Under the diagnosis of sudden coronary death is understood as the sudden death of a patient, the cause of which is the arrest of cardiac activity.
The disease is more likely to affect men, whose age is between 35-45 years. It occurs in 1-2 children in every 100,000 people.
- 1 Causes and risk factors
- 2 Forecast and danger
- 3 Symptoms before the onset of
- 4 Syndrome First aid
- 5 Differential diagnosis
- 6 Tactics for treatment
- 7 Prevention
Causes and risk factors
The main cause of the BC is the common pronounced arteriosclerosis of the coronary vessels when in the pathological processtwo or more major branches are involved.
Physicians explain the development of sudden death as follows:
- myocardial ischemia ( in acute form).The condition develops because of the excessive need of the heart muscle in oxygen( against the background of psychoemotional or physical overstrain, alcohol dependence);
- asystole - stop, complete cessation of heart rate;
- reduced coronary blood flow due to a sharp drop in blood pressure, including in sleep and at rest;
- ventricular fibrillation - flicker and flutter;
- violation of the functioning of the electrical system of the body .It starts to work irregularly and decreases with a life-threatening frequency. The body stops receiving blood;
- among the reasons does not exclude the possibility of coronary artery spasm;
- stenosis - lesion of the main arterial trunks;
- atherosclerotic plaques, postinfarction scars, vascular ruptures and tears, thrombosis.
The following conditions are considered risk factors: the
- suffered a heart attack, during which a large area of the myocardium was damaged. Coronary death occurs in 75% of cases after myocardial infarction. The risk persists for six months;
- ischemic disease;
- episodes of loss of consciousness without a specific cause - syncope;
- cardiomyopathy is a dilution - the risk is to reduce the pumping function of the heart;
- cardiomyopathy is hypertrophic - a thickening of the heart muscle;
- vascular disease, heart disease, weighty history, high cholesterol, obesity, tobacco smoking, alcoholism, diabetes mellitus;
- ventricular tachycardia and ejection fraction up to 40%;
- episodic cardiac arrest in a patient or in a family history, including heart block, decreased heart rate;
- vascular anomalies and congenital malformations;
- is an unstable level of magnesium and potassium in the blood.
Forecast and Danger
In the first minutes of the , it is important to consider how much the blood flow has decreased critically.
The main complications and risks of sudden death are as follows:
- skin burns after defibrillation;
- relapse of asystole and ventricular fibrillation;
- stomach overflow with air( after artificial ventilation);
- bronchospasm - develops after intubation of the trachea;
- damage to the esophagus, teeth, mucosa;
- fracture of the sternum, ribs, damage to lung tissue, pneumothorax;
- bleeding, air embolism;
- damage to the arteries for intracardiac injections;
- acidosis - metabolic and respiratory;
- encephalopathy, hypoxic coma.
Symptoms before the onset of the
syndrome Statistics show that about 50% of all incidents occur without the development of previous symptoms. Some patients experience dizziness and heart palpitations.
Given the fact that sudden death rarely develops in persons without coronary pathology, symptoms can be supplemented with the symptoms:
- fatigue, a feeling of suffocation against the background of heaviness in the shoulders, pressure in the chest zone;
- change in the nature and frequency of pain attacks.
First aid for
Every person who undergoes a sudden death before his eyes should be able to provide first aid first-aid. The main principle is the implementation of CPR - cardiopulmonary resuscitation .The procedure is performed manually.
To this end, repeated squeezing of the chest should be realized, inhaling air in the respiratory tract. This will avoid brain damage due to lack of oxygen and support the victim before the arrival of resuscitators.
The tactics for carrying out CPR are shown in this video:
The action plan is presented in this video:
To avoid errors during CPR, watch this video:
The pathological state develops suddenly, but a consistent development of symptoms can be traced. Diagnosis is performed during the examination of a patient : the presence or absence of a pulse on the carotid arteries, lack of consciousness, swelling of the cervical veins, cyanosis of the torso, respiratory arrest, tonic one-fold reduction of skeletal muscles.
The diagnostic criteria can be summarized as follows:
- lack of consciousness;
- on large arteries, including the carotid is not palpable;
- heart sounds are not tapped;
- respiratory arrest;
- no pupillary response to light source;
- skin becomes gray with a cyanotic shade.
You can save the patient only with emergency diagnosis and medical care .The person is placed on a hard base on the floor, the carotid artery is checked. When cardiac arrest is detected, artificial respiration techniques and cardiac massage are implemented. Resuscitation begins with a single punch on the middle zone of the sternum.
The remaining activities are as follows:
- Immediate realization of closed heart massage - 80/90 ppm;
- , mechanical ventilation. Any available method is used. Provides airway patency. Manipulations do not interrupt for more than 30 seconds. Intubation of the trachea is possible.
- is provided with defibrillation: the beginning is 200 J, if there is no result, 300 J, if there is no result, 360 J. Defibrillation is a procedure that is realized by means of special equipment. The doctor acts on the chest with an electrical impulse in order to restore the heart rhythm;
- in the central veins is inserted a catheter. Served adrenaline - every three minutes for 1 mg, lidocaine 1.5 mg / kg. In the absence of the result - repeated entry in the identical dosage every 3 minutes is shown;
- if no result is given ornid 5 mg / kg;
- in the absence of the result - novocainamide - up to 17 mg / kg;
- in the absence of the result - magnesium sulfate - 2 g.
- with asystole is indicated for emergency administration of atropine 1 g / kg every 3 min. The doctor eliminates the cause of asystole - acidosis, hypoxia, etc.
During the implementation of cardiopulmonary resuscitation, all drugs are injected quickly, in / in. When access to the vein is absent, "Lidocaine", "Adrenaline", "Atropine" is injected into the trachea, with an increase in dosage of 1.5-3 times. A special membrane or tube should be placed on the trachea. The preparations are dissolved in 10 ml of isotonic NaCl solution.
If it is not possible to use any of the presented methods of drug administration, the physician decides to perform intracardiac injections of .The reanimatologist operates a thin needle, strictly observing the technique.
Treatment is discontinued if there are no signs of effectiveness of for resuscitation within half an hour, the patient is not amenable to drug treatment, a persistent asystole with multiple episodes is revealed. Resuscitation does not begin when from the moment of stopping blood circulation has passed more than half an hour or if the patient documented the refusal of measures.
The principles of prevention are that a patient suffering from coronary heart disease should pay close attention to his / her well-being. He must track changes in physical condition, actively take prescribed medicines and adhere to medical recommendations .
For the realization of such goals is used pharmacological support of : the intake of antioxidants, preductal, aspirin, curantil, beta-adrenoblockers.
Tobacco smoking with is prohibited, especially during stress or after physical exertion. It is not recommended to stay in stuffy premises for a long time, it is better to avoid long flights.
If the patient realizes that can not cope with the stress of , it is advisable to consult with a psychologist in order to develop an adequate response method. Consumption of fatty, heavy food should be kept to a minimum, overeating is excluded.
Restriction of one's own habits, conscious control of the health status of are those principles that will help prevent acute coronary insufficiency as the cause of death and save life.
Finally, we offer to watch one more video about what symptoms this condition is accompanied, how to prevent it and help if it was not possible: