Why can the heart stop in young people. Sudden cardiac arrest. Factors that increase the risk of SIDS

Once a year, at least, the media report another death from sudden cardiac arrest: an athlete right on the field during a game or a schoolboy in physical education classes. But many people die for the same reason, falling asleep and not waking up. What is it, is cardiac arrest so sudden and can it be foreseen, MedAboutMe figured out

By "sudden death from cardiac arrest" is meant, in the absence of other options, the death of a person who was in a stable condition within the next hour. Cardiac arrest is not such a rare event, unfortunately. According to the Ministry of Health, in Russia alone, from 8 to 16 people per 10,000 of the population die from sudden cardiac arrest every year, which is 0.1-2% of all adult Russians. In the whole country, 300 thousand people die this way every year. 89% of them are men.

In 70% of cases, sudden cardiac arrest occurs outside the walls of the hospital. In 13% - in the workplace, in 32% - in a dream. In Russia, the chances of survival are low - only one person out of 20. In the US, the probability that a person will survive is almost 2 times higher.

The main cause of death most often is the lack of timely assistance.

• Hypertrophic cardiomyopathy.

One of the most famous reasons why a person who does not complain about his health can die. Most often, the name of this disease flashes in the media in connection with the sudden death of famous athletes and little-known schoolchildren. So, in 2003, football player Marc-Vivier Foe died of hypertrophic cardiomyopathy right during the game, in 2004 - football player Miklós Feher, in 2007 - strongman Jesse Marunde, in 2008 - Russian hockey player Alexei Cherepanov, in 2012 - football player Fabrice Muamba, in January of this year - a 16-year-old schoolboy from Chelyabinsk... The list goes on.

The disease often affects young people under the age of 30. At the same time, despite the "sports" history of the disease, most of the deaths occur at the time of minor exertion. Only 13% of deaths occurred during a period of increased physical activity.

In 2013, scientists found a gene mutation that causes thickening of the myocardium (most often we are talking about the wall of the left ventricle). In the presence of such a mutation, the muscle fibers are not arranged in an orderly manner, but randomly. As a result, a violation of the contractile activity of the heart develops.

Other causes of sudden cardiac arrest include:

• Ventricular fibrillation.

Chaotic and therefore hemodynamically inefficient contraction of individual sections of the heart muscle is one of the varieties of arrhythmia. This is the most common type of sudden cardiac arrest (90% of cases).

• Ventricular asystole.

The heart simply stops working, its bioelectrical activity is no longer recorded. This condition causes 5% of cases of sudden cardiac arrest.

• Electromechanical dissociation.

The bioelectrical activity of the heart is preserved, but there is practically no mechanical activity, that is, impulses go on, but the myocardium does not contract. Doctors note that this condition practically does not occur outside the hospital.

Scientists point out that most people who experience sudden cardiac arrest also had the following conditions:

• mental disorders (45%);
• asthma (16%);
• heart disease (11%);
• gastritis or gastroesophageal reflux disease (GERD) (8%).

Literally in a few seconds from its beginning, develop:

• weakness and dizziness;
• after 10-20 seconds - loss of consciousness;
• after another 15-30 seconds, the so-called tonic-clonic convulsions develop,
• breathing rare and agonal;
• clinical death occurs at 2 minutes;
• pupils dilate and stop responding to light;
• the skin turns pale or becomes bluish (cyanosis).

The chances of survival are low. If the patient is lucky and there is a person nearby who is able to conduct an indirect heart massage, the likelihood of surviving the syndrome of sudden cardiac arrest increases. But for this it is necessary to "start" the heart no later than 5-7 minutes after it stopped.

Danish scientists analyzed cases of sudden death from cardiac arrest. And it turned out that the heart, even before it stopped, let know that something was wrong with it.

In 35% of patients with sudden death syndrome from arrhythmia, at least one symptom was observed that speaks of heart disease:

• fainting or pre-syncope - in 17% of cases, and this was the most common symptom;
• pain in the chest;
• The patient has already undergone successful resuscitation of cardiac arrest.

As well as 55% of people who died from hypertrophic cardiomyopathy, more than 1 hour before their sudden death, experienced:

• fainting (34%);
• chest pain (34%);
• shortness of breath (29%).

American researchers also point out that every second person who was overtaken by sudden cardiac arrest experienced manifestations of cardiac dysfunction - and not an hour or two, but in some cases several weeks before the critical moment.

Thus, 50% of men and 53% of women noted chest pain and shortness of breath 4 weeks before the attack, and almost all (93%) had both symptoms 1 day before sudden cardiac arrest. Only one in five of these people went to the doctors. Of these, only a third (32%) managed to escape. But from the group that did not seek help at all, even fewer survived - only 6% of patients.

The complexity of the prediction of sudden death syndrome lies also in the fact that not all of these symptoms appear at the same time, so it is impossible to accurately track the critical deterioration in health. 74% of people had one symptom, 24% had two, and only 21% had all three.

So, we can talk about the following main signs that may precede sudden cardiac arrest:

• Chest pain: 1 hour to 4 weeks before attack.
• Difficulty breathing, shortness of breath: from an hour to 4 weeks before an attack.
• Fainting: shortly before the attack.

If these signs are present, you should contact a cardiologist and undergo an examination.

• If you have chest pain and shortness of breath, you should immediately consult a doctor for a heart examination. Remember: Seeking medical attention in a timely manner increases a person's chance of life with sudden cardiac arrest by 6 times.
• A person who has experienced sudden cardiac arrest needs immediate chest compressions.
• Do not try to give the victim any medication, including the popular nitroglycerin. It may worsen the patient's condition.

• The main causes of cardiac arrest
• Symptoms of cardiac arrest
• Cardiac arrest and clinical death
• Risk groups and further life

Increasingly in the modern world there are people with a sick heart. Cardiac arrest has become a common occurrence in medical practice. This all happens for a number of reasons and is often not related to the main diagnosis, that is, it has nothing to do with diseases. Stress is a phenomenon that affects not only the heart, but also the brain and other organs, leading to irreversible changes in the body. In most cases, doctors are able to cope with cardiac arrest, there are many methods of emergency care. You can always identify factors and risk groups, but it is important to do everything in order to avoid unpleasant situations, and even more so death. In many sources, you can find information on how to provide first aid and what symptoms may be in case of cardiac arrest.

The main causes of cardiac arrest

The heart is a complex organ of the human body, which ensures the vital activity of a person, supplying blood and oxygen to all muscles and organs. This is also a muscle that works rhythmically and harmoniously. Well-coordinated work ensures not only the well-being of a person, but also the normal functioning of the whole organism and each organ separately. This well-coordinated work can be disrupted by the following factors:

• failure of the ventricles (fibrillation);
• lack of bioelectric activity, its activity;
• asistology;
• tachycardia.

The above factors are direct causes. The most common of these is incorrect or chaotic work of the ventricles, in other words,. Simply put, each of them is a small feature associated with an overload or a violation in the rhythmic work of the heart muscle. Often, the upcoming stop can be indicated by breathing that does not correspond to normal, very rapid or with hoarseness.

Even before the moment of stopping, there may be a lack of oxygen in the tissues, especially due to a slow stop. In this case, the chances of a quick rescue are reduced, but the likelihood of preventing cardiac arrest itself increases. The main thing for both those around you and the one who is threatened is to pay attention to the changes in time and contact a specialist.

The reasons for this pathology can be different:

• myocarditis;
• ischemic diseases;
• various metabolic processes;
• sudden drop or rise in temperature.

All this is associated with lifestyle, if there are no pathological reasons for cardiac arrest. Smoking and alcohol affect the activity of the brain and heart, respectively, can cause cardiac arrest. This is very common among drug addicts. The most likely risk group after the age category is drug addicts. Drugs can affect the heart in a variety of ways. Treatment in such cases is useless, the only option for a drug addict is to get rid of addiction in all possible ways. Watching films, one can often observe how a patient's heart stops on the operating table during an operation. Manipulations in the body can, of course, lead to this, but this is most often affected by a change in temperature or a sharp blood loss, and, accordingly, a change in body temperature, a failure.

With low heart pressure, cardiac arrest is also possible. Often, a loss of consciousness can become a harbinger of this, and then, after 10 minutes, cardiac arrest.

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Symptoms of cardiac arrest

Influencing factors can become irreversible and lead to death. Symptoms of cardiac arrest can help you understand what exactly needs to be done to save a life and restore its work. Symptoms of cardiac arrest, detected in time, can often become an opportunity to save lives, since after a cardiac arrest, clinical death can occur, oxygen starvation of the organs begins.

Signs of cardiac arrest are convulsions, a gradual cessation of pulsation in the blood vessels, rare breathing and loss of breath, loss of consciousness, lack of reaction to light, a sharp change in complexion or skin in general. The symptoms are not easy, but with a cardiac arrest, a person stops his life, because not a single organ is able to function without a working heart.

The easiest way to track the symptoms in a person suffering from diabetes, coronary heart disease. Hoarseness and a change in complexion and skin for others can be the main signal that a person may experience cardiac arrest as a result of myocardial infarction. Using the example of those who suffer from drug addiction, we can say: dilated pupils also indicate that there is a reboot in the work of the heart muscle (this often causes it to stop). In this case, overwork due to irregular and unstable work of the heart can be eliminated by simple manipulations, as in first aid (indirect massage is done).

Update: October 2018

Cardiac arrest is the equivalent of clinical death. As soon as the heart ceases to perform its pumping functions and pump blood, changes begin in the body, called thanatogenesis or the onset of death. Fortunately, clinical death is reversible, and in a number of situations of sudden cessation of breathing and heart, they can be restarted.

Actually, sudden cardiac arrest is precisely the cessation of its effective work. Since the myocardium is a community of many muscle fibers that must contract rhythmically and synchronously, their chaotic contraction, which will even be recorded on a cardiogram, can also refer to cardiac arrest.

Causes of cardiac arrest

• Cause of 90% of all clinical deaths- ventricular fibrillation. In this case, the same chaos of contractions of individual myofibrils will take place, but the pumping of blood will stop and the tissues will begin to experience oxygen starvation.
• Cause of 5% of cardiac arrests- complete cessation of heart contractions or asystole.
• Electromechanical dissociation- when the heart does not contract, but its electrical activity is maintained.
• Paroxysmal ventricular tachycardia, in which an attack of heartbeats with a frequency of more than 180 per minute is accompanied by the absence of a pulse in large vessels.

All of the above conditions can lead to the following changes and diseases:

Cardiac pathologies

• IHD () -, acute myocardial oxygen starvation (ischemia) or its necrosis, for example, with
• inflammation of the heart muscle ()
• myocardiopathy
• heart valve disease
• pulmonary embolism
• cardiac tamponade, such as blood pressure from an injury to the heart sac
• dissecting aortic aneurysm
• acute thrombosis of the coronary arteries

Other reasons

• drug overdose
• chemical poisoning (intoxication)
• overdose of drugs, alcohol
• airway obstruction (foreign body in the bronchi, mouth, trachea), acute respiratory failure
• accidents - electric shock (use of weapons for self-defense - stun guns), gunshot, stab wounds, falls, blows
• state of shock - pain shock, allergic, with bleeding
• acute oxygen starvation of the whole organism during suffocation or respiratory arrest
• dehydration, decreased blood volume
• abrupt increase in blood calcium levels
• cooling
• drowning

Predisposing factors in cardiac pathologies

• smoking
• hereditary predisposition
• overload of the heart (stress, intense physical activity, overeating, etc.).

Drugs that cause cardiac arrest

A number of drugs can provoke a cardiac catastrophe and cause clinical death. As a rule, these are cases of interaction or overdose of drugs:

• Means for anesthesia
• Antiarrhythmic drugs
• Psychotropic drugs
• Combinations: calcium antagonists and third-class antiarrhythmics, calcium antagonists and beta-blockers, some antihistamines and antifungal drugs cannot be combined, etc.

Signs of cardiac arrest

The appearance of the patient, as a rule, leaves no doubt that something is wrong here. As a rule, the following manifestations of cessation of cardiac activity are noted:

• Lack of consciousness, which develops after 10-20 seconds from the onset of an acute situation. In the first seconds, a person can still make simple movements. After 20-30 seconds, convulsions may additionally develop.
• Paleness and cyanosis of the skin, in the first place, the lips, the tip of the nose, the earlobes.
• Rare breathing, which stops after 2 minutes from cardiac arrest.
• No pulse on large vessels of the neck and wrists.
• Absence of heartbeats in the area below the left nipple.
• Pupils dilate and stop responding to light- 2 minutes after stopping.

Thus, after cardiac arrest, clinical death occurs. Without resuscitation, it will develop into irreversible hypoxic changes in organs and tissues, called biological death.

• The brain after cardiac arrest lives 6-10 minutes.
• As casuistry, cases of preservation of the cerebral cortex after a 20-minute clinical death when falling into very cold water are described.
• From the seventh minute, brain cells begin to progressively die.

And although resuscitation is supposed to be carried out for at least 20 minutes, the victim and his rescuers have only 5-6 minutes in reserve, guaranteeing the subsequent full life of the victim from cardiac arrest.

First aid for cardiac arrest

Given the high risk of death from sudden ventricular fibrillation, civilized countries equip public places with defibrillators, which can be used by almost any citizen. The device has detailed instructions or voice guidance in several languages. Russia and the CIS countries are not spoiled by such excesses, therefore, in the event of a sudden cardiac death (suspicion of it), you will have to act independently.

More and more legislation limits even a doctor passing by a fallen person in the street in the possibilities of performing primary cardiopulmonary resuscitation. After all, now a doctor can do his work only during the hours allotted to him on the territory of his medical institution or jurisdictional territory and only according to his specialization.

