Sudden Cardiac Death:EKG Clues

Regardless of the underlying pathology, whether it is known or not, we need to identify markers that can predict the risk of SCD in different patient population. Despite the advancement of our knowledge and modern imaging methods, the electrocardiogram (ECG) has been and continues to be considered one of the main screening methods that can provide useful information in assessing arrhythmic risk in different types of patients.(1)

Identifying EKG Clues for Potential Cardiac Risk

Critical reading and interpretation skills are vital for physical and occupational therapists because they enable the accurate and timely identification of life-threatening findings on medical records, such as EKG abnormalities that signal a risk for sudden cardiac death. Misinterpreting or overlooking these critical data points, like a prolonged QT interval or certain arrhythmias, could lead to inappropriate exertion during therapy, directly triggering a fatal event. By thoroughly and accurately interpreting this information, therapists can immediately stop or modify treatment and alert the medical team, potentially preventing a sudden cardiac arrest. This skill transforms the therapist from a treatment provider into an essential safety checkpoint, directly saving the patient’s life through proactive risk management.

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The Brugada pattern is a distinctive ECG finding associated with Brugada syndrome, a genetic disorder linked to SCD in patients with structurally normal hearts. (3)

In approximately 5 percent of sudden cardiac deaths, no demonstrable anatomic abnormality is found. Some cases are caused by sudden arrhythmia death syndrome. A prolonged QT interval is a common thread among the various entities associated with sudden arrhythmia death syndrome. (4)

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References

1. Leonardo Calò, Oreste Lanza, Cinzia Crescenzi, Cristian Parisi, Germana Panattoni, Annamaria Martino, Marco Rebecchi, Pierpaolo Tarzia, Pellegrino Ciampi, Fabiana Romeo, Stefano Canestrelli, Elisa Silvetti, Ermenegildo De Ruvo, The value of the 12-lead electrocardiogram in the prediction of sudden cardiac death, European Heart Journal Supplements, Volume 25, Issue Supplement_C, May 2023, Pages C218–C226, 
2. Abdelghani SA, Rosenthal TM, Morin DP. Surface Electrocardiogram Predictors of Sudden Cardiac Arrest. Ochsner J. 2016 Fall;16(3):280-9. PMID: 27660578; PMCID: PMC5024811.
3. El Sayed M, Goyal A, Callahan AL. Brugada Syndrome. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-
4. Meyer JS, Mehdirad A, Salem BI, Kulikowska A, Kulikowski P. Sudden arrhythmia death syndrome: importance of the long QT syndrome. Am Fam Physician. 2003 Aug 1;68(3):483-8. Erratum in: Am Fam Physician. 2004 May 15;69(10):2324. PMID: 12924831.