Cardiac death. Sudden coronary death: causes, how to avoid

Among the deaths caused by cardiovascular diseases, the leader is sudden coronary death. It occurs when the heart suddenly stops functioning. Sudden death is defined as death that occurs instantly or occurs within a few hours after an exacerbation of the main symptoms.

In medicine there is no single cause of such death, since the factors of occurrence are different. All over the world, hundreds of thousands of people die this way every year, most often men over 35 years of age.

In children, sudden death due to heart disease occurs in exceptional cases and is recorded very rarely.

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Yet doctors say the most common cause of death is heart attack. Every year the number of deaths around the world does not decrease, and their age is becoming older.

Sudden death from myocardial infarction (heart attack) is a medical problem, but in our country it is noticeable decrease its level through improvement comprehensive measures, including treatment with anticoagulants, sanatorium-resort therapy and subsequent monitoring of the employment of patients.

Differences between sudden cardiac arrest and attack

The terms "cardiac arrest" and " heart attack” are often used, mistakenly synonymizing them. In fact, we are talking about various diseases. They are connected by one circumstance - a heart attack can aggravate the situation, which will ultimately lead to sudden cardiac arrest.

Heart attack - bigger problem circulatory system, in which blood flows to the heart in a smaller volume or its access is not possible at all. The cause may be the formation of clots or a sharp narrowing of the artery - in both cases, it becomes blocked.

If blood does not flow to the heart muscle, it forms oxygen deficiency, and it is damaged, which more often occurs as an irreversible process.

Such changes may appear against the background coronary disease hearts. Walls blood vessels become covered with plaques that narrow the artery. When a plaque breaks off, a clot forms in the damaged area, which blocks blood flow.

Sudden cardiac arrest is expressed as a sudden cessation of heart function. The cause is usually cardiac dysfunction due to electrical disturbance. A sudden change in the mode of contraction of the heart (too often) leads to flutter (fibrillation) of the ventricles, and blood no longer enters the body.

The pumping of blood stops, and this leads to the stoppage of all organs. The body experiences such a strong shock that the patient can almost immediately lose consciousness. First aid in this case must be provided immediately, otherwise death guaranteed in 90-95% of cases.

In case of cardiac arrest, manual cardiac resuscitation can be achieved by applying pressure to chest and blowing air into the lungs.

It is necessary to ensure the flow of oxygen to the brain until it resumes heart rate, including using a defibrillator. This is a device that affects the heart using an electrical impulse.

Symptoms

The symptoms of a heart attack are such that they cannot be ignored.

You should pay attention to the following signs:

• long-lasting and with full dedication top part bodies;
• a feeling of tightness and pressure in the chest;
• lack of pain response to stabilizing drugs (nitroglycerin);
• paleness, excessive sweating, and the skin becomes cold and clammy;
• dizziness, fainting,
• feeling of fullness in the stomach, vomiting;
• difficulty breathing;
• an anxious state reaching the point of panic without visible reasons.

But this does not happen in all cases. In a quarter of cases, especially in women, the symptoms are vague. This may be a flu-like condition or fatigue. Sometimes abdominal pain and shortness of breath appear.

Such atypicality is very dangerous, since the patient may not pay attention specifically to the disturbance in heart rhythm and may not qualify his condition as a heart attack. If it doesn't follow immediate reaction in the form of providing assistance or calling an ambulance, you can die within a few hours or days.

As for sudden cardiac arrest, symptoms may include rapid heartbeat or dizziness. These signs indicate serious problems heart rate.

Most often, a person and the people around him do not have time to react; everything happens very quickly. But usually sudden cardiac arrest is not accompanied by any symptoms.

After myocardial infarction there is a mass, but the greatest danger is cardiac arrest and the onset of clinical death. By virtue of various reasons blood flow stops, all organs begin to die.

There are only a few minutes for resuscitation, otherwise the processes occurring in the body, especially in the brain, will become irreversible and biological death will occur.

Many tissues and organs survive clinical death quite normally for a long time. But in the brain, in the absence of oxygen, they accumulate very quickly. harmful substances, which affect its viability in the future. It can be concluded that the consequences of clinical death during a heart attack, their severity, may depend on the speed with which resuscitation was carried out.

The external signs of death from a heart attack are no different from the signs that accompany sudden death - the skin becomes very pale as the blood flow stops functioning.

Causes of death from heart attack

In medicine, the main cause of death due to myocardial infarction is identified as abnormal heart rhythm.