That is, an obstetrician-gynecologist resuscitating a person with sudden cardiac arrest on the street can get very undeserved. Fortunately, such punishments do not apply to non-medics, so mutual assistance is still the main chance for salvation for the victim.

In order not to look indifferent or illiterate in a critical situation, it is worth remembering a simple algorithm of actions that can save a life that has fallen or is lying on the street and preserve its quality.

To make it easier to remember the order of actions, let's call them by the first letters and numbers: OP 112 SODA.

• O- Assess the risk

Approaching the lying not too close, we loudly ask if he hears us. People under the influence of alcohol or drugs, as a rule, mumble something. If possible, we pull the body off the roadway / walkway, remove the electrical wire from the victim (if an electric shock occurred), release

• P- check the reaction

From a standing position, getting ready to jump back and quickly run away, pinch the ear lying behind the lobe and wait for a response. If there were no groans or curses, and the body is lifeless, go to point 112.

• 112 - telephone call

This is a general emergency telephone number, dialed from mobile phones in the Russian Federation, the CIS countries and many European countries. Since there is no time to lose, someone else will take care of the phone, which you should choose in the crowd, turning to the person personally so that he has no doubts about the task assigned.

• FROM– heart massage

Putting the victim on a flat hard surface, you need to start an indirect heart massage. Immediately forget everything that you saw on this topic in the films. Pushing up from the sternum on bent arms, it is impossible to start a heart. The arms must be kept straight throughout the resuscitation. The straight palm of the weaker hand will be laid across the lower third of the sternum across. A stronger palm is placed perpendicularly on top of it. This is followed by five non-childish pressing movements with all weight on outstretched arms. In this case, the chest should move no less than five centimeters. You will have to work, as in a gym, not paying attention to the crunch and rattle under your arms (the ribs will then heal, and the pleura will be sewn up). 100 pushes should be made per minute.

• O- ensure airway patency

To do this, the person’s head is gently thrown over, so as not to damage the neck, with fingers wrapped in any scarf or napkin, they quickly pull out dentures and foreign objects from the mouth, push the lower jaw forward. In principle, you can skip the point, The main thing is not to stop pumping your heart. Therefore, someone else can be put on this item.

• D- artificial respiration

For thirty strokes of the sternum, there are 2 breaths from mouth to mouth, previously covered with gauze or a scarf. These two breaths should not take more than 2 seconds, especially if one person is doing the resuscitation.

• BUT- it's adyes

Upon arrival at the place of the ambulance or rescue services, it is necessary to prudently and promptly set sail home, unless the victim is your close friend or relative. This is insurance against unnecessary complexities of personal life.

First aid for a child

A child is not a small adult. This is a completely original organism, approaches to which differ. Cardiopulmonary resuscitation remains especially relevant for children in the first three years of life. At the same time, you should not give in to panic and act as quickly as possible (after all, there are only five minutes left).

• The child is laid on the table, swaddled or undressed, the mouth is freed from foreign objects or impurities.
• Then, with the pads of the second and third fingers of the hand, located on the lower third of the sternum, they press with a frequency of 120 shocks per minute.
• The jerks should be neat, but intense (the sternum is shifted to the depth of the finger).
• After 15 compressions, two breaths are taken into the mouth and nose, covered with a napkin.
• Parallel to resuscitation, an ambulance is called.

First aid for cardiac arrest

Medical care depends on the reason why cardiac arrest has developed. The most commonly used defibrillator. The effectiveness of manipulation decreases by about 7% every minute, so the defibrillator is relevant for the first fifteen minutes after the disaster.

For ambulance teams, the following algorithms have been developed to help with sudden cardiac arrest.

• If clinical death occurred in the presence of the brigade, a precordial blow is applied. If cardiac activity is restored after it, then saline is injected intravenously, an ECG is taken, if the heart rhythm is normal, artificial ventilation of the lungs is carried out and the patient is taken to the hospital.
• If there is no heartbeat after the precordial beat, the airway is restored using an airway, tracheal intubation, Ambu bag, or mechanical ventilation. Then, sequentially, a closed heart massage and ventricular defibrillation are performed, after restoring the rhythm, the patient is taken to the hospital.
• With ventricular tachycardia or ventricular fibrillation, I use defibrillator discharges of 200, 300 and 360 J sequentially or 120, 150 and 200 J with a biphasic defibrillator.
• If the rhythm is not restored, amiodarone, intravenous procainamide is used with a discharge of 360 J after each injection of drugs. If successful, the patient is hospitalized.
• In the case of asystole, confirmed by ECG, the patient is transferred to a ventilator, atropine and epinephrine are administered. Re-record the ECG. Next, they look for a cause that can be eliminated (hypoglycemia, acidosis) and work with it. If the result is fibrillation, go to the algorithm for its elimination. When the rhythm stabilizes - hospitalization. With persistent asystole - a statement of death.
• With electromechanical dissociation - tracheal intubation. Venous access, search for a possible cause and its elimination. epinephrine, atropine. In case of asystole as a result of measures, act according to the asystole algorithm. If the result was fibrillation, go to the algorithm for its elimination.

