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Semin Neurol 2017; 37(01): 013-018
DOI: 10.1055/s-0036-1593861
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cardiac Issues in Cardiac Arrest

Wulfran Bougouin
1   Paris Cardiovascular Research Center (PARCC), Paris, France
2   Université Paris Descartes-Sorbonne Paris Cité, Paris, France
3   Department of Cardiology, Georges Pompidou European Hospital, Paris, France
4   Paris Sudden Death Expertise Center, Paris, France
,
Alain Cariou
1   Paris Cardiovascular Research Center (PARCC), Paris, France
2   Université Paris Descartes-Sorbonne Paris Cité, Paris, France
4   Paris Sudden Death Expertise Center, Paris, France
5   Medical Intensive Care Unit, Cochin Hospital, Paris, France
› Author Affiliations
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Publication History

Publication Date:
01 February 2017 (online)

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Abstract

The prognosis of cardiac arrest (CA) remains poor, with a survival rate at hospital discharge between 6 and 10%. To improve this disappointing outcome, efforts are needed regarding each step in the chain of survival. In this review, the authors focus on cardiac issues, as the heart itself could be both a cause and a target in this setting. Acute myocardial infarction is very illustrative of this duality. As it is a frequent cause of CA, an early invasive strategy (through immediate coronary angiography) has been proposed by several teams and is now recommended in specific situations. In addition, a postresuscitation syndrome is commonly observed in these patients, which often includes transient myocardial dysfunction. Identification and management of this cardiac complication is a key target in the hemodynamic management of these patients. Finally, regarding survivors at hospital discharge, secondary prevention targeting the risk of recurrence of cardiac arrhythmia is mandatory in specific indications (especially through implantable cardiac defibrillators). Overall and as a truism, cardiac issues are crucial before, during, and after occurrence of CA.

Keywords

sudden cardiac death - cardiac arrest - epidemiology - registry - prognosis - sudden death - myocardial infarction - implantable cardioverter defibrillator - cardiogenic shock
 

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