🏥 Stations

🧠 Qbank

📖 Book

😃 More

💳 Pricing

🔒 Dashboard

📖 OSCE Learning

🔒 OSCE Stations

🔒 Qbank

🔐 Membership
Share your insights

Help us by sharing what content you've recieved in your exams


Cardiorespiratory arrest

Medicine > Cardiovascular

Differential Diagnosis Schema 🧠

Cardiac Causes

  • Acute Myocardial Infarction: Severe, crushing chest pain, often radiating to the left arm or jaw, associated with diaphoresis and nausea.
  • Pulmonary Embolism: Sudden onset of dyspnoea, pleuritic chest pain, haemoptysis, often in the context of recent surgery or immobility.
  • Cardiac Tamponade: Distant heart sounds, hypotension, distended neck veins, often after chest trauma or pericarditis.
  • Arrhythmias: Palpitations, syncope, and sudden collapse, can be associated with a history of previous arrhythmias or ischemic heart disease.

Respiratory Causes

  • Severe Asthma: History of asthma, wheezing, difficulty speaking in full sentences, use of accessory muscles.
  • Tension Pneumothorax: Sudden onset dyspnoea and pleuritic chest pain, decreased breath sounds on the affected side, tracheal deviation.
  • Aspiration: Sudden onset of respiratory distress after vomiting or eating, particularly in individuals with a history of swallowing difficulties.
  • Acute Respiratory Distress Syndrome (ARDS): Rapid onset of severe dyspnoea, hypoxaemia, often following trauma, sepsis, or severe pneumonia.

Neurological Causes

  • Massive Stroke: Sudden onset of focal neurological deficits, decreased level of consciousness, often in the context of hypertension or atrial fibrillation.
  • Subarachnoid Haemorrhage: Thunderclap headache, loss of consciousness, neck stiffness, often with a history of polycystic kidney disease or berry aneurysms.
  • Seizures: Sudden loss of consciousness with tonic-clonic movements, postictal confusion, can be associated with a history of epilepsy.
  • Raised Intracranial Pressure: Headache, vomiting, papilloedema, bradycardia, and hypertension.

Metabolic Causes

  • Hypoglycaemia: Altered mental state, diaphoresis, tremors, often in patients with diabetes on insulin or sulfonylureas.
  • Electrolyte Imbalances: Muscle cramps, weakness, altered mental state, often in patients with renal failure or on diuretics.
  • Severe Acidosis: Kussmaul respiration, altered mental status, often in patients with diabetic ketoacidosis or lactic acidosis.
  • Drug Overdose: Altered level of consciousness, respiratory depression, pinpoint pupils in the case of opioid overdose.

Key Points in History 🥼

Presenting Complaint

  • Chest Pain: Associated with myocardial infarction, pulmonary embolism, or aortic dissection.
  • Shortness of Breath: Suggests cardiac causes like heart failure, respiratory causes like severe asthma, or pulmonary embolism.
  • Syncope: Can indicate arrhythmias, severe aortic stenosis, or massive pulmonary embolism.
  • Seizures: Consider neurological causes such as intracranial haemorrhage or metabolic disturbances.
  • Palpitations: May point to arrhythmias, particularly in those with a history of ischemic heart disease or cardiomyopathy.

Background

  • Past Medical History: Previous myocardial infarctions, history of hypertension, diabetes, or asthma.
  • Drug History: Use of anticoagulants, antiarrhythmics, insulin, or medications that prolong the QT interval.
  • Family History: Sudden cardiac death, inherited arrhythmias, or thromboembolic disorders.
  • Social History: Smoking, alcohol use, or illicit drug use, particularly cocaine, which can precipitate cardiac events.
  • Recent Surgery or Trauma: Particularly relevant for pulmonary embolism or cardiac tamponade.

Possible Investigations 🌡️

Bedside Tests

  • ECG: To identify arrhythmias, myocardial ischemia, or signs of pulmonary embolism.
  • Capillary Blood Glucose: To rule out hypoglycaemia as a cause of altered mental status.
  • Pulse Oximetry: To assess oxygen saturation and identify hypoxia.
  • Arterial Blood Gas: To assess for hypoxaemia, acidosis, or hypercarbia.
  • Urine Drug Screen: To identify potential drug overdose.

Laboratory Tests

  • Troponin: To rule out myocardial infarction.
  • D-dimer: To support the diagnosis of pulmonary embolism, particularly in the context of high clinical suspicion.
  • Full Blood Count: To identify anaemia, infection, or other haematological abnormalities.
  • Urea and Electrolytes: To assess for electrolyte imbalances or renal function impairment.
  • Liver Function Tests: To assess for hepatic function, which may be relevant in drug toxicity or sepsis.
  • Coagulation Profile: To assess for bleeding disorders or the effect of anticoagulant therapy.

Imaging

  • Chest X-ray: To identify pneumothorax, pulmonary oedema, or widened mediastinum suggestive of aortic dissection.
  • CT Pulmonary Angiogram: Gold standard for diagnosing pulmonary embolism.
  • Echocardiography: To assess cardiac function, wall motion abnormalities, or pericardial effusion.
  • CT/MRI Brain: If neurological cause is suspected, to identify haemorrhage, infarction, or mass effect.

No comments yet 😉

Leave a Reply

Cardiovascular