Abstract

OBJECTIVE:

To investigate the causes for cardiac arrest in severe acute respiratory syndrome (SARS) patients.

METHODS:

Retrospective analysis of the epidemiological history, clinical presentation, the change of laboratory tests, chest radiography, and treatment of 15 SARS patients with cardiac arrest.

RESULTS:

The average age of the patients was 60 years. Eight had a history of exposure to SARS patients, among them 6 were household contacts. Eight patients had no underlying diseases, and another 8 complained of extreme anxiety. Abnormalities of cardiac enzymes were present in 10 patients. Myocardial ischemia and arrhythmia were present in 5 patients. Bilateral, multifocal lung infiltrates were present in 13 of the 15 patients. Four patients died after defecation and 9 died during relatively stable periods.

CONCLUSIONS:

It was suggested that the causes for cardiac arrest in SARS patients may include: (1) the lung injury caused by the SARS virus leads to hypoxemia and thus an unsteady state of the myocardial electricity; (2) SARS virus directly causes injury to the myocardial cells and/or the conduct system; (3) SARS infection aggravates the original myocardial pathological change, worsening the conduct block; (4) extreme anxiety leads to extra secretion of catecholamine, which causes instability of myocardial electricity; (5) defecation worsens hypoxemia, which induces arrhythmia (ventricular fibrillation) and causes cardiac arrest.