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sudden cardiac death

sudden cardiac death. “natural death from cardiac causes heralded by abrupt loss of consciousness”.

leverett-reynaud
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sudden cardiac death

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  1. sudden cardiac death “natural death from cardiac causes heralded by abrupt loss of consciousness”

  2. Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to the rest of your body. Sudden cardiac arrest is different from a heart attack, which occurs when blood flow to a portion of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest. Sudden cardiac arrest is a medical emergency. If not treated immediately, it causes sudden cardiac death. With fast, appropriate medical care, survival is possible. Administering cardiopulmonary resuscitation (CPR) — or even just compressions to the chest — can improve the chances of survival until emergency personnel arrive.

  3. The cardiovascular continuum Sudden death Myocardialinfarction Arrhythmia & Loss of muscle Coronary thrombosis Myocardial ischaemia Remodelling Ventricular dilatation CAD Atherosclerosis LVH Heart failure Risk factors (HT, LDL, DM, etc) Endstage heart disease

  4. Causes of Sudden Cardiac Death(SCD) congenital acquired • Electrical • Heart muscle • Valvar • arterial • Atheromatous coronary disease • Hypertension • Post viral • Rheumatic heart disease

  5. SCD Rare < 15 years of age 15-35 years:- congenital electrical atheromatous >35 years atheromatous hypertension

  6. Myths of excercise

  7. AICD: automatic implantable cardiac defibrillator For those identified to be high risk for SCD

  8. SCD: how can we improve our chances?

  9. Statins save lives

  10. A 28 % Reduction in LDL-C significantly reduces cardiovascular events Major corronary events Coronary deaths Cardiovascular deaths All-cause deaths • 0 • -5 • -10 • -15 Per cent proportional risk reduction -21 % • -20 -27 % • -25 -29 % -31 % • -30 • -35 Meta-analysis illustrating the beneficial effects of statin therapy LaRosa et al, JAMA 1999; 282: 2340-2346 Proven Mortality Benefits In Lowering LDL

  11. Can we predict the # plaque?

  12. Can we predict the # plaque? Intravascular ultrasound (IVUS)

  13. The pleiotrophic effects of statins…..anti-inflammatory

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