The Canadian journal of cardiology
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Sudden death is usually the result of hemodynamically destabilizing ventricular tachycardia or ventricular fibrillation. Because the only definitive treatment for ventricular tachycardia/ventricular fibrillation is a direct current shock, and because that defibrillating shock must be given very quickly to be effective, the American Heart Association's "chain of survival" approach to persons with a cardiac arrest emphasizes early access to care, early cardiopulmonary resuscitation, early cardiac defibrillation and early advanced life support. ⋯ The automated external defibrillator enables life-saving defibrillation therapy to be provided to the cardiac arrest victim by nontraditional responders, such as the general public. The present review evaluates the current role of the automated external defibrillator in the ongoing struggle to prevent sudden cardiac death.
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The therapy for chronic obstructive lung disease (COPD) is largely symptomatic in nature, involving the use of bronchodilators and steroids, and the judicious use of antibiotics. None of these have been shown to have a consistent beneficial impact on outcome. Moreover, the outcome of patients with COPD is determined, to some extent, by the occurrence of cardiovascular events. ⋯ There appear to be direct links between lung injury and concomitant vascular injury by virtue of a systemic inflammatory state induced by lung inflammation. The present paper raises the possibility that the outcome of patients with COPD may be improved significantly through aggressive use of therapies known to prevent cardiovascular events. Moreover, angiotensin II is also a direct mediator of lung injury; interruption of this mechanism of injury might simultaneously prevent both cardiovascular and pulmonary morbidity and mortality in patients with chronic lung disease.