Elizabeth H. Dineen, DO, Eric J. Lavonas, MD, MS and Aaron M. Orkin, MD, MSC, MPH discuss the guidelines and rationale for dealing with respiratory and cardiac arrest when opioids are suspected, emphasizing the crucial role naloxone plays in restarting respiration, the steps to take in different emergency scenarios, and why carrying naloxone can potentially save lives.

Elizabeth H. Dineen, DO and Eric J. Lavonas, MD, MS discuss how opioid-related cardiac arrest cases differ from typical cardiac arrests, emphasizing the role of asphyxiation and the impact on brain lactate levels and pH. Highlighting the difference in outcomes between sudden cardiac arrest, those caused by opioid poisoning, and the challenges in resuscitation and reperfusion.

 Elizabeth H. Dineen, DO and Cameron Dezfulian, MD discuss how opioid-related cardiac arrests differ from traditional cardiac arrests and how they are changing demographics of affected patients. Focusing on the unique challenges in responding to these emergencies, the isolated nature of opioid use, leading to unwitnessed or unreported incidents and the distinct pathophysiology of respiratory depression due to opioid poisoning.

Cameron Dezfulian, MD and Aaron M. Orkin, MD, MSC, MPH discuss the challenges in distinguishing severe opioid overdose from actual cardiac arrest in pre-hospital settings, the dichotomy of patient outcomes—those who can be resuscitated with naloxone and rescue breaths, versus those who progress to full-on cardiac arrest, the implications for clinical outcomes and guideline development.

Vlad Zaha, MD, PhD, FACC and William Zoghbi, MD, MACC, FAHA, FASE discuss the critical role of echocardiography in managing hypertrophic cardiomyopathy, especially during surgical or procedural interventions and explore septal reduction therapies such as surgical myectomy and alcohol septal ablation, and highlight the importance of detailed heart anatomy and procedural guidance to ensure optimal patient outcomes.