Thus, if a sudden cardiac arrest occurs, the first and main criterion that should be taken into account is time. The patient's survival and the quality of his future life depend on the quick start of assistance.

The cessation of cardiac activity, or cardiac arrest (asystole), is fraught with a violation of the vital functions of the body and is a life-threatening condition with poor prognosis. However, often a further prognosis depends on the ability of the surrounding people to qualitatively, quickly and competently provide first aid to the victim. According to statistics, two-thirds of all cases of cardiac arrest occur outside the walls of medical institutions, therefore, as a rule, assistance is provided by strangers who do not have a medical education. That is why any person should be able to navigate in such circumstances and know how to provide primary resuscitation.

Why can cardiac arrest occur?

Most often, ventricular asystole, or the absence of heart contractions, occurs in elderly people with a history of serious organic heart disease. In this case, asystole is called sudden cardiac death. In addition, ventricular asystole, as the immediate cause of death, occurs during various injuries, poisonings and other accidents.

So, the main conditions that can cause fatal circulatory disorders, and the causes of cardiac arrest:

a) Cardiac diseases:

• , often extensive
• Acute violations of the rhythm and contractility of the heart (, frequent ventricular),
• Stratification and rupture.

The main factors capable of provoking sudden cardiac arrest in cardiac patients are smoking, alcohol abuse, age over 60 years, male sex, overweight, presence and.

b) Acute and chronic diseases of the internal organs and the brain:

1. Acute respiratory failure, for example, with a prolonged severe attack of bronchial asthma,
2. Severe metabolic disorders - coma in diabetes mellitus, severe last stages of renal and hepatic insufficiency,
3. Long-term and severe diseases of the lungs, kidneys and other internal organs,
4. Terminal stage of oncological diseases.

c) Accidents:

• drowning,
• Asphyxia, or suffocation when foreign bodies enter the lumen of the larynx or bronchi,
• chemical poisoning,
• Injuries received as a result of catastrophes, accidents or at home,
• Burn, pain, traumatic shock,
• Electrical injury (electric shock).

Cardiac arrest in children

The cessation of cardiac activity can occur not only in adults and the elderly, but also in children. In addition to the listed common causes that can cause asystole in a child, there is a separate concept - sudden infant death syndrome (SIDS). This is a syndrome characterized by a fatal violation of breathing and heartbeat that occurred at night during sleep in a child under the age of one year who does not currently suffer from serious somatic or infectious diseases.

As a rule, SIDS occurs most often in babies aged 2-5 months. As the main cause of the development of the syndrome, there is a violation of the function of the heart and blood vessels in the child's body, which are characterized by physiological immaturity at this age. Factors that can contribute to crib death include sleeping on a soft mattress with lots of soft pillows, blankets, or toys, sleeping in an unventilated room with dry air, and putting the baby to sleep in the prone position. Aggravating factors can be the features of pregnancy and childbirth - multiple pregnancy, asphyxia in childbirth, prematurity, etc. Bad habits of the mother can also contribute to the syndrome (the baby, when smoking parents, inhales caustic tobacco smoke, and parents who drink alcohol lose their quick reaction and cannot provide adequate care for the baby at night).

Prevention measures for ADHD in infants include:

• Sleep in a well ventilated area
• Sleeping on a hard mattress without a pillow
• The exclusion of tight swaddling, which prevents the active movements of the baby in sleep,
• Exclusion of bad habits of parents,
• Co-sleeping with the mother, which promotes good tactile stimulation of the baby during sleep, is allowed only if the mother can provide sufficient sensitivity and vigilance at night.

Video: about sudden death syndrome in children and adults

Signs of cardiac arrest and clinical manifestations

A person who does not have medical skills will not always be able to correctly assess the condition of the victim, sometimes mistakenly believing that he simply became ill, while his condition requires emergency resuscitation. Therefore, it is important to be able to distinguish the clinical signs of asystole. Due to the fact that the vast majority of cases of cardiac arrest are associated with sudden cardiac death, we will dwell on its signs in more detail.

Clinically, symptoms can manifest themselves in several ways:

1. In the first case, a person doing his job, being in a hospital or just walking down the street, suddenly falls, loses consciousness, turns blue, begins to wheeze and suffocate. When you try to shout a person or shake the shoulder, there is no reaction.
2. In the second option, sudden death can occur in a dream. At the same time, the surrounding people may not immediately notice the need to save a life, because the person looks just sleeping.

