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Extrasystole is the most common type of cardiac arrhythmia. Expert opinion: sudden cardiac arrest Frequent cardiac arrests

For many of us, cardiac arrest is necessarily associated with death. Meanwhile, it is often possible to bring a person back to life some time after his heart has stopped. How is this possible?

Reversible death

When the heart stops, so-called clinical death occurs. After 10-20 seconds the person loses consciousness. He stops breathing, his pulse and other external signs vital functions of the body, the pupils stop responding to light. At this stage, the cells of the body gradually begin to die, the activity of all organs, including the brain, kidneys and liver, is disrupted. But for some time it is still possible to reverse this process.
It is believed that doctors usually have 3-4, maximum 5-6 minutes for the resuscitation process. During this period, the higher parts of the brain can still remain viable under conditions of hypoxia (oxygen starvation). According to the outstanding Soviet pathophysiologist, founder of the school of domestic resuscitation V.A. Negovsky, the revival of people is possible even after this period.

Under what conditions can a person be resuscitated?

A few years ago international group Scientists have discovered that within a few minutes after the heart stops beating, a person's brain cells still continue to function and glimpses of consciousness appear. The fact is that, deprived of oxygen, neurons begin to use previously accumulated energy reserves. Study author Dr Jens Dreyer from the Medical University of Berlin commented: “After circulatory arrest, the spread of depolarization means the loss of accumulated electrochemical energy in brain cells and the appearance of
toxic processes that ultimately lead to death. The important thing is that it is reversible - to a certain extent - when circulation is restored."
“Modern standards prescribe resuscitation within 30 minutes after the last heartbeat,” says Dmitry Yeletskov, an anesthesiologist-resuscitator from Volgograd. “Resuscitation stops when a person’s brain dies, namely when registering an EEG.”
But, as a rule, when the heart stops for too long, the cerebral cortex or all its parts die. When creating special conditions(for example, hypothermia - artificial cooling of the body), the processes of degeneration of the higher parts of the brain can be slowed down, and the period of successful resuscitation increases significantly.
According to the Ministry of Health, every year from a sudden stop
About 0.1-2% of all adult Russians die from heart disease. On average, according to world statistics, only 30% of victims survive under such circumstances. At the same time, brain activity is completely restored only in 3.5–5% of cases.

New techniques

Resuscitator Sam Parnia from the State University of New York Medical Center at Stony Brook (USA) in his book “The Lazarus Effect” argues that with the appropriate equipment and the level of training of specialists, it would be possible to bring back to life even those whose hearts do not beat. four to five hours. The brain, he says, finally dies only eight hours after the heart stops.
According to Sam Parnia, the optimal method of cardiopulmonary resuscitation (ECPR), which is used by Japanese and South Korean doctors. In this case, the patient is connected to a closed cardiac massage and artificial respiration apparatus, as well as to a membrane oxygenator - a device that controls blood circulation and oxygen saturation. During resuscitation, the patient's body should be cooled to slow down metabolic processes and prevent rapid cell death. To do this, gel bags are tied to the patient's torso and lower limbs, which are also connected to a device that regulates the temperature. An alternative is to cool the blood through a catheter inserted into the neck or groin.
The only catch is that in this way it is possible to cool only the heart and other tissues, but cannot penetrate the brain. However, recently a method has emerged that allows cooling of the brain through the nose by pumping cold steam into it. Perhaps, thanks to medical advances, the chances of survival from cardiac arrest will increase.

Let's expose! Do we start the heart with a defibrillator? October 8th, 2013

There was a post recently and its readers criticized it quite a bit. What do you say about this?

Myth: If the heart stops, it can be started again with a defibrillator.

Such scenes in Hollywood movies always end well. The hero lies on a hospital bed without moving and only rhythmic sound signals notify that all is not lost. And then, suddenly, the signal gets stuck on one note, and an ominous straight line appears on the monitor.

