Coronary Vasospasm as an Underlying Etiology of Out-of-Hospital Cardiac Arrest

Takagi, Yusuke

doi:10.1253/circj.cj-13-0060

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…For example, if an acute cerebrovascular event or a massive pulmonary embolism is suspected, CT of the head and thorax should be performed on the way from the catheterisation laboratory to the intensive care unit. If an alternative cause of OHCA is not identified, coronary artery spasm should be considered, since several studies have shown that spasm may trigger lethal arrhythmias and lead to sudden death [52][53][54] . Accordingly, if the index procedure reveals normal coronary arteries, if the patient survives with no or minimal neurological sequelae, and if there is no other obvious cause of arrest, a coronary artery spasm provocation test may be performed during a second coronary angiogram by an experienced operator using either intracoronary acetylcholine or ergonovine 54,55 .…”

Section: Search For Non-cardiac Cause Of Arrestmentioning

confidence: 99%

Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI)/Stent for Life (SFL) groups

Noč

Fajadet

Lassen³

et al. 2014

EuroIntervention

231

156

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Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation myocardial infarction (STEMI) and high-risk non-ST-segment elevation -ACS (NSTE-ACS) without OHCA and should undergo immediate (if STEMI) or rapid (less than two hours if NSTE-ACS) coronary invasive strategy. Comatose survivors of OHCA with ECG criteria for STEMI on the post-resuscitation ECG should be admitted directly to the catheterisation laboratory. For patients without STEMI ECG criteria, a short "emergency department or intensive care unit stop" is advised to exclude non-coronary causes. In the absence of an obvious non-coronary cause, CAG should be performed as soon as possible (less than two hours), in particular in haemodynamically unstable patients. Immediate PCI should be mainly directed towards the culprit lesion if identified. Interventional cardiologists should become an essential part of the "survival chain" for patients with OHCA. There is a need to centralise the care of patients with OHCA to experienced centres.

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Section: Search For Non-cardiac Cause Of Arrestmentioning

confidence: 99%

Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI)/Stent for Life (SFL) groups

Noč

Fajadet

Lassen³

et al. 2014

EuroIntervention

231

156

View full text Add to dashboard Cite

show abstract

“…Coronary artery spasm has been associated with lethal arrhythmias and sudden death, though its diagnosis remains a challenge, particularly in patients acutely unwell with heightened adrenergic states 73 74. Where clinical suspicion is high, provocation testing using either intracoronary acetylcholine or ergonovine can be considered at repeat angiography once the patient is stable and recovered 75.…”

Section: Is Immediate Cag Recommended For All Oohca Survivors?mentioning

confidence: 99%