It can be expressed in the following manifestations:

Risk factors

Sudden cardiac arrest may occur for some time after suffered a heart attack myocardium. This can be provoked by a whole list, headed by hereditary diseases heart disease, cigarette addiction and high cholesterol.

It is also worth keeping the following factors in mind:

• heart failure, in which the heart has difficulty pumping blood;
• diabetes;
• overweight;
• presence of drug addiction;
• the presence of cardiac anomalies and diseases, including congenital ones;
• previous cases of cardiac arrest, loss of consciousness (even among relatives);
• congenital pathologies of blood vessels;
• taking medications whose action is aimed at suppressing arrhythmia.

Sudden cardiac death is a natural death due to cardiac dysfunction that occurs within an hour from the onset of acute manifestations of the disease.

The most common cause sudden death is coronary heart disease (CHD). The main mechanisms of sudden cessation of blood circulation are ventricular fibrillation (more often) and ventricular asystole (less often).

The most important risk factors for sudden cardiac death are malignant arrhythmias, decreased contractile function left ventricle and episodes acute ischemia myocardium. The combination of these factors is especially unfavorable. Identification of these risk factors using clinical and instrumental studies (daily ECG monitoring, echocardiography, etc.) allows us to identify patients with increased risk sudden death and accept preventive measures. Reducing the risk of sudden death may help active treatment and prevention of malignant ventricular arrhythmias, in particular with amiodarone, sotalol, implantation of portable defibrillators, as well as the use of angiotensin-converting enzyme inhibitors, β-blockers and adrenergic blockers.

In the event of sudden circulatory arrest, timely and correctly carried out resuscitation measures allow some patients to be brought back to life.

Keywords: circulatory arrest, ventricular fibrillation, cardiac asystole, risk factors, malignant arrhythmias, prevention, resuscitation.

DEFINITIONS, CLINICAL SIGNIFICANCE

The term “sudden cardiac death” refers to natural death caused by cardiac dysfunction that occurs within an hour of the onset of acute manifestations of the disease.

Depending on the cause, a distinction is made between sudden arrhythmic death associated with the development of arrhythmic circulatory arrest, and nonarrhythmic death caused by acute manifestation morphological changes in the heart or blood vessels incompatible with life, in particular rupture of the myocardium with cardiac tamponade, rupture of aortic aneurysm, massive thromboembolism, etc. Sudden arrhythmic death is observed much more often and has incomparably more important, as it is one of the leading causes of all deaths associated with cardiovascular diseases. According to epidemiological studies conducted in Europe and the United States, the annual incidence of sudden cardiac death in people aged 20-75 years is approximately 1 in 1000. In the United States, approximately 300,000 cases of sudden cardiac death are recorded annually.

Sudden arrhythmic death, occurring within an hour from the onset of acute manifestations of heart disease in the absence of morphological changes incompatible with life, is one of the most common and important causes of cardiovascular mortality.

ETIOLOGY, PATHOGENESIS

The most common and the most important reason Sudden cardiac death is coronary heart disease (CHD), which accounts for about 90% of all cases. The remaining 10% are caused by diseases that cause myocardial hypertrophy ( aortic stenosis, hypertrophic cardiomyopathy etc.), myocarditis, dilated cardiomyopathy, alcoholic heart disease, prolapse mitral valve, syndromes of ventricular preexcitation and prolonged interval QT and other reasons. Depending

Depending on whether death is associated or not with ischemic heart disease, sudden coronary and non-coronary death are distinguished.

Sudden arrhythmic death can also occur in persons without obvious signs organic damage hearts.

The main mechanism of sudden circulatory arrest is ventricular fibrillation, which, along with prefibrillatory ventricular tachycardia, occurs in approximately 80% of patients. In other cases, the mechanism of sudden circulatory arrest is associated with bradyarrhythmias transforming into ventricular asystole, and occasionally with electromechanical dissociation.

The leading cause of sudden death is ischemic heart disease, and the most common mechanism is ventricular fibrillation.

RISK FACTORS

The most important risk factors for sudden death are the presence of malignant ventricular arrhythmias and decreased left ventricular contractility. Of the ventricular arrhythmias, the most dangerous are fibrillation and ventricular flutter, which cause circulatory arrest. Patients resuscitated from ventricular fibrillation are at high risk for sudden death. Ventricular fibrillation is most often preceded by paroxysms of ventricular tachycardia. The most dangerous are paroxysms of polymorphic ventricular tachycardia with a high rhythm frequency, which are often directly transformed into ventricular fibrillation. In patients with severe organic changes heart, in particular in post-infarction patients, the presence of episodes of monomorphic sustained ventricular tachycardia (lasting more than 30 s) is a proven risk factor for sudden death. Threatening arrhythmias in such patients are frequent (more than 10 per hour), especially group and polytopic, ventricular extrasystoles. The presence of malignant ventricular arrhythmias is one of the signs of electrical instability of the heart.

Manifestations of electrical instability of the myocardium can also be a decrease in variability sinus rhythm, prolongation of the ECG QT interval and decreased baroreflex sensitivity.

Arrhythmias that may threaten the development of ventricular asystole are weakness syndrome sinus node with syncope or pronounced bradycardia and atrioventricular block of the 2nd-3rd degree with similar manifestations, especially of the distal type.

The decrease in LV contractility is no less than important factor risk of sudden death. This factor is manifested by a decrease in LV ejection function of less than 40%. In patients IHD important a risk factor for sudden death is the presence of episodes of acute myocardial ischemia, manifested by the development of acute coronary syndrome.

The combination of the above risk factors is especially unfavorable.

The main risk factors for sudden death are malignant ventricular arrhythmias, decreased left ventricular contractility, and episodes of acute myocardial ischemia in patients with coronary artery disease.

DIAGNOSTICS

The main clinical manifestations of circulatory arrest are sudden loss of consciousness and absence of pulse large vessels, in particular on carotid arteries. The last sign is very important, as it allows you to distinguish circulatory arrest from syncope of other origins. When blood circulation stops, convulsive agonal breathing is usually observed. These signs are sufficient to diagnose circulatory arrest. You should not waste time on auscultation of the heart, examination of the pupils, measurement blood pressure etc., however, if it is possible to evaluate the ECG picture using a cardioscope, then this may be important for determining the tactics of resuscitation measures. With ventricular flutter on the ECG

Rice. 14.1. Ventricular flutter and fibrillation:

a - ventricular flutter; b - large-wave fibrillation;

c - shallow wave fibrillation

Rice.14.2. Various mechanisms of cardiac asystole:

a - when atrioventricular block occurs; b - upon cessation of paroxysm of atrial fibrillation; c - upon cessation of paroxysm of supraventricular tachycardia; d - upon termination of ventricular tachycardia

a sawtooth curve with rhythmic waves is revealed, the frequency of which is approximately 250-300 per minute, and the elements of the ventricular complex are indistinguishable (Fig. 14.1 a). In ventricular fibrillation, there are no ventricular complexes on the ECG, instead there are waves various shapes and amplitudes. Their frequency can exceed 400 per minute. Depending on the amplitude of the waves, large- and small-wave fibrillation is distinguished (Fig. 14.1 b and c). With ventricular asystole, there are no ventricular complexes on the ECG, a straight line is recorded, sometimes with teeth R or single

complexes QRS. Cardiac arrest is often preceded by severe bradycardia, but ventricular asystole can occur at the moment of cessation of paroxysms of tachyarrhythmias (Fig. 14.2).

A rare mechanism of sudden death - electromechanical dissociation is diagnosed in cases where clinical picture In the event of circulatory arrest, electrical activity is recorded on the ECG, often in the form of a rare nodal or idioventricular rhythm.

Timely identification of risk factors for sudden death is very important. Despite the large number of modern instrumental methods, detailed questioning and clinical examination sick. As noted above, sudden death most often threatens patients who have had a myocardial infarction, have malignant ventricular arrhythmias, signs of heart failure, post-infarction angina, or episodes of silent myocardial ischemia. Therefore, when questioning the patient, it is necessary to carefully clarify the patient’s complaints and collect a detailed history of the disease, identify clinical signs of ischemic heart disease, arrhythmias, heart failure, etc. Of the special research methods, the most important are daily ECG monitoring, physical stress tests and echocardiography (Table 14.1).

PREVENTION

Approaches to the prevention of sudden death are based on addressing the main risk factors: malignant arrhythmias, left ventricular dysfunction and myocardial ischemia.

According to international randomized studies, in patients who have suffered a MI with left ventricular dysfunction and have threatening ventricular arrhythmias, treatment and prevention of the latter with antiarrhythmic drug amiodarone can significantly reduce the risk of sudden death. If there are contraindications to the use of this drug, sotalol can be used.