In both cases, the hallmark of cardiac arrest is an absent carotid pulse, normally palpable under the skin of the neck near the angle of the mandible. In addition, asystole is accompanied by respiratory arrest, manifested by the absence of chest movements, as well as a deep loss of consciousness and a sharp pallor or cyanosis of the skin.

Episodic ventricular asystole occurs in patients with which includes a severe degree of sinoatrial blockade, bradycardia-tachycardia syndrome and some other syndromes. With a pronounced violation of conduction in the heart, in this case, ventricular asystole may develop, which is clinically manifested by a feeling of cardiac arrest, loss of consciousness or convulsions and is called. The heart during such episodes of asystole either begins to work further due to the emergence of "slip" rhythms, or resuscitation may be required if asystole lasts more than two minutes.

episodic asystole on ECG

Diagnostic criteria

If a person sees a victim who has lost consciousness, one should immediately determine what is supposedly caused by such a condition - coma or cardiac arrest with the possible development of a fatal outcome. For this you need to follow this algorithm:

Emergency care and treatment

Providing first aid for cardiac arrest

Primary resuscitation measures are aimed at restoring the activity of the heart and lungs, and at preventing hypoxia (lack of oxygen) of the brain. Their effectiveness is higher the earlier they are started. Due to the fact that the brain is able to withstand acute hypoxia for 5-8 minutes (the so-called clinical death), the heart should be “started” precisely at these times, since brain death (biological death) inevitably develops in a few minutes.

Emergency care is provided according to the ABC algorithm.

The first thing to start with is laying the victim on a hard surface (couch, floor, ground), since resuscitation on a soft surface is ineffective. Next, the immediate resuscitation of the victim begins:

"A" (Air open the way) - restoration of airway patency. It is necessary to tilt the head of the victim up to provide access to the oral cavity and to revise it with a finger wrapped in a cloth (handkerchief, napkin) in order to free the oropharynx from vomit, blood, foreign bodies, etc.

"B" (Breath support) - artificial lung ventilation. It is carried out if after the execution of paragraph "A" the victim did not have spontaneous breathing and heartbeat. It is carried out as follows: the assisting person (resuscitator) in the kneeling position takes a deep breath, and, bending over the patient, exhales deeply into the patient's nose or mouth. If in the nose, then the patient's mouth should be closed, if in the mouth, then, accordingly, pinch the nostrils with the fingers of the free hand. The effectiveness of the measure is evaluated by the rise of the patient's ribs with each blow and by the appearance of spontaneous breathing.

According to the latest changes in healthcare legislation, the resuscitator has the right not to perform artificial respiration if he believes that this benefit may pose a threat to his health. For example, if a patient may have tuberculosis or there is a violation of the integrity of the skin and mucous membranes with the presence of blood in the oral cavity as a likely source of viral hepatitis or HIV infection. In this case, they immediately begin to carry out the next item of the algorithm.

"C" (Circulation support) - indirect heart massage (closed). Heart massage is carried out as follows - the resuscitator also, kneeling, presses the patient's chest with two palms located one on top of the other, while the arms should be straightened at the elbow joints for greater massage efficiency. Movements should be fast and precise. The force of pressing should be calculated in such a way that it is sufficient to “start” the heart, but at the same time not so strong as to cause a fracture of the ribs. Every few minutes, the appearance of an independent heartbeat and pulse on the carotid artery should be evaluated.

The frequency and ratio of artificial respiration and indirect heart massage is 2 air blows every 15 chest compressions for one minute when assisted by one resuscitator and 1 air blowing every 5 chest compressions when assisted by two resuscitators (15:2 and 5: 1 respectively).

Video: first aid for cardiac arrest

Provision of medical assistance

Professional medical assistance begins upon the arrival of the ambulance team, continues in the ambulance and in the intensive care unit of the hospital to which the victim will be taken. Physicians carry out intravenous administration of adrenaline, dopamine and other drugs that support heart contractions, as well as electrical “reboot” of the heart using electric current.

If there is no spontaneous heartbeat and breathing after 30 minutes, biological death is declared.

Lifestyle for survivors of cardiac arrest

A patient who has experienced cardiac arrest should be sensitive to his health. To do this, it is necessary to be examined and find out the reason that caused such a serious condition.

After the diagnosis is made, the patient must follow the basics of a healthy lifestyle and rational nutrition, eradicate bad habits, and limit significant physical activity. In addition, it is necessary to regularly take the drugs prescribed by the doctor and undergo a timely examination of the cardiovascular system offered by the attending physician.

