Fast Five Quiz: Sudden Cardiac Death

March 27, 2023

Obtaining a thorough history from the patient, family members, or other witnesses is necessary to obtain insight into the events surrounding the sudden death. Patients who are at risk for SCD may have prodromes of chest pain, fatigue, palpitations, and other nonspecific complaints. History and associated symptoms to some degree depend on the underlying etiology of SCD. For example, SCD in an older patient with significant coronary artery disease may be associated with preceding chest pain due to a myocardial infarction, whereas SCD in a younger patient may be associated with history of prior syncopal episodes and/or a family history of syncope and SCD and due to inherited arrhythmia syndromes. A prior history of left ventricle impairment (ejection fraction < 30%-35%) is the most potent common risk factor for sudden death.

Patients may exhibit specific factors relating to the development of coronary artery disease and, subsequently, myocardial infarction and ischemic cardiomyopathy, including:

  • Family history of premature coronary artery disease

  • Smoking

  • Dyslipidemia

  • Hypertension

  • Diabetes

  • Obesity

  • Sedentary lifestyle

Each patient may also have specific risk factors, signs, or symptoms relating to any underlying cardiovascular disease, including:

  • Coronary artery disease

  • Dilated cardiomyopathy

  • Hypertrophic cardiomyopathy

  • Valvular disease

  • Long-QT syndrome

Student athletes are not recommended to undergo routine ECG testing. However, those with abnormal physical examination findings and/or those with a significant personal or family history may undergo such testing. Individuals may exhibit brief myoclonic or seizure-like activity.

Learn more about physical findings associated with SCD.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.