In the most at-risk patients, particularly those resuscitated from ventricular fibrillation or having episodes of sustained ventricular tachycardia, it is possible to reduce the risk of sudden death by implanting a portable defibrillator. In patients with bradyarrhythmias that threaten the development of ventricular asystole, implantation of a pacemaker is necessary.

The use of β-blockers (in the absence of contraindications and good tolerance), as well as angiotensin-converting enzyme inhibitors, may play a significant role in patients with an increased risk of sudden death. Reducing the risk of sudden death in patients with coronary artery disease is facilitated by treatment with antiplatelet agents, statins, and, if indicated, surgical revascularization of the heart.

Data on the prevention of sudden death in patients with coronary artery disease are summarized in table. 14.2.

Table 14.2

Prevention of sudden death in patients with coronary artery disease. Modified by N.A. Mazuru with modification (2003)

Class of evidence
Class I Data beyond doubt	β-blockers Statins Acetylsalicylic acid ACE inhibitors Implantation of a cardioverter-defibrillator in resuscitated patients or patients with LVEF<40% в сочетании с желудочковой тахикардией
Class II A Data are conflicting, but evidence of benefit is overwhelming	Amiodarone (in the presence of malignant or potentially malignant ventricular arrhythmias) Amiodarone in combination with β-blockers (if necessary) ω-3 polyunsaturated fatty acids Aldesterone antagonists
Class II B The data is conflicting, the evidence is less convincing	Implantation of a cardioverter-defibrillator or radiofrequency ablation in patients with ventricular tachycardia with LVEF >40% Angiotensin II receptor blockers

In patients with bradyarrhythmias that threaten the development of ventricular asystole, implantation of a pacemaker is necessary.

resuscitation

With timely and correct implementation resuscitation measures, many patients with sudden stop blood circulation

nia can be brought back to life. As already noted, the diagnosis of circulatory arrest is very important, distinguishing the latter from syncope of another nature. If circulatory arrest is detected, a sharp blow with a fist should be applied to the heart area, which sometimes allows you to restore cardiac activity, but more often this is not enough, and it is necessary to call a resuscitation team. At the same time you should start indirect massage hearts and artificial respiration or artificial pulmonary ventilation (ALV). Cardiac massage is carried out with the patient lying on his back on a hard bed and consists of applying sharp pressure with two palms superimposed on each other in the area of ​​the lower third of the sternum. With proper cardiac massage, with each beat on large arteries, you can palpate the pulse wave, and on the oscilloscope screen - a ventricular complex of sufficiently high amplitude. Artificial respiration should be carried out simultaneously with cardiac massage, which requires the participation of a second person. Before starting mechanical ventilation, the patient's head should be tilted back and the lower jaw should be pushed forward, which facilitates the passage of air. Breathing is carried out mouth to mouth through gauze or a handkerchief, or using a special Ambu bag. Cardiac massage and mechanical ventilation are aimed at maintaining blood circulation and gas exchange in tissues. If these measures are started 5-6 minutes late or are carried out ineffectively, then irreversible dysfunction occurs primarily in the cerebral cortex, however, if these measures are carried out correctly, tissue viability can be maintained for quite a long time.

The main goal of resuscitation measures is to restore effective cardiac activity. In some cases, indirect cardiac massage is sufficient for this, but more often additional measures are required, depending on the mechanism of circulatory arrest. When ventricular flutter or fibrillation occurs, cardiac activity can usually be restored only with the help of high-power electrical defibrillation. If the patient is under ECG monitoring control, and it is initially known that the mechanism of circulatory arrest is ventricular fibrillation, then resuscitation can begin directly with electrical defibrillation. In cases where it is not possible to quickly determine the mechanism of stopping blood circulation,

rotation, it is advisable to carry out blind defibrillation, since the probability of ventricular fibrillation is approximately 80%, and with cardiac asystole, the electrical discharge does not cause significant harm. After an electrical discharge, urgent registration of an ECG or adjustment of a cardioscope is necessary, since various consequences of the discharge are possible, requiring differentiated tactics. With ventricular asystole, cardiac massage and mechanical ventilation are necessary. If there is no effect within a few minutes, intracardiac injections of adrenaline should be performed and cardiac massage should be continued.

The nature and sequence of resuscitation measures during circulatory arrest are presented in the diagram.

Rice. 14.3. Scheme of resuscitation measures to stop bleeding

The main goal of resuscitation in case of circulatory arrest is the restoration of cardiac activity, the main resuscitation measures are chest compressions, artificial respiration and electrical defibrillation.