In some cases, for example, in the presence of severe life-threatening arrhythmias, or in case of heart defects that caused asystole, surgical treatment may be required - implantation or surgical correction of the defect.

Consequences of cardiac arrest

Of course, cardiac arrest cannot pass without a trace for the body, since the functioning of all organs and systems of the body, and, first of all, the brain, is sharply disrupted. Depending on the time that the brain has spent without oxygen, neurological consequences of varying severity develop - from mild memory and attention impairments with a rapid (during the first minute) start of the heart, to severe post-resuscitation illness with a coma in the case of a long time of brain hypoxia ( 5-6 minutes or more).

Forecast

The prognosis for cardiac arrest is extremely unfavorable, since the risk of biological death is high. – death from cardiac arrest occurs in 70% of patients with ventricular asystole. With a well-provided primary benefit and timely qualified medical care, the prognosis is more favorable, especially if the restoration of heart function occurred in the first three minutes, when the brain had not yet had time to suffer from hypoxia.

There is a category of people who endured complete asystole not once, but several times with quite successful resuscitation. Unfortunately, such cases are quite rare in medicine, since with each subsequent cardiac arrest, the chances of a successful restoration of blood circulation and respiration decrease.

Video: sudden cardiac arrest, the program “Live healthy”

There are a large number of factors in our troubled world that can lead to the death of a person. A huge number of people leave our lives every day. The causes of death can be natural (old age, incurable disease) or violent (accident, fire, drowning, war, etc.). However, today there is one cause of death that claims a large number of lives every year. Although death can be prevented in this case, it is heart failure, which often comes on suddenly, even in quite healthy people. We are taught how to provide first aid, however, as practice shows, faced with such a situation, not everyone can immediately take the necessary measures to save a person. In order to do everything right, you need to know what you are facing in this case.

How to determine that the heart has stopped. Symptoms of cardiac arrest.

There are several main signs by which cardiac arrest can be identified.

• No pulse in large arteries. In order to determine the pulse, it is necessary to put the middle and forefinger on the carotid artery and, if the pulse is not detected, resuscitation should begin immediately.
• Lack of breath. Breathing can be determined with the help of a mirror, which must be brought to the nose, as well as visually - by the respiratory movements of the chest.
• Dilated pupils that do not respond to light. It is necessary to shine a flashlight into the eyes and, if there is no reaction (the pupils do not narrow), this will indicate the cessation of the functioning of the myocardium.
• Blue or gray complexion. If the natural pinkish color of the skin changes, this is an important sign that indicates a violation of blood circulation.
• Loss of consciousness that occurs for 10-20 seconds. Loss of consciousness is associated with ventricular fibrillation or asystole. They are determined by a pat on the face or with the help of sound effects (loud claps, screaming).

How to save a person. How much time is there. First aid and medical care for cardiac arrest.

If you are close to a person who has this disease, the main thing on your part is not to hesitate. You have only 7 minutes so that the cardiac arrest passes for the victim without serious consequences. If it is possible to return a person within 7-10 minutes, then the patient is likely to have mental and neurological disorders. Belated help will lead to a deep disability of the victim, who will remain incapacitated for life.

The main task in providing assistance is to restore breathing, heart rhythm and start the circulatory system, since oxygen enters the cells and tissues with blood, without which the existence of vital organs, especially the brain, is impossible.

Before assisting, it is necessary to make sure that the person is unconscious. Slow down the victim, try to call out to him loudly. If all else fails, it is worth providing first aid, which includes several basic steps.

• The first step is to lay the patient on a hard surface and tilt his head back.
• After that, free the airways from foreign bodies and mucus.
• The next step is mechanical ventilation (mouth to mouth or nose)
• Indirect (external) cardiac massage. Before proceeding to this stage, it is necessary to perform a “precordial blow” - you should beat with your fist in the middle part of the sternum. The main thing is that the blow should not be directly in the region of the heart, as this can aggravate the situation of the victim. Precordial stroke helps to immediately resuscitate the patient or increases the effect of cardiac massage. After the preparatory procedure, if the patient could not be resuscitated, they proceed to external massage.

Every two or three minutes, it is necessary to check the condition of the victim - pulse, breathing, pupils. As soon as breathing appears, resuscitation can be stopped, however, if only a pulse appears, it is required to continue artificial ventilation of the lungs. Heart massage should be done until the skin color begins to acquire a normal, natural color. If the patient cannot be brought back to life, then assistance can be stopped only when the doctor arrives, who can give permission to stop resuscitation.

It is important to remember that these activities are only the initial stage of assistance to the victim, which must be done before the doctors arrive.

