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In his The Kite Runner (2003), Khaled Hosseini uses storytelling for at least two purposes: to show how the first-person narrator yearns to alleviate or at least control the profoundly destructive impact of a single past experience on his adult mind and to show how, through such a recollection and reconstruction process, the narrator feels satisfied with his atonement by the end of his narration. Storytelling helps Hosseini’s narrator to reconfigure his unfavourable experiences, which act both as the central concern of the narrative plot and as a shared quality weaving the central characters together. Cognitive narratologists, such as Monika Fludernik and David Herman, consider representation of experience an important basic element of narrativity or the qualities that make a narrative accepted as narrative. By focusing on his personal and human-like experiences, the protagonist Amir’s storytelling not only functions as a significant tool to alleviate his intense suffering, but also facilitates the readers’ emotional engagement in Hosseini’s storyworld.

Background Considering that most patients resuscitated from out-of-hospital sudden cardiac arrests (SCA) die in the intensive care unit (ICU), early systematic etiologic investigation may represent an important strategy towards targeted therapy and appropriate prevention to first-degree relatives at risk. Purpose We aimed to determine the extent to which SCA cases who died in the ICU were investigated. Methods In this prospective ongoing multicentre population-based registry, data from all SCA patients who died in ICU were analyzed. The extent of investigations was defined as complete either in case a combination of coronary angiography (CA), brain, chest CT scan, and trans-thoracic echocardiography (TTE) was performed, or diagnosis found after one of those. SCAs dying in the first 24 hours were excluded because of their poor hemodynamic condition for investigation. Results Of the 18,622 out-of-hospital cardiac arrests from May 2011 to May 2016, 3028 SCA (16%) were admitted alive to ICU, and 2190 (72.3%) died in ICU. After first day exclusion, 947/1417 (66.8%) fulfilled criteria for complete investigations and 470/1417 (33.2%) in the other group. In the group with incomplete investigations, CA was performed in 162 patients (34.6%), TTE in 207 (44.2%), and brain and/or chest CT in 186 (39.6%). A final diagnosis was made for 895 patients (94.5%) in the group with complete investigations: 403 (45.0%) acute CAD, 149 (16.7%) chronic CAD, 115 (12.9%) neurological causes, 80 (8.9%) structural non-ischemic heart disease, 48 (5.4%) pulmonary embolism. Overall, among all unexplained SCA who died in ICU, 434 (89.3%) had incomplete investigation. Conclusions Over a third of SCA who died in ICU did not undergo complete etiologic investigations, preventing from potential adequate familial screening. Improvement in systematic medical assessment is crucial to provide appropriate therapy and prevention to family members. [ABSTRACT FROM AUTHOR]

Sudden cardiac death, mostly related to ventricular arrhythmia, is a major public health issue, with still very poor survival at hospital discharge. Although coronary artery disease remains the leading cause, other etiologies should be systematically investigated. Exhaustive and standardized exploration is required to eventually offer specific therapeutics and management to the patient as well as his/her family members in case of inherited cardiac disease. Identification and establishing direct causality of the detected cardiac anomaly may remain challenging, underlying the need for a multidisciplinary and experimented team., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Since the appearance of the COVID-19 pandemic in 2020, the direct mortality related to COVID-19 infections has been monitored worldwide, with a daily count of the number of deaths due to COVID-19. Several measures have been undertaken in the societal and professional field, and the healthcare systems have been reorganized to limit the virus spread, and to cope with the surge of hospital admissions for COVID-19. Questions have been raised regarding the indirect effect of the pandemic, with uncertainties regarding the impact of delays in non-COVID diseases management, due to lockdown, postponement of non-urgent medical consultations and interventions, and decrease in screening. Sudden cardiac death could have been impacted by all those changes, and is generally a good surrogate of public health. In the current article, we review the impact of the COVID-19 pandemic on the epidemiology and outcome of sudden cardiac death., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Out-of-hospital cardiac arrest is most often due to an acute coronary artery occlusion. The cause of coronary thrombosis in cardiac arrest is debated. Plaque erosion could be a trigger leading to immediate thrombus formation followed by ventricular fibrillation or rapid ventricular tachycardia. Coronary artery spasm is frequent: spasm provocation tests should be performed in survivors with normal coronary arteries. Use of drugs such as cocaine can lead to sudden death and blood sampling at arrival is recommended in survivors of out-of-hospital cardiac arrest. Delivery of immediate and effective basic life support remains the most important predictive factor for survival in out-of-hospital cardiac arrest., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Some anomalous connections of the coronary arteries may be associated with a risk of sudden cardiac death. In opposite with others cardiac diseases at risk of sudden cardiac death, the relationship between these congenital abnormalities and the risk of sudden cardiac death are not well understood. A correction of the anomaly is generally indicated after an aborted sudden cardiac death. Primary prevention strategy after the discovery of an anomaly at risk is debated. Even if the absolute risk of sudden death is very low, a pre-participation screening in young athletes may be discussed due to a non-rare incidence., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Sudden cardiac death is defined as a natural and unexpected death, in a previous apparently healthy individual. It represents a major public health issue, with up to 50% of the cardiovascular mortality. Using data from the Paris Sudden Death Expertise Centre registry, this article summarises the main cardiovascular abnormalities associated with sudden cardiac death, the different preventives approaches, and provides a systematic diagnostic approach., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Sudden cardiac death is a major public health problem with around 40,000 cases per year in France. Epidemiological, clinical and prognostic differences according to gender have been described in most cardiovascular diseases, including sudden cardiac death. In this article, we will review gender differences in sudden cardiac death incidence, circumstance of occurrence, management, and prognosis., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Sudden cardiac death is a major public health issue, with high incidence and disappointing survival. Therefore, prevention of sudden death and identification of high-risk patients are essential tools, especially in the field of coronary artery disease, which is the main cause of sudden death. Prevalence of coronary artery disease is higher among men, leading to a higher rate of coronary artery disease-related sudden cardiac death. The current issues are identification of gender-specificities regarding coronary artery disease, rhythmic complications and management., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Sudden cardiac death is an unexpected cardiac arrest without obvious extra-cardiac cause. Epidemiology of sudden cardiac death has been poorly documented in France, mainly because of challenging requirement in order to capture all cases in a specific area. The Parisian registry (Sudden Death Expertise Center, European Georges Pompidou Hospital, Paris) was initiated in May 2011 and analyzed data of all sudden death in Paris and suburbs (6.6 millions inhabitants). Over 3 years, the annual incidence estimated to 50-70 per 100,000. Those occurred mainly in men (69%), with a mean age of 65 year, and at home (75%). The event was witnessed in 80% of cases, but bystander cardiopulmonary resuscitation was initiated in only half of cases. Initial cardiac rhythm was ventricular fibrillation in 25%. Survival to hospital discharge remains low (8%).

Primary cardiac tumors are rare but potentially fatal. No studies have discussed this issue yet on the national level. We describe the epidemiology of cardiac tumors in adults in Lebanon. The data were taken from the hospitals, the patients and/or their doctors by means of a questionnaire. Fifty-seven cases of cardiac tumors were found, mainly myxomas in the left atrium. Dyspnea was the most frequent symptom. Transthoracic echocardiography was the main diagnostic tool. Transesophageal echocardiography was inconstantly made, scanner and MRI rarely while contrast echocardiography has never been used. Almost half of the patients had a follow-up and none had a familial screening. The collected data urged us to propose a unique and homogenous strategy for diagnosis, treatment and follow-up of cardiac tumors in Lebanon.