When it's quite healthy man dies suddenly, they talk about sudden unexplained death. To the question “why?” Doctors helplessly shrug their shoulders, and relatives shed tears. But in some cases, tragedy can be avoided by winning back several trump cards from evil fate in advance!

3 ways to cheat fate

According to statistics, one person dies suddenly every 40 minutes. In most cases, tragedy happens to men 45-54 years old who have not complained of health, have lived life to the fullest and made bright plans for the future. Death comes quickly, like a lightning strike. For the relatives of the deceased, the incident comes as a shock. However, examining such cases, doctors came to the conclusion that the cause of sudden death is most often cardiac arrest. How does it happen that a heart that has been working without interruption for decades suddenly stops forever?

Fatigue or a wake-up call?

In most cases, the cause of sudden death is myocardial infarction or severe arrhythmia leading to cardiac arrest. These are manifestations of coronary heart disease (angina) - a condition when the heart muscle lacks oxygen.

A disease like this does not develop suddenly. Fatal manifestations are preceded by months and years. If you hear in time alarm bell and begin treatment, tragedy is avoided. If you give up on the symptoms of malaise, continuing to work without sparing your stomach, sooner or later your heart cannot stand it.

Signs of an impending heart attack may include:

• increasing fatigue, weakness, and decreased performance over 1-2 weeks;
• periodic interruptions in the functioning of the heart, a feeling of fading, increased tremors in the chest;
• shortness of breath, feeling of lack of air;
• chest pain that can spread to the abdomen, back, left shoulder blade, arm, lower jaw;
• numbness of hands.

It is characterized by deterioration of well-being during physical activity (climbing stairs, fast walking), with excitement, and also after smoking.

Such symptoms cannot be attributed to fatigue, age, or magnetic storms. To give up on them means to sign your own death sentence. When discomfort in the area of ​​the heart, you need to sit or lie down, if possible, dissolve a nitroglycerin tablet under your tongue. Immediately after improvement, contact for medical care. Whenever burning pain in the chest you need to call as quickly as possible ambulance and swallow ½ aspirin tablet. This is the case when the minute decides fate.

It's not beer that kills people...

According to international studies, alcohol greatly increases the risk of sudden death among men. And everyone can save themselves from this risk! Not only does it lead to fatal consequences. Even a single dose can kill a healthy and strong man in his prime.

Blood thickens, clotting processes are disrupted, which contributes to the formation blood clots- blood clots. In addition, a drunk person usually falls asleep in uncomfortable position, does not feel the need to roll over to the other side or free a numb arm or leg. Compression of blood vessels doubles the risk of thrombosis. Waking up with a hangover, a person rises sharply, the blood clot breaks off and makes its fatal journey from the veins lower limbs into the vessels of the lungs. Blockage of the latter leads to instant death - a person simply suffocates.

In addition to thrombosis, acute alcohol poisoning can cause:

• toxic damage to the heart muscle, which leads to the development life threatening arrhythmias and cardiac arrest;
• paralysis respiratory center, then the person falls asleep and never wakes up.

Stress: good or bad

Could this tragedy have been prevented? Probably yes. After all, literally the day before the incident, he promised his wife to finally take a vacation and go to Zheleznovodsk on a voucher. But time was lost, and the man fell victim to nervous overload.

Destroys the body, but the basis is simple chemical reaction. When a person faces difficulty, the adrenal glands produce stress hormones: adrenaline, norepinephrine, cortisol. These substances are a secret weapon, a dope that allows you to perform super tasks when necessary. If the problem is solved, we feel the taste of victory and even some euphoria from success. It is the hormones of joy that are released into the blood: endorphins and enkephalins. Under their influence, we quickly recover and are ready for new achievements.

It is completely different when a person is constantly in a state of anxiety. Accumulating in large quantities, stress hormones have destructive effect on the tissue, constrict blood vessels, make the heart beat faster, and increase blood pressure. A person loses the ability to rejoice, sleeps poorly, becomes aggressive and irritable. Similar nervous exhaustion very often ends in a cardiovascular disaster: stroke or heart attack.

What if our whole life is a continuous overcoming? You can make stress work for you! We need to find a use for stress hormones and release adrenaline. The best way to do this is physical education. Sports goals can be different: hitting the basketball basket with the ball, knocking out all the targets at the shooting range, or putting a chess checkmate on your neighbor. The main thing is that there must be a winner in impromptu competitions!