Ambulance doctors use special methods to further maintain the life of the victim. The main task of physicians is restoring the patient's breathing. For this use mask ventilation. If this method does not help or it is impossible to use it, then resort to tracheal incubation- this method is the most effective in ensuring the patency of the respiratory tract. However, only a specialist can install the tube into the trachea.

To start the heart, doctors use a defibrillator, a device that delivers an electrical current to the heart muscle.

Special medications also come to the aid of doctors. The main ones are:

• Atropine- used for asystole.
• epinephrine(adrenaline) - necessary to strengthen and increase the heart rate.
• Bicarbonate of soda- It is often used in prolonged cardiac arrest, especially in cases where cardiac arrest was caused by acidosis or hyperkalemia.
• Lidocaine , amiodarone and bretylium tosylate- are antiarrhythmic drugs.
• Magnesium sulfate helps stabilize heart cells and stimulates their excitation
• Calcium used for hyperkalemia.

Causes of cardiac arrest

There are several main causes of cardiac arrest

The first place is ventricular fibrillation. In 70-90% of cases, this particular cause is a consequence of cardiac arrest. The muscle fibers that make up the walls of the ventricles begin to contract randomly, which leads to interruptions in the supply of blood to organs and tissues.

Second place - ventricular asystole- complete cessation of electrical activity of the myocardium, which accounts for 5-10% of cases.

Other reasons include:

• ventricular paroxysmal tachycardia with the absence of a pulse in large vessels;
• electromechanical dissociation- electrical activity in the form of rhythmic QRS complexes without corresponding contractions of the ventricles;

There is also a genetic predisposition Romano-Ward syndrome, which is associated with the inheritance of ventricular fibrillation.

In addition, in a completely healthy person, cardiac arrest is possible, the cause of which may be the following factors:

• Hypothermia (body temperature drops below 28 degrees)
• electrical injury
• Medicines: cardiac glycosides, adrenergic blockers, analgesics, and anesthetics
• Drowning
• Lack of oxygen, such as by suffocation
• Cardiac ischemia . People with coronary artery disease who abuse alcohol are very much at risk, since cardiac arrest in this case occurs in almost 30% of cases.
• Atherosclerosis
• Arterial hypertension and left ventricular hypertrophy
• Anaphylactic and hemorrhagic shock
• Smoking
• Age

In the presence of one or more factors, you should be more attentive to your health. It is advisable to regularly undergo examinations with a cardiologist. To control the work of the heart, it is possible to use the Cardiovisor device, with which you will always be aware of the state of your main organ. Regular monitoring of the cardiovascular system will allow you to live a full life.

Consequences of cardiac arrest

To my deepest regret only 30% of people survive after cardiac arrest, and worst of all, to a normal life, without serious harm to health, only 3.5% returned. Basically, this is due to the fact that timely assistance was not provided.

The consequences of cardiac arrest very much depend on how quickly they began to provide assistance to the victim. The later the patient was brought back to life, the greater the likelihood of serious complications. Lack of oxygen supply to vital organs for a long time leads to ischemia(oxygen starvation). Most common in cardiac arrest survivors ischemic damage to the brain, liver and kidneys, which greatly influence the subsequent life of a person.

Due to vigorous cardiac massage, rib fractures and pneumothorax are possible.

Cardiac arrest in children

Cardiac arrest in children- this is a rather rare phenomenon, which, unfortunately, occurs more and more every year. The causes of this pathology in children are different and very often come to light only after autopsy. Most often, this is a genetic predisposition, which is associated with abnormal work of the cardiovascular system. How to predict and prevent danger? Often in children, cardiac arrest is heralded by bradycardia. Often, respiratory failure or shock can lead to cardiac arrest. Also, the factors of this pathology in children include ischemic heart disease.

If, nevertheless, the child had a cardiac arrest, timely correct assistance, correct resuscitation by doctors is important, since it is they who will affect the further health of the child. Such measures include correctly performed artificial lung ventilation, oxygenation (oxygenation of tissues and organs), temperature control, blood pressure, and blood glucose levels.
With an external heart massage, it must be remembered that the ribs of children are not so strong and, most importantly, do not overdo it with pressure on them. Depending on the age of the child, they press with two or three fingers, and for newborns, an indirect heart massage is done with the thumbs, while clasping the baby's chest with his hands. Only thanks to the right approach of doctors, the survival and normal health of the child in the future is possible.
None of us is completely protected from this terrible phenomenon. However, we can protect ourselves and minimize the likelihood of myocardial arrest. By using the service,

Your heart will never give you unpleasant surprises. After all, regular monitoring of the work of the heart is an important step towards health!

Rostislav Zhadeiko, especially for the project .

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