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Source: Barletta JF. Cardiac arrest. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146055661. Accessed May 22, 2017.
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CONDITION/DISORDER SYNONYMS
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Cardiopulmonary arrest.
Circulatory arrest.
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Cessation of cardiac mechanical activity as confirmed by absence of signs of circulation (eg, undetectable pulse, unresponsiveness, apnea).
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Coronary artery disease.
Cardiomyopathies (eg, hypertrophic or dilated cardiomyopathy)
Structurally abnormal congenital cardiac conditions.
Structurally normal but electrically abnormal heart conditions.
In pediatric patients, cardiac arrest may follow respiratory failure or progressive shock.
Out-of-hospital arrests often associated with trauma, sudden infant death syndrome, drowning, poisoning, choking, severe asthma, and pneumonia.
In-hospital arrests associated with sepsis, respiratory failure, drug toxicity, metabolic disorders, and arrhythmias.
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Primary cardiac arrest: Arterial blood fully oxygenated at time of arrest.
Secondary cardiac arrest: Results from respiratory failure, leading to hypoxemia, hypotension, and cardiac arrest.
Usually results from arrhythmias in adults (eg, ventricular fibrillation [VF], pulseless ventricular tachycardia [PVT]).
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An estimated 320,000 or more people in the United States who experience emergency medical services (EMS)-assessed out-of-hospital cardiac arrest.
Survival to hospital discharge following out-of-hospital cardiac arrest is only 10.6% and survival with good neurologic function is only 8.3%.
In-hospital cardiac arrests occur in roughly 200,000 patients in the United States annually and this rate may be increasing.
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PREVENTION AND SCREENING
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Because primary cause is coronary artery disease, preventive measures include healthy diet, appropriate exercise, smoking cessation, blood pressure control, and management of dyslipidemia.
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Family history of coronary artery disease.
Personal history of myocardial infarction (MI) or previous cardiac arrest.
Smoking.
Hypertension.
Dyslipidemia.
Obesity.
Diabetes.
Sedentary lifestyle.
Increasing age.
Male sex.
Use of certain illegal drugs (cocaine, amphetamines)
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CLINICAL PRESENTATION
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Preceeding an arrest:
Anxiety.
Crushing chest pain.
Diaphoresis.
Nausea or vomiting.
Following an arrest.
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MEANS OF CONFIRMATION AND DIAGNOSIS
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Observation of clinical findings consistent with cardiac arrest.
Confirmation by evaluating vital signs, especially heart rate and respirations.
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DIAGNOSTIC PROCEDURES
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DIFFERENTIAL DIAGNOSIS
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Acute coronary syndrome.
Trauma.
Hypovolemia.
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