The second important step is to learn to enjoy life in all its manifestations. By noticing pleasant little things, you accumulate the same hormones of joy that help strengthen your failing health. Laughter, kindness, love, chocolate and good old comedy - this is a simple recipe for dealing with stress!

And of course, the third way to drive the “bony” away is to monitor your health. Excess weight, poor nutrition, smoking, mistrust of the doctor and refusal timely treatment can play a bad joke even on the most zealous optimist!

Natalya DOLGOPOLOVA,
doctor
city ​​"Stoletnik" No. 23, 2013

Adults are a phenomenon that takes root in daily life modern man. It is happening more and more often. But no one can say for sure that the deceased was seriously ill. That is, in fact, death occurs suddenly. There are a number of reasons and risk groups that can influence this phenomenon. What does the public need to know about sudden death? Why does it occur? Is there any way to avoid it? All features will be presented below. Only if you know about the phenomenon all the information known on this moment, you can try to somehow avoid encountering such a situation. In fact, everything is much more complicated than it seems.

Description

Sudden adult death syndrome is a phenomenon that became widespread in 1917. It was at this moment that such a term was first heard.

The phenomenon of death, and causeless death, of a person with good health. Such a citizen, as already mentioned, did not have any serious illnesses. In any case, the person himself did not complain of any symptoms, and also did not receive treatment from a doctor.

Accurate definition this phenomenon No. Exactly the same as the real mortality statistics. Many doctors argue about the reasons why this phenomenon occurs. Sudden adult death syndrome is a mystery that is still unsolved. There are many theories according to which they die. More about them below.

Risk group

The first step is to figure out who is most often exposed to the phenomenon being studied. The thing is that sudden adult death syndrome occurs quite often in Asians. Therefore, these people are at risk.

SIDS (sudden unexplained death syndrome) is also often observed in people who work a lot. That is, workaholics. In any case, this is the assumption made by some doctors.

The risk group includes, in principle, all people who:

• unhealthy family environment;
• hard work;
• constant stress;
• available serious illnesses(but then usually death is not sudden).

Accordingly, the majority of the planet's population is exposed to the phenomenon being studied. No one is safe from it. According to doctors, during an autopsy it is impossible to establish the cause of a person’s death. This is why death is called sudden.

However, as already mentioned, there are several assumptions according to which the mentioned phenomenon occurs. Sudden death syndrome in an adult can be explained by several methods. What assumptions exist regarding this topic?

Man vs chemistry

The first theory is the effect of chemistry on the human body. Modern people surrounded by a variety of chemicals. They are everywhere: in furniture, medicines, water, food. Literally at every step. Especially in food.

There is very little natural food. Every day the body receives huge doses of chemicals. All this cannot pass without a trace. And so sudden adult death syndrome occurs. The body simply cannot withstand the next charge of chemistry that surrounds modern man. As a result, life activity ceases. And death comes.

The theory is supported by many. After all, as practice has shown, over the last century, unexplained deaths have begun to occur quite often. It was during this period that the progress of human development was observed. Therefore, we can consider the impact of environmental chemicals on the body as the first and most likely cause.

Waves

The following theory can also be scientifically explained. It's about about electromagnetic waves. It's no secret that a person has been under the influence of magnetism all his life. Pressure surges are very well felt by some people - they begin to feel bad. It proves Negative influence electromagnetic waves per person.

At the moment, scientists have proven that the Earth is the second most powerful planet in the world producing radio emissions. solar system. The body, being constantly in such an environment, suffers some kind of malfunction. Especially in combination with exposure to chemicals. And this is where sudden adult death syndrome arises. Actually electromagnetic waves force the body to stop performing functions to ensure human life.

It's all about breathing

But the following theory may seem somewhat unconventional and even absurd. But it is still actively promoted around the world. Quite often, sudden death syndrome occurs during sleep in an adult. Regarding this phenomenon, some put forward incredible assumptions.

The point is that during sleep the human body functions, but in an “economical” mode. And a person dreams during such periods of rest. Horror can cause the body to refuse to function. More precisely, breathing is impaired. It stops because of what it sees. In other words, out of fear.

That is, a person does not realize in a dream that everything that happens is not reality. As a result, he dies in life. As already said, a somewhat incredible theory. But it does happen. By the way, sudden death syndrome in infants during sleep is explained in a similar way. Scientists say that if, while resting, a child dreams that he is in the womb, then breathing will stop. And the baby “forgets” to breathe, since oxygen must be supplied to him through the umbilical cord. But all this is just speculation.

