Nagla srčana smrt

master's thesis

• Title (english): Sudden cardiac death
• Author: Eugen Ciglenečki
• Mentor: Mislav Puljević (mentor)
• Committee member: Davor Puljević (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Mislav Puljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Nagla srčana smrt (NSS) je neočekivana, iznenadna smrt uzrokovana kardijalnom patologijom koja dovodi doživotno ugrožavajućih aritmija te prestanka krvotoka, a koja se događa jedan sat od nastupa simptoma, a u odsutstvu drugih potencijalno smrtonosnih uzroka.NSS je uzrok 25% svih smrti. Razlikujemo ishemijske i neishemijske uzroke koji dovode do NSS-a. Akutni koronarni sindrom je najčešći uzrok NSS-a (75%). Prevencija NSS-a dijeli se na primarnu i sekundarnu. Cilj primarne prevencije je sačuvati pojedince koji su pod povećanim rizikom za nastanak NSS-a, a koji nisu doživjeli ventrikularnu aritmiju ili resuscitirani srčani zastoj.Sekundarna prevencija su sve mjere koje se poduzimaju kako bi se smanjio rizik od NSS-a u bolesnika koji su već doživjeli abortirani srčani zastoj ili životno ugrožavajuće aritmije. U prevenciji, važno je učinkovito prepoznavanje osoba pod povećanim rizikom za nastanak NSS-a. Budući da, osim ejekcijske frakcije lijevog ventrikula, još uvijek nemamo druge prognostičke čimbenike rizika, teško je provesti kvalitetnu stratifikaciju rizika. Posljedično tome 50% srčanih zastoja događa se u bolesnika bez poznate bolesti srca i bez prepoznatih rizičnih čimbenika. Zbog toga su potrebni dodatni napori kako bi se istražili drugi potencijalni stratifikatori rizika. Važnost točnog prepoznavanje osoba pod povećanim rizikom je iznimno velika budući da postoji učinkovita metoda prevencije u vidu ugradbenog kardioverter-defibrilatora (ICD).Sve randomizirane studije o prevenciji NSS-a pokazale su da je liječenje ICD-om učinkovitije u odnosu na terapiju antiaritmijskim lijekovima. Međutim, kod bolesnika s ICD-om i učestalim recidivima aritmija indicirana je kombinirana terapija s antiaritmicima ili primjenom kateterske ablacije.

Abstract (english)

Sudden cardiac death (SCD) is an unexpected death caused by cardiac pathology leading to life-threatening arrhythmias and cardiac arrest, occurring one hour after the onset of symptoms, and in the absence of other potentially lethal causes. SCD is the cause of 25% of all deaths. There are ischemic and non-ischemic causes that lead to SCD. Acute coronary syndrome is the most common cause of SCD (75%). Prevention of SCD is divided into two groups- primary and secondary. The goal of primary prevention is to preserve individuals who are at increased risk for SCD and who have not experienced ventricular arrhythmia or resuscitated cardiac arrest. Secondary prevention includes all methods taken to reduce the risk of SCD in patients who have already experienced aborted cardiac arrest or life-threatening arrhythmias. It is very important to effectively identify people at increased risk of SCD. The left ventricular ejection fraction (LVEF) is the only risk predictor of SCD and this is the reason why is difficult to perform risk stratification. Consequently, 50% of heart failures occur in patients without known heart disease and without recognized risk factors. Therefore other potential risk factors need to be explored. The accurate identification of people at increased risk is extremely important since there is an effective prevention devicecalledimplantablecardioverterdefibrillator (ICD). All randomized studies about prevention of SCD have shown that ICD treatment is more effectivethanantiarrhythmic drug therapy. However, in patientswith ICD and frequent recurrence ofarrhythmias, combinedantiarrhythmictherapy or catheter ablation is indicated.

• Keywords: nagla srčana smrt; primarna prevencija; sekundarna prevencija; ugradbeni kardioverter-defibrilator (ICD)
• Keywords (english): sudden cardiac death; primary prevention; secondary prevention; implantable cardioverter defibrillator (ICD)
• Language: croatian
• URN:NBN: urn:nbn:hr:105:908601
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-02-24 14:40:09