergency treatment of cardiogenic sudden death

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
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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 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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Is there a difference between sudden cardiac death and myocardial infarction?

Sudden cardiac death refers to the death of patients caused by various reasons such as cardiac enlargement, ventricular aneurysm, cardiac valve dysfunction, arrhythmias, and cardiac infections. Myocardial infarction leading to myocardial death is just one type of sudden cardiac death, mainly due to insufficient cardiac blood supply, leading to arrhythmias, heart failure, shock, acute death caused by the formation of intracardiac thrombosis, or death caused by complications after a heart attack. Therefore, the range of sudden cardiac death is quite broad, including myocardial infarction.

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The difference between sudden cardiac death and myocardial infarction.

Sudden cardiac death refers to the sudden death of a patient caused by various heart diseases. The most common causes include malignant arrhythmias such as ventricular fibrillation and ventricular tachycardia, severe bradycardia, significant valvular dysfunction, or the sudden occlusion of the coronary arteries leading to death. Myocardial infarction, on the other hand, refers to the sudden cessation of blood supply to the heart vessels, causing myocardial death and leading to arrhythmias or valvular dysfunction, which presents a range of symptoms in patients. Myocardial infarction can result in death in 30% of patients, but with medical intervention, the mortality rate can significantly decrease. Therefore, in cases of sudden cardiac death, the patients are already deceased. However, the mortality rate from myocardial infarction under natural circumstances is relatively high, reaching 30%. With current medical interventions, the rate of mortality due to sudden cardiac death can be reduced to less than 10%.