Infection

What else can you hear? What are the causes of sudden adult death syndrome? The following assumption generally looks like a fairy tale. But it is sometimes expressed.

As already said, an incredible, fabulous theory. There is no need to believe this assumption. Rather, such a story is an ordinary “scarecrow”, which was invented in order to somehow explain sudden death syndrome in adults.

Overwork

Now some information that looks more like the truth. The thing is that, as already mentioned, Asians are at risk of people susceptible to sudden death syndrome. Why?

Scientists have put forward a certain assumption. Asians are people who work constantly. They work very hard. And so the body at one point begins to deplete. It “burns out” and “turns off.” As a result, death occurs.

That is, in fact, the sudden death of an adult occurs due to the fact that the body is overworked. Work is often to blame for this. As statistics show, if you pay attention to Asians, many die right at work. Therefore, you should not work to exhaustion all the time. This pace of life has a negative impact on health. A person does not show any other signs other than fatigue.

Stress

Also among the most common theories regarding death without cause is stress. Another assumption that you can believe in. As already mentioned, people who are constantly in a nervous environment not only have a high risk of disease and cancer, they are also classified as a high-risk population that may experience sudden death syndrome.

The theory is explained in almost the same way as in the case of permanent job and stress - the body “wears out” from stress, then “switches off” or “burns out.” As a result, death occurs without any apparent reason. The effects of stress cannot be detected at autopsy. Exactly the same as negative impact intense, systematic and continuous work.

Results

What conclusions follow from all of the above? Sudden nocturnal death syndrome, as well as daytime death in adults and children, is unexplained phenomenon. Exists great amount various theories that allow one or another group of people to be classified as at risk. Doctors and scientists to this day cannot find an exact explanation for this phenomenon. Just like putting forward a clear definition of sudden death syndrome.

Only one thing is clear - so that it doesn’t happen high risk to die for no apparent reason must be carried out healthy image life, worry less and relax more. In modern conditions, bringing an idea to life is very problematic. In any case, doctors recommend at least minimizing tension and the amount of stress. Workaholics need to understand that they also need to rest. Otherwise, such people may die suddenly.

If you lead as healthy a lifestyle as possible, the likelihood of sudden death is minimized. Every person should remember this. No one is immune from the mentioned phenomenon. Scientists are trying to study it as best as possible and find exact reason the appearance of this phenomenon. So far, as has already been emphasized, this has not been done. All that remains is to believe numerous theories.

Sudden cardiac death(SCD) is a sudden cessation of cardiac activity, presumably due to the occurrence of ventricular fibrillation or cardiac asystole (cardiac arrest). Death is considered sudden if it occurs within 6 hours from the onset of the first symptoms of the disease. Currently, many researchers propose that in case of sudden cardiac death, the time interval from the first symptoms of the disease to death should be considered no more than 1 hour.

SCD is death due to cardiac pathology, which was preceded by sudden loss consciousness within an hour after occurrence acute symptoms; Preexisting heart disease may be known, but the time and manner of death is unexpected

Causes of sudden cardiac death

In the vast majority of cases (85-90%), the cause of SCD is ischemic heart disease, and any of its clinical options, including asymptomatic course, when SCD is the first and last clinical manifestation diseases.

Those at greatest risk for SCD are:

• patients with acute MI (especially in the first hour of infarction);
• patients with unstable angina;
• patients with a history of myocardial infarction, especially those with cardiomegaly and congestive heart failure;
• patients with coronary artery disease with high grade ventricular arrhythmias;
• patients with coronary artery disease who have several major risk factors ( arterial hypertension, hyperlipidemia, smoking, disorders carbohydrate metabolism and etc.).

Causes of SCD according to J. Ruskin

• Cardiac ischemia;
• Dilated cardiomyopathy;
• Left ventricular hypertrophy,
• Hypertrophic cardiomyopathy;
• Acquired heart defects;
• Congenital heart defects;
• Acute myocarditis;
• Developmental anomalies coronary arteries;
• Sarcoidosis;
• Amyloidosis;
• Heart tumors;
• Left ventricular diverticula;
• WPW syndrome;
• Long QT syndrome;
• Drug proarrhythmia;
• Cocaine intoxication;
• Severe electrolyte imbalance;
• Idiopathic ventricular tachycardia(VT);
• Predictors of SCD.

