Etiology of sudden cardiac arrest: Literature review and proposal for an intensive care unit study protocol

Area of Science:

• Cardiology
• Intensive Care Medicine
• Genetics

Background:

• Sudden cardiac arrest (SCA) is a critical event with varied etiologies across age groups.
• Determining the cause of SCA is complex, involving both cardiac and noncardiac factors.
• Prevalence of causes differs, with structural heart disease in older adults and cardiomyopathies/electrical diseases in younger individuals.

Purpose of the Study:

• To review the epidemiology, etiology, and investigation of SCA.
• To propose a structured diagnostic algorithm for SCA patients in emergency and intensive care settings.
• To emphasize a multidisciplinary approach and early genetic testing for improved management.

Main Methods:

• Review of SCA epidemiology and etiology.
• Proposal of a four-stage diagnostic protocol: initial evaluation, nonischemic cardiac assessment, neuroprognostication, and autopsy/genetic testing.
• Highlighting the role of intensivists, cardiologists, neurologists, geneticists, and pathologists.

Main Results:

• A comprehensive diagnostic algorithm for SCA patients is presented.
• The importance of identifying reversible causes and specific cardiac/noncardiac etiologies is stressed.
• Early genetic testing can identify heritable diseases and aid in family screening.

Conclusions:

• A structured, multidisciplinary diagnostic approach can enhance the management of SCA.
• Early identification of SCA etiology through a systematic protocol is crucial for patient outcomes.
• Genetic testing plays a vital role in diagnosing heritable conditions and facilitating family-centered care.