Doctors burst in. One of them constantly shouts: “Defibrillator! We're losing him! And then a few discharges, dramatic music, and certainly someone’s cry “LIVE, DAMMIT YOU!”, and miraculously the heart begins to beat. The hero is saved!

And everything would be fine, but... the problem is that a defibrillator cannot be used to restart a stopped heart. Alas.

In medicine, a straight line on the monitor is called asystole and means the absence of heart contractions. The idea that these contractions can be restored by electric shock seems absolutely sound.

In order to understand why this is not so, we must first understand how the heartbeat occurs.

The heart usually receives 60-100 tons of “impacts” per minute from stimulating cells in top wall right atrium (sinoatrial node). These specialized cells create an electrical differential between the inside and outside of the cell membrane. At a certain moment, an impulse is sent down the heart muscle, causing it to contract. This electrical signal travels throughout the heart.

You are probably thinking, if the heart contracts from the impulses it creates, then why can’t it be made to contract with the help of outside influence? Let's figure it out.

The sinoatrial node creates an electrical differential using electrolytes such as potassium, sodium and calcium. We will not quote the lecture for medical students, however, for some understanding of why shock therapy does not work, we will briefly summarize what is happening in our body.

The electrical charge of these electrolytes passes through the cell walls using channels named after the electrolytes themselves—sodium channels, calcium channels, and so on.

Before contraction, potassium is mainly found inside the cells, while sodium and calcium are found outside. Blood pressure (if you didn't have it, you would simply die) occurs when sodium penetrates into cells. This causes potassium to move out of the cells, creating an electrical potential.

When this potential becomes high enough, calcium channels open. When calcium channels are open, sodium and calcium rush into the cells, creating a certain charge. When a charge is formed, the heart sends out an impulse called depolarization.

Move the slider and change the transparency of the heart.

Where is this impulse created by the sinoatrial node directed? It immediately passes into the atrium. Then a pulse is formed in another cellular node, called the atrioventricular node. All this allows lower section the heart receives blood from the upper section. The atrioventricular node transmits the impulse below, to the His bundle, and further along two pathways called the right and left bundles.

It is this electrical conductivity that doctors look for when peering at the monitor. Simply put, this impulse causes a contraction, which creates the pulse. However, sometimes the presence of an impulse does not mean anything. It happens that normal electrical conductivity is reflected on the monitor, but there is no pulse. This phenomenon is called pulseless electrical activity (PEA). This is one reason why doctors still have to check pulse and blood pressure even if a person is connected to a heart monitor.

If someone goes into cardiac arrest and has no pulse, an electric shock may be needed, depending on how the conduction system works. During cardiac arrest, there may be several types of electrical rhythms. Let's look at the most common ones and figure out why electric shocks sometimes work.

The most common heart rhythm during cardiac arrest is called ventricular fibrillation (arrhythmic contraction of the muscle fibers of the atrium). When the sinoatrial node fails to fire, many other cells in the heart try to do so. As a result, multiple areas of the heart are shaken simultaneously from different directions. Instead of measured beats, we see a heart attack.

With this rhythm, the heart cannot pump blood through itself. The only way to make all these various areas hearts work in unison again - an electric shock more powerful than those they create.

When you run that kind of charge of electricity through those cells, it activates all the electrolytes from the cells at the same time. The only hope (and this is really just a hope) is that the normal functioning of cardiac electrolytes, flowing through cell membranes in an orderly manner, will resume.

In a state of asystole, a person does not have such an electrical differential that can be shown by a heart monitor. In reality, there are simply no electrolytes inside the cell that can create an impulse. In such a situation, the discharge will not help. Thus, if asystole ( complete absence ventricular contractions) appeared before you could use a defibrillator, all you can do is burn the heart high temperature from the category.

It is a myth that you can overcome asystole with a defibrillator. To do this, the heart must produce a certain electrical impulse.

