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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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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How to self-rescue from sudden cardiac death

Sudden cardiac death is now also a very critical illness often occurring in coronary heart disease. We frequently see news reports of sudden deaths at airports and public places. At such times, self-rescue is extremely difficult. Unless you have a history of coronary heart disease and carry medications with you, if you experience symptoms like chest tightness and shortness of breath, you could take these medications to help yourself. Otherwise, sudden cardiac death occurs abruptly, causing the heart to stop beating within a very short period, and the patient cannot self-rescue.

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Written by Xie Zhi Hong
Cardiology
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Is sudden cardiac death an acute myocardial infarction?

Sudden cardiac death refers to a phenomenon where a variety of heart diseases cause acute death in patients, with the most common causes being malignant arrhythmias such as ventricular tachycardia, ventricular fibrillation, or severe bradycardia, primarily related to myocardial infarction. However, not all cases of sudden cardiac death are due to myocardial infarction; this condition generally accounts for about 70%. Other causes of sudden cardiac death include existing dilated cardiomyopathy, thyrotoxic cardiomyopathy, or severe terminal stenosis of the mitral or aortic valves, which can also lead to sudden cardiac death. Another scenario involves atrial fibrillation leading to atrial thrombosis, causing thrombus detachment and resulting in extensive cerebral infarction leading to sudden death; this is also classified as sudden cardiac death. Therefore, while the majority of sudden cardiac deaths are related to myocardial infarction and arrhythmias, not all sudden cardiac deaths are due to myocardial infarction.

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Written by Xie Zhi Hong
Cardiology
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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%.

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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.