Sentinel Symptoms in Patients with Unexplained Cardiac Arrest: From the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER).
Sentinel Symptoms in Unexplained Cardiac Arrest. Background: Warning symptoms may provide an opportunity to diagnose genetic disorders leading to preventative therapy. We explored the symptom history of patients with apparently unexplained cardiac arrest to determine the frequency of sentinel sympto...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 23; no. 1; pp. 60 - 67 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2012
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=70359859&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 70359859 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2012 vid: 23 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 70359859 104630993 104630993 10.1111/j.1540-8167.2011.02185.x 70359859 ppf: 60 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Sentinel Symptoms in Patients with Unexplained Cardiac Arrest: From the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER). aug: au: KRAHN, ANDREW D. HEALEY, JEFFREY S. SIMPSON, CHRISTOPHER S. CHAUHAN, VIJAY S. BIRNIE, DAVID H. CHAMPAGNE, JEAN GARDNER, MARTIN SANATANI, SHUBHAYAN CHAKRABARTI, SANTABHANU YEE, RAYMOND SKANES, ALLAN C. LEONG‐SIT, PETER AHMAD, KAMRAN GOLLOB, MICHAEL H. KLEIN, GEORGE J. GULA, LORNE J. SHELDON, ROBERT S. affil: University of Western Ontario, London, Ontario, Canada sug: subj: Heart Arrest Symptoms Sentinel Event Syncope Diagnosis Human Interviews Hereditary Diseases ROC Curve Middle Age Adult Male Female Family Canada Questionnaires Multicenter Studies Genetic Screening Electrocardiography Electrophysiology Two-Tailed Test T-Tests Data Analysis Software Descriptive Statistics Chest Pain Arrhythmia Sensitivity and Specificity Funding Source Middle Aged: 45-64 years Adult: 19-44 years Male Female ab: Sentinel Symptoms in Unexplained Cardiac Arrest. Background: Warning symptoms may provide an opportunity to diagnose genetic disorders leading to preventative therapy. We explored the symptom history of patients with apparently unexplained cardiac arrest to determine the frequency of sentinel symptoms. Methods: Patients with apparently unexplained cardiac arrest and no evident cardiac disease underwent systematic clinical evaluation. Patients and first-degree relatives were interviewed to determine the presence of cardiac symptoms, and those with syncope underwent 2 structured Calgary Syncope Score questionnaires to determine the probable mechanism of syncope. Results: One hundred consecutive cardiac arrest patients (age 43.0 ± 13.4 years, 60% male) and 63 first-degree relatives (age 37.6 ± 16.3 years, 54% female) were enrolled. Previous cardiac symptoms were present in 69% of cardiac arrest patients compared to 43% of family members (P = 0.001). Prior syncope was present in 26% of cardiac arrest patients, compared to 22% of family members (P = 0.59). Twenty-four of 25 cardiac arrest patients who completed the syncope questionnaires had a syncope versus seizure score <1 favoring syncope. The area under the receiver operator curve (ROC) for the syncope mechanism score was 0.79 for identifying patients with subsequent cardiac arrest (95% CI, 0.6328-0.9395, P = 0.004). A score of ≤-2 had a sensitivity of 68% and specificity of 85%. Thirty percent of patients with a proven genetic cause had preceding syncope versus 19% in patients with noninherited or idiopathic causes (P = 0.032). Conclusions: Syncope that may represent a sentinel event is present in a modest proportion of patients and family members, and is often suggestive of an arrhythmia. (J Cardiovasc Electrophysiol, Vol. 23, pp. 60-66, January 2012) pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|