Or these other revelations: did you know, but VAZ is a mystery - What do you think? The original article is on the website InfoGlaz.rf Link to the article from which this copy was made -

“Man is mortal, but his main misfortune is that he is mortal suddenly,” these words, put by Bulgakov into Woland’s mouth, perfectly describe the feelings of most people. There is probably no person who is not afraid of death. But along with the big death, there is a small death - clinical. What is it, why do people who have experienced clinical death often see divine light, and is this not a delayed path to heaven - in the material on the site.

Clinical death from a medical point of view

The problems of studying clinical death as a borderline state between life and death remain one of the most important in modern medicine. Unraveling its many mysteries is also difficult because many people who have experienced clinical death do not fully recover, and more than half of patients with similar condition it is not possible to revive them, and they die for real - biologically.

So, clinical death is a condition accompanied by cardiac arrest, or asystole (a condition in which the heart stops contracting first). various departments heart, and then cardiac arrest occurs), respiratory arrest and deep, or transcendental, cerebral coma. Everything is clear with the first two points, but about whom it is worth explaining in more detail. Typically, doctors in Russia use the so-called Glasgow scale. The eye opening reaction, as well as motor and speech reactions are assessed using a 15-point system. 15 points on this scale correspond to clear consciousness, and minimum score– 3, when the brain does not respond to any types of external influence, corresponds to an extreme coma.

After stopping breathing and cardiac activity, a person does not die immediately. Consciousness turns off almost instantly, because the brain does not receive oxygen and oxygen starvation occurs. But nevertheless, in a short period of time, from three to six minutes, he can still be saved. Approximately three minutes after breathing stops, cell death in the cerebral cortex begins, the so-called decortication. The cerebral cortex is responsible for higher nervous activity and after decortication resuscitation measures Although they can be successful, a person may be doomed to a vegetative existence.

After a few more minutes, cells in other parts of the brain begin to die - in the thalamus, hippocampus, and cerebral hemispheres. A condition in which all parts of the brain have lost functioning neurons is called decerebration and actually corresponds to the concept of biological death. That is, reviving people after decerebration is, in principle, possible, but the person will be doomed to remain on artificial ventilation and other life-sustaining procedures for the rest of his life.

The fact is that vital (vital - website) centers are located in the medulla oblongata, which regulates breathing, heartbeat, cardiovascular tone, as well as unconditioned reflexes like sneezing. At oxygen starvation medulla oblongata, which is actually a continuation of the spinal cord, is one of the last parts of the brain to die. However, despite the fact that the vital centers may not be damaged, by that time decortication will have already occurred, making it impossible to return to normal life.

Other human organs, such as the heart, lungs, liver and kidneys, can survive without oxygen for much longer. Therefore, one should not be surprised by the transplantation, for example, of kidneys taken from a patient who is already brain dead. Despite brain death, the kidneys are still in working order for some time. And the muscles and intestinal cells live without oxygen for six hours.

Currently, methods have been developed that can increase the duration of clinical death to two hours. This effect is achieved using hypothermia, that is, artificial cooling of the body.

As a rule (unless, of course, it happens in a clinic under the supervision of doctors), it is quite difficult to determine exactly when cardiac arrest occurred. According to current regulations, doctors are required to carry out resuscitation measures: cardiac massage, artificial respiration within 30 minutes from start. If during this time it was not possible to resuscitate the patient, then it is stated biological death.

However, there are several signs of biological death that appear within 10–15 minutes after brain death. First, Beloglazov’s symptom appears (when pressing on eyeball the pupil becomes like a cat's), and then the cornea of the eyes dries out. If these symptoms are present, resuscitation is not performed.

How many people survive clinical death safely?

It may seem that most people who find themselves in a state of clinical death come out of it safely. However, this is not the case; only three to four percent of patients can be resuscitated, after which they return to normal life and do not suffer from any mental disorders or loss of body functions.

Another six to seven percent of patients, being resuscitated, nevertheless do not fully recover and suffer various lesions brain. The vast majority of patients die.

Such sad statistics largely due to two reasons. The first of them is that clinical death can occur not under the supervision of doctors, but, for example, at the dacha, from where the nearest hospital is at least half an hour’s drive. In this case, doctors will arrive when it is no longer possible to save the person. Sometimes it is impossible to defibrillate in a timely manner when ventricular fibrillation occurs.

