Exploration of Cardiology

Table 1. Main potential causes of cardiac arrest in young patients.

Category	Cause	Typical context	Diagnostic/Screening approach
Cardiac structural	Myocarditis	Viral illness, post-infectious, post-vaccination	cMRI; endomyocardial biopsy in selected cases
	Hypertrophic cardiomyopathy	Most common inherited cause; high risk in athletes	Echocardiography/cMRI; family screening; genetic testing
	ARVC	Exercise-related arrest; ventricular arrhythmias	Holter monitoring, echocardiography; cMRI, and genetic testing
	Dilated cardiomyopathy	Genetic, toxic, or inflammatory; may be asymptomatic	Echocardiography/cMRI; genetic testing; family screening
	Congenital heart disease	Repaired or unrepaired lesions	Echocardiography; cMRI/CT; review of surgical history
	Coronary artery anomalies	Sudden collapse during exertion, especially in athletes	Coronary CT angiography or cMRI
	Premature coronary artery disease	Smoking, familial hypercholesterolemia, and stimulant use	ECG; echocardiogram, coronary imaging; lipidic profile
Cardiac channelopathies	Long-QT syndrome	Syncope or arrest during exertion, emotion, or rest	ECG (QTc); exercise testing; genetic testing; family screening
	Brugada syndrome	Arrest during sleep or fever; more common in males	ECG, including high right precordial leads; provocative testing; genetic testing
	CPVT	Stress- or exercise-induced ventricular arrhythmias	Exercise stress test; Holter monitoring; genetic testing
	WPW syndrome	Rapid atrial arrhythmias degenerating to VF	ECG; electrophysiology study
Non-cardiac	Asthma/Airway disease	Severe exacerbation causing hypoxia	Pulmonary history; spirometry; toxicology if unclear
	Epilepsy	Unwitnessed arrest, often during sleep	Neurology evaluation; EEG; review seizure control
	Drug toxicity	Opioids, cocaine, amphetamines, and QT-prolonging drugs	Toxicology screening; medication review
	Pulmonary embolism	Hypercoagulable states, pregnancy, and immobilization	D-dimer; CT pulmonary angiography
	Anaphylaxis	Known allergies, recent exposure	Clinical diagnosis; serum tryptase
Idiopathic	Sudden arrhythmic death syndrome	Structurally normal heart at autopsy	Molecular autopsy; genetic testing; cascade family screening

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ARVC: arrhythmogenic right ventricle cardiomyopathy; CPVT: catecholaminergic polymorphic ventricular tachycardia; CT: computed tomography; cMRI: cardiac magnetic resonance imaging; VF: ventricular fibrillation; WPW: Wolf-Parkinson-White.

Declarations

Acknowledgments

Part of this study has been published as a Meeting Abstract and may be consulted in the abstract book of the 13th Challenges in Cardiology. It was presented as an oral communication at the ESC Acute Cardiovascular Care congress 2024, in Athens.

Author contributions

MD: Conceptualization, Writing—original draft, Writing—review & editing. SF: Conceptualization, Writing—review & editing. SR: Conceptualization, Validation, Supervision. CA: Conceptualization, Writing—review & editing, Validation, Supervision. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study complies with the Declaration of Helsinki. Ethical approval is not required for case studies according to the local ethical committee.

Consent to participate

Informed consent was obtained from the patient.

Consent to publication

Not applicable.

Availability of data and materials

All relevant data are present in the manuscript.

Funding

Not applicable.

Copyright

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Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

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