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 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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Is cardiopulmonary resuscitation effective for sudden cardiac death?

Is cardiopulmonary resuscitation useful for sudden cardiac arrest? Of course, it is useful. The emergency measure for sudden cardiac arrest is to perform cardiopulmonary resuscitation. If the patient receives CPR within four minutes, they are very likely to survive. If there is a delay beyond four minutes, the patient’s life might still be prolonged if resuscitated, but they might suffer brain death and potentially become vegetative. Therefore, it is crucial to administer immediate cardiopulmonary resuscitation to a patient experiencing sudden cardiac arrest, as this is the primary method of resuscitation.

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Written by Chen Guang Yin
Cardiology
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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 Zhang Yue Mei
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Does sudden cardiac death have a connection with overwork?

Sudden cardiac death is directly related to overexertion, particularly in individuals with coronary heart disease, congenital heart disease, rheumatic heart disease, viral myocarditis, and heart rhythm disorders, especially those accompanied by heart failure. Excessive strain can increase the burden on the heart, exacerbate heart failure, lead to arrhythmias, and in severe cases, result in sudden death. Therefore, patients with structural heart disease must follow a doctor's guidance to routinely use effective medications for treatment, rest adequately, avoid overexertion, and maintain a low-fat, low-salt diet to minimize factors that increase cardiac load and prevent the occurrence of sudden death.

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Does sudden cardiac death relate to coronary heart disease?

Some studies suggest that 70% of sudden cardiac deaths are caused by arrhythmias. Most of these arrhythmia-induced sudden deaths are associated with coronary artery atherosclerosis. Some are caused by acute myocardial infarction leading to sudden cardiac death. These are all caused by coronary heart disease. Therefore, sudden cardiac death is related to coronary heart disease. Thus, if coronary heart disease is suspected in a patient, it is crucial to perform early examinations and treatments to prevent the occurrence of myocardial infarction. Typical symptoms of coronary heart disease include intermittent chest tightness and chest pain, which can improve after a few minutes, and should therefore be taken seriously.