The second reason remains the nature of the damage to the body during clinical death. If we are talking about massive blood loss, resuscitation measures are almost always unsuccessful. The same applies to critical myocardial damage during a heart attack.

For example, if a person, as a result of a blockage in one of the coronary arteries more than 40 percent of the myocardium is affected, death is inevitable, because the body cannot live without heart muscles, no matter what resuscitation measures are taken.

Thus, it is possible to increase survival rate in case of clinical death mainly by equipping crowded places with defibrillators, as well as by organizing flying ambulance teams in hard-to-reach areas.

Clinical death for patients

If clinical death for doctors is emergency, in which it is necessary to urgently resort to resuscitation measures, then for patients it often seems to be the road to a brighter world. Many people who experienced clinical death talked about seeing the light at the end of the tunnel, some meeting their long-dead relatives, others looking at the earth from a bird's eye view.

“I had a light (yes, I know how it sounds), and I seemed to see everything from the outside. It was bliss, or something. No pain for the first time in so long. And after clinical death, there was a feeling that I had lived some kind of someone else’s life and now I’m just sliding back into my skin, my life - the only one in which I feel comfortable. It’s a little tight, but it’s a pleasant tightness, like a worn pair of jeans that you’ve been wearing for years,” says Lydia, one of the patients who suffered. clinical death.

It is precisely this feature of clinical death, its ability to cause vivid images, is still the subject of much controversy. From a purely scientific point of view, what is happening is described quite simply: brain hypoxia occurs, which leads to hallucinations in the actual absence of consciousness. What kind of images a person has in this state is a strictly individual question. The mechanism by which hallucinations occur has not yet been fully elucidated.

At one time the endorphin theory was very popular. According to her, much of what people feel during near-death experiences can be attributed to the release of endorphins due to extreme stress. Since endorphins are responsible for pleasure, and in particular even for orgasm, it is not difficult to guess what many people who experienced clinical death thought after it ordinary life just a burdensome routine. However, in recent years this theory was debunked because researchers found no evidence that endorphins were released during clinical death.

There is also a religious point of view. As, indeed, in any cases that are inexplicable from the standpoint of modern science. Many people (including scientists) are inclined to believe that after death a person goes to heaven or hell, and the hallucinations that those who experienced clinical death saw are only proof that hell or heaven exist, just like afterlife at all. It is extremely difficult to give any assessment to these views.

However, not all people experienced heavenly bliss during clinical death.

“I suffered clinical death twice in less than one month. I didn’t see anything. When they returned me, I realized that I was nowhere, in oblivion. I had nothing there. I came to the conclusion that there you free yourself from everything by total loss yourself, probably, along with your soul. Now death doesn’t really worry me, but I enjoy life,” accountant Andrei cites his experience.

In general, studies have shown that at the moment of human death, the body loses a small amount of weight (literally a few grams). Adherents of religions hastened to assure humanity that at this moment from human body the soul is separated. However scientific approach states that the weight of the human body changes due to chemical processes occurring in the brain at the moment of death.

Doctor's opinion

Current standards require resuscitation within 30 minutes of the last heartbeat. Resuscitation stops when a person’s brain dies, namely upon EEG registration. I personally once successfully resuscitated a patient whose heart had stopped. In my opinion, the stories of people who have experienced clinical death are in most cases a myth or fiction. I have never heard such stories from patients of our medical institution. There were no such stories from colleagues either.

Moreover, people tend to call completely different conditions clinical death. Perhaps the people who supposedly suffered it did not actually die, they simply had syncope, that is, fainting.

The main cause that leads to clinical death (as well as, in fact, to death in general) remains cardiovascular diseases. Generally speaking, such statistics are not kept, but we must clearly understand that clinical death occurs first, and then biological death. Since the first place in mortality in Russia is occupied by heart and vascular diseases, it is logical to assume that they most often lead to clinical death.