Sports occupy a special place among the causes of SCD. The official definition of “sudden death in sports” includes cases of death that occur directly during physical activity, as well as within 1-24 hours from the onset of the first symptoms that forced a change or cessation of activity. The following are the most common reasons VSS in sports:

• cardiac causes;
• injuries;
• pharmacological drugs (doping).

To the most dangerous species sports include:

• Bize jumping (parachute jumping from high-rise buildings and bridges);
• free diving (diving without scuba gear);
• diving in underwater caves;
• downhill skiing;
• windsurfing on big waves;
• Mountain bike;
• mountaineering;

SCD in sports is often caused by the following reasons:

Clinic

About 1/4 of cases of SCD occur instantly and without visible warning signs. However, as a survey of relatives of the deceased shows, in other patients, 1–2 weeks before sudden death, various, not always specific, prodromal symptoms are observed, indicating an exacerbation of the disease: increased frequency of pain in the heart (sometimes of atypical localization), shortness of breath, general weakness and a significant decrease in performance and exercise tolerance, palpitations and interruptions in heart function, etc.

SCD can be caused by excessive physical or neuropsychic stress, but can occur at rest, for example, during sleep. Immediately before the onset of SCD, approximately half of the patients experience a painful anginal attack, often accompanied by the fear of imminent death.

Most cases of SCD (about 90%) occur in out-of-hospital settings - at home, at work, in transport, which determines the frequent fatal outcome of this form of IHD. If the patient is in a hospital, in particular in a block intensive care, the diagnosis of SCD should be made within seconds and resuscitation measures initiated immediately.

Immediately during suddenly developed ventricular fibrillation or cardiac asystole, the patient develops severe weakness, dizziness. After a few seconds, as a result of complete cessation cerebral blood flow the patient loses consciousness, a tonic contraction appears skeletal muscles, noisy breathing.

Upon examination skin pale with a grayish tint, cold to the touch. The pupils begin to dilate quickly. The pulse in the carotid arteries is not detected, heart sounds are not heard. After about 1.5 minutes, the pupils are maximally dilated. There is an absence of pupillary and corneal reflexes. Breathing quickly slows down, becomes agonal, very rare individual “convulsive breathing movements" After 2.5–3 minutes, breathing stops completely. It should be remembered that approximately 3 minutes after the onset of ventricular fibrillation or asystole, irreversible changes occur in the cells of the cerebral cortex.

If the patient is under ECG monitoring, the following changes can be detected at the time of sudden cardiac death:

Prevention of SCD

Prevention of SCD is medical and social measures carried out in persons who have experienced cardiac arrest ( secondary prevention) or have a high risk of developing it (primary).

Modern methods of preventing SCD:

— implantation of a cardioverter-defibrillator;

— carrying out continuous drug antiarrhythmic therapy;
— performing radiofrequency ablation of ventricular arrhythmias;

— implementation of revascularization of the coronary arteries;

— surgery ventricular arrhythmias.

Prevention of SCD in athletes.

• Constantly undergo medical examinations. Detection of the disease on early stage reduces the risk of sudden death and promotes more successful treatment.
• Avoid overly intense exercise. All athletes should be aware of the risk of SCD associated with vigorous athletic activity. A person must choose a sport suitable for his age and general physical condition. Untrained people should not begin to participate in high-intensity sports without a proper period of training. The pulse should not be higher than 170 beats per minute, especially if the athlete is over 35 years old. To adapt to physical activity, athletes should warm up well, warm up and not cool their body during the entire period of training. This strategy will help reduce the likelihood of arrhythmias in the post-training period.
• React to the first signs. The first signs of illness, such as chest pain or increased fatigue, precede sudden cardiac death. If these symptoms occur, you should stop immediately. physical activity and seek medical help. The overenthusiasm of marathon runners and spectators who encourage these athletes to push through pain to the finish line is very concerning. This attitude towards athletes should not be encouraged, as it is potentially dangerous for them. You should also avoid intense loads during colds and infectious diseases.
• Avoid overheating the body. Since high temperatures increase your heart rate and can cause arrhythmia, you should avoid hot baths and showers immediately after exercise. You should also avoid high-intensity exercise when high temperature environment, because factors such as loss of fluid and trace elements (Na, K) can play a fatal role. In endurance events such as the marathon, fluid and electrolyte losses must be replaced by athletes to the maximum extent possible.
• No smoking. All athletes should avoid smoking. Not only is smoking a risk factor for coronary artery disease, it also causes an increase in free fatty acids in the blood serum and increases the production of catecholamines, which can cause arrhythmias immediately after exercise.