Causes of pulseless electrical activity (mnemonic)

Last revised by Bahman Rasuli on 30 Aug 2020

Pulseless electrical activity is a very disconcerting emergency medical scenario with very high mortality unless its etiology can be quickly ascertained and corrected. A mnemonic to remember the different causes of pulseless electrical activity is:

  • MAD (triple H) CAT


  • H: hypoxia/hypothermia
  • H: hypovolemia
  • H: hypokalemia/hyperkalemia

A useful way to remember the mnemonic is recalling Triple H, one of the biggest WWE stars, and his "mad cat".

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Cases and figures

  • Tension pneumothorax
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  • Massive pulmonary embolism
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  • Cardiac tamponade
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