Dmitry Yeletskov

anesthesiologist-resuscitator, Volgograd

One way or another, the phenomenon of near-death experiences deserves careful study. And it’s quite difficult for scientists, because in addition to the fact that it is necessary to establish which chemical processes in the brain lead to the appearance of certain hallucinations, it is also necessary to distinguish truth from fiction.

The main symptom of a heart attack is sharp pain in the chest, pain may radiate to left hand and shoulder or in the neck and jaw area. The cause of a heart attack can be coronary arterial disease, angina pectoris (angina pectoris) or a more serious condition - coronary thrombosis, in which the lumen of the coronary artery is completely closed. Complete obstruction of an artery means that the part of the heart muscle that received its blood supply from that artery can no longer function or be nourished—a condition called myocardial infarction. This can lead to cardiac arrest.

Pain in the area chest can usually be caused by physical exertion or emotional stress. In most cases, the pain lasts a few minutes and then subsides. As a rule, patients suffering from angina pectoris carry either a spray or nitroglycerin tablets, however, this medicine should be in the first aid kit to provide emergency assistance. If the attack is not stopped by nitroglycerin, then the same treatment should be carried out as for myocardial infarction.

It is better to treat patients suffering from angina with sedation, as this prevents the occurrence of stress during dental intervention. When conducting local anesthesia preference is given to prilocaine ( Citanest ) with felypressin instead of adrenaline.

The pain of myocardial infarction is much stronger and longer lasting than that of angina pectoris. Collapse and cardiac arrest may occur. Quite often, myocardial infarction is accompanied by nausea and vomiting, which can cause airway obstruction. The skin is pale, cold sticky sweat appears, the pulse is weak, blood pressure is reduced, and breathing is difficult.

Required actions;

- Call an ambulance. — Position the patient in a dental chair with the backrest raised. This makes breathing easier. — Make sure the airway is clear. - Keep the patient warm and immobile. — Prepare a saliva ejector and a vacuum cleaner in case of vomiting. — Be ready to begin resuscitation efforts and maintain vital functions. — If a device for inhalation anesthesia is available, use it! - This can help until the ambulance arrives - the patient is provided with sufficient oxygen, and nitrous oxide relieves pain. —Give the patient 300 mg tablets of soluble aspirin.

Cardiac arrest is the most serious complication of collapse. It may be a consequence of angina pectoris.

Signs of cardiac arrest:

sudden loss

bluish color

Call an ambulance immediately.

Begin and continue until the ambulance arrives with resuscitation actions aimed at maintaining vital body functions.

Stroke- a very severe form of collapse, which can be fatal. A stroke is caused by a sudden loss of blood supply to the brain due to a ruptured vessel or blockage by a blood clot. The very first symptom is acute headache, then partial paralysis and collapse may follow.

If this happens during dental treatment, then the patient must be brought into a horizontal position, loosen the collar, create access to oxygen and call an ambulance, and be ready to perform resuscitation.

Cardiac arrest: causes and consequences

Cardiac arrest is an extremely life-threatening condition. It often occurs suddenly even in young healthy people. What are the main causes of cardiac arrest and how can you help the victim?

Cardiac arrest is the complete cessation of effective cardiac activity.

To save the life of a person who has had a cardiac arrest, there are approximately 5-7 minutes. After this time, even if it is possible to resume cardiac activity, the consequences can be very serious, including complete disability.

Cardiac arrest: how to recognize

Cardiac arrest has fairly clear clinical symptoms, knowledge of which can allow timely implementation of emergency resuscitation measures.

After stopping, the heart stops pumping blood, which naturally causes the disappearance of the pulse in all large arteries. 10-20 seconds after the heart stops, a person loses consciousness, and after 30-60 seconds breathing disappears. During cardiac arrest, the pupils are wide and do not react to light, the skin of the face takes on a gray-blue color.

Remember, resuscitation measures should be carried out as early as possible, but nevertheless not before you are sure that in front of you there really is a person with cardiac arrest.

Options and causes of cardiac arrest

It is customary to identify several main causes of cardiac arrest.

Ventricular asystole . Absent during asystole electrical activity heart - a straight line is recorded on the monitor or ECG film. The cause of asystole can be any serious illness cardiovascular system, but more often it is severe myocardial infarction or pulmonary embolism. Other causes of asystole include: electrical trauma (including from a lightning strike), overdose of cardiac glycosides, intracardiac manipulation, anesthesia and serious metabolic disorders.
Ventricular fibrillation. The most common type of cardiac arrest: up to 90% of cases occur. With this pathology, individual muscle fibers of the ventricles of the heart begin to contract asynchronously and very quickly, which is a completely ineffective option from a hemodynamic point of view - the heart stops pumping blood. Rapid and erratic contraction quickly depletes the heart's reserves, and it stops all activity. The causes of fibrillation are similar to those presented above.
Electromechanical dissociation . A variant of stopping the mechanical activity of the heart while maintaining its electrical activity. This pathology occurs in severe metabolic disorders- hyperkalemia, acidosis, hypoxia, as well as hypothermia. strangulation, drowning, chest trauma (for example, with valvular pneumothorax), cardiac tamponade, overdose or inappropriate combination of certain cardiac drugs.

Cardiac arrest: consequences

Despite the fact that the spinal cord and brain together make up no more than 2-3% of body weight, they account for about 15% of cardiac output.

Existing regulatory processes make it possible to preserve the functions of the central nervous system at blood circulation levels up to 25% of normal, however indirect massage The heart pump, which is most often used when it stops, provides only 5% of the normal flow.

That is why the speed of restoration of normal heartbeat plays a key role: the sooner cardiac activity is resumed, the less likely it is to develop complications.

Among the consequences from the central nervous system are:

amnesia - memory impairment of various types (possible loss of all events preceding the injury or only partial loss of memory for events occurring immediately before cardiac arrest);
blindness - occurs due to damage to the visual part of the brain; in some cases, the function of the damaged part of the brain is taken over by other parts and vision is restored;
convulsions are fairly common consequences of cardiac arrest, usually convulsions are isolated in nature, for example, periodic repeated spasms of the limb or involuntary chewing movements;
hallucinations - may accompany seizures; visual, auditory and other types of hallucinations are possible.

The prognosis for cardiac arrest depends on the time elapsed from the moment of cardiac arrest to a successful outcome cardiopulmonary resuscitation. Thus, with a five-minute cardiac arrest and half-hour resuscitation, complete recovery after cardiac arrest is observed in approximately 50% of cases.

If the time of cardiac arrest exceeded 6 minutes, and resuscitation lasted longer than 15 minutes, the chances of restoring the person’s vital functions are extremely low.

Sudden death occurs in completely healthy people

According to the definition of the World Health Organization, sudden death includes cases of death of practically healthy individuals or patients whose condition was considered quite satisfactory. It is obvious that most people have certain health conditions that do not have a significant impact on daily life and do not reduce its quality. In other words, pathological changes on the part of organs and systems, if they exist in such people, they are persistently compensated in nature. Such representatives of humanity are classified as “virtually healthy.” It is in this group that the phenomenon that scientists call sudden death occurs most often. What is surprising in this phrase is not the second word (all people die sooner or later), but the first. Sudden is an unexpected death that occurs without any warning, in the midst of complete well-being. This catastrophe has so far defied any prediction. It has no precursors or signs that could alert doctors. Studying numerous, increasingly common, cases of sudden death, experts came to the conclusion that this event always has vascular causes, which allows it to be classified as a vascular catastrophe.

A major businessman with a typical Georgian surname, one of the heirs to the wealth of the collapsed Soviet Union, he had already endured all the hardships of the division of property and lived a healthy and correct life in London. He probably had enough money for a full-fledged medical examination, and personal doctors wouldn’t even let me in suspicious noise in the area of the heart. Death came suddenly and completely unexpectedly. He was a little over 50. An autopsy did not reveal any cause of death.

There are no accurate statistics on sudden death because there is no generally accepted definition of this concept. However, it is estimated that every 60-75 seconds in the United States, 1 person dies from unexpected cardiac arrest. The problem of sudden cardiac death, which has attracted the attention of cardiologists for many decades, has become acute again in recent years, when large population-based studies conducted by the World Health Organization demonstrated an increasing incidence of sudden death among adults, and not only adults. It turned out that cases of sudden death are not so rare, and this problem requires close study.

During a pathological examination (autopsy) of the deceased, as a rule, it is not possible to detect signs of damage to the heart or blood vessels that could explain the sudden stop of blood circulation. Another feature of sudden death is that if timely assistance is provided, such patients can be revived, and in practice this happens quite often. Typically, resuscitation is performed through artificial respiration and closed cardiac massage. Sometimes, to restore blood circulation, a punch to the chest, in the area of the heart, is enough. If a disaster occurs in a medical facility or in the presence of emergency doctors, then a high-voltage electric discharge is used to restore blood circulation - defibrillation.

Sudden death, which is based on pathological changes in the heart, is usually called sudden cardiac death. Cardiac causes account for the majority of sudden deaths. The basis for such a judgment is statistical data indicating that pathological changes in the heart are noted, even if the victim has never complained about his state of health. Atherosclerosis of the coronary arteries can be found in more than half of people who die as a result of sudden cessation of blood circulation. Scars on the heart muscle, which indicate a previous heart attack, and an increase in heart mass are found in 40-70% of cases.

Some obvious causes, such as fresh blood clots in the coronary arteries during sudden cardiac death, can be found extremely rarely. With careful examination (it is clear that all cases of sudden death serve as the basis for careful examination), it is almost always possible to detect some pathology. However, this does not make sudden death any less mysterious. After all, all changes in the heart and blood vessels exist and are formed long time, and death occurs suddenly and completely unexpectedly. Latest methods cardiovascular research ( ultrasound scanning, spiral computed tomography) detect the smallest changes in blood vessels and heart without any opening of the body. And these data show that certain changes can be found in almost all people who, fortunately, for the most part live well into old age.

Since in cases of sudden death no destruction of the cardiovascular system can be detected, it remains to be assumed that this catastrophe is associated with dysfunction, and not with a change in the structure of the heart. This assumption was confirmed with the development and introduction into clinical practice of methods for long-term monitoring of heart function ( ECG registration within hours and days). It became clear that sudden death most often (65-80%) is directly related to ventricular fibrillation.

Ventricular fibrillation is a very frequent (up to 200 or more per minute), erratic contraction of the ventricles of the heart - fluttering. Fluttering is not accompanied by effective contractions of the heart, so the latter ceases to perform its main, pumping function. Blood circulation stops and death occurs. Sudden ventricular tachycardia - an increase in contractions of the ventricles of the heart to 120-150 beats per minute - sharply increases the load on the myocardium, quickly depletes its reserves, which leads to cessation of blood circulation.

This is what a disruption of the normal rhythm into a state of ventricular flutter looks like on an electrocardiogram:

As a rule, flutter is followed by complete cardiac arrest due to depletion of its energy reserves. But fibrillation cannot be considered the cause of sudden death; rather, it is its mechanism.

It is generally accepted that the most important causative factor of sudden cardiac death is acute myocardial ischemia - a violation of the blood supply to the heart muscle caused by spasm or blockage of the coronary arteries. Exactly so: it is generally accepted, because nothing else comes to mind when experts consider the heart as an organ that consumes blood like an engine that consumes fuel. Indeed, oxygen starvation leads to disruptions in the ability of the heart muscle to contract and increases sensitivity to irritation, which contributes to rhythm disturbances. It was established that violations nervous regulation heart function (imbalance of autonomic tone) can lead to rhythm disruption. It is known for sure that stress contributes to the occurrence of arrhythmia - hormones change the excitