About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Causes of Pulseless Electrical Activity (PEA)
Introduction
Pulseless Electrical Activity (PEA) refers to a condition in which the heart's electrical activity continues, but it does not produce effective mechanical contractions, leading to the absence of a palpable pulse. PEA is a life-threatening condition that requires immediate medical attention.
Main Causes of PEA
The causes of PEA can be remembered using the mnemonic "H's and T's", which categorizes reversible causes:
H’s (Common Metabolic and Circulatory Causes)
- Hypovolemia – Severe blood loss or dehydration leading to reduced cardiac output.
- Hypoxia – Insufficient oxygen supply causing cardiac dysfunction.
- Hydrogen ion (Acidosis) – Metabolic or respiratory acidosis impacting cardiac contractility.
- Hyperkalemia or Hypokalemia – Abnormal potassium levels affecting heart function.
- Hypothermia – Low body temperature reducing metabolic and cardiac activity.
T’s (Common Structural and Traumatic Causes)
- Tension pneumothorax – Air trapped in the pleural space causing compression of the heart.
- Tamponade (Cardiac Tamponade) – Fluid accumulation around the heart restricting its function.
- Toxins – Drug overdoses or poisoning affecting cardiac performance.
- Thrombosis (Pulmonary or Coronary) – Blood clots in lungs (pulmonary embolism) or coronary arteries (heart attack) leading to circulatory failure.
Additional Considerations
While the H’s and T’s list covers most potential causes, other conditions such as severe infections (sepsis) or advanced heart failure may also contribute to PEA.
Diagnosis and Immediate Treatment
- Recognizing PEA: Absence of a pulse despite ECG activity.
- Immediate Actions: Commence Cardiopulmonary Resuscitation (CPR), address reversible causes, and prepare for advanced interventions such as epinephrine administration and fluid resuscitation.
Conclusion
PEA is a critical emergency requiring prompt identification of reversible causes. Effective management following clinical guidelines improves survival outcomes.
Source recommendations
1. American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines
- https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194
- https://pubmed.ncbi.nlm.nih.gov/33081530/
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000918
2. European Resuscitation Council (ERC) Guidelines on Advanced Life Support
- https://pubmed.ncbi.nlm.nih.gov/33773825/
- https://cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Ad.pdf
- https://www.resuscitationjournal.com/article/S0300-9572(21)00063-0/fulltext
- https://cprguidelines.eu/guidelines-2021
- https://www.erc.edu/courses/advanced-life-support
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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Our answers to your questions are based on the clinical recommendations of countries with the most developed healthcare systems in the field of cardiology in the USA, the EU and Japan.
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We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
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Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.