sturge_weber
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guys please tell, what is the most common cause of sudden cardiac death
i thought it will be hypertrophic cardiomyopathy, but kaplan says its ischaemic heart disease of atherosclerotic origin
please tell if anyone knows
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| gpsbrar
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CAD coronary artery disease. Hypertrophic cardiomyopathy is number 2.
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| reet
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CAD ---coz artery blocks suddenly...no bloody(coronary) supply---ischemia-INFARCTION (Pump failure)
1.whts the cause of sudden death in ATHELETES???
2.When ARYTHMIAS are the cause of sudden death???
Edited by reet on 09/16/05 - 09:54 PM
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| an
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in athletes, hypertr cardiomyopathy..
arrhythmias, in ischemic heart ds, may be the first manif of IHD... especially shortly after acute MI
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| reet
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yes!!!ARRYTHMIAS R THE MAIN CAUSE of sudden death in IHD.
ANY OTHER goood CAuses of arrythmias???
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| an
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long QT synd
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| p53
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reet, I think you should review pathophysiology of hypertrophic cardiomyopathy. I guess you are confusing it with myocardial hypertrophy due to hypertension. Patients with hypertrophic cardiomyopathy die not because of volume overload, but because of intrinsic (genetic) defect in myocardium, and they die suddenly - especially during heavy physical excercise. why? what is the main cause of sudden death in the hypertrophic cardiomyopathy? is it 1. dynamic obstruction to the left ventricular outflow (anterior mitral leaflet moves toward the hypertrophied ventricular septum during systole and this is exaggerated during physical activity), or 2. ventricular arrhythmias, which are also exaggerated during exercise because of increased myocardial ischemia or 3. thromboembolization (there is atrial fibrillation)?
As to sturge's question - sudden cardiac death is one of the 4 clinical manifestations of ischaemic heart disease (1. MI, 2. Angina Pectoris, 3. Chronic IHD with heart failure, 4. sudden cardiac death), though it may have (much more rarely) other causes. IHD by itself is due to atherosclerosis in 90% of cases.
Edited by p53 on 09/16/05 - 10:10 AM
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| md999
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Good call p53. If you dont mind, can I ask what you recommend to study for pathophysiology?
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| reet
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p53 thanks alot
got the perfect answer
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| sturge_weber
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hey thanks p53....
well explained
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| p53
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OK, you're welcome, but does anyone know the answer to my question (what's most common mechanism of sudden death in hypertrophic cardiomyopathy from above three)?
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| gpsbrar
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Occlusion of LAD
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| p53
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your answer isn't correct, gpsbrar.
md999, I don't know what to recommend to you. It depends on what is your aim and how much time do you have. Personally I have read 'Robbins and Cotran Pathologic Basis of Disease' and did corresponding questions from 'Robbins and Cotran Review of Pathology' and www.webpath after every chapter.
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| p53
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OK, guys, answer is 2. ventricular arrhythmias.
I have my step 1 on october 27. I'll not be online before then - want to concentrate solely on my study and preparation. Wish good luck to all of you and remember - never give up - we were born to be winners! Goodbye.
Yours truly - guardian of genome.
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| gpsbrar
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Pathophysiology: More than 80% of SCD events occur in individuals with coronary artery disease (CAD). Strong evidence suggests that impaired left ventricular (LV) function and frequent and complex ventricular ectopy in patients with coronary heart disease are important predictors of SCD, particularly in the postinfarction period. The largest group of prehospital patients with cardiac arrest (65-85%) have ventricular fibrillation (VF) identified as the initial rhythm by emergency rescue personnel. Approximately 20-30% of patients from all documented sudden death events have bradyarrhythmia or asystole at the time of initial contact, indicating a terminal event from massive myocyte necrosis, pump failure, or VF progression to asystole. Only 7-10% have sustained ventricular tachycardia (VT) as the initial rhythm on contact, and VT is associated with the best overall prognosis.
FROM ARTICLE: http://www.emedicine.com/med/topic276.htm
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| gpsbrar
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So I think for the exam purpose we should take it coronary artery disease of atherosclerotic origin as in Kaplan. Well I don't know. PLease tell what every one else thinks about this question.
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| sturge_weber
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all the best p53, u will do great...
our wishes with u
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| gpsbrar
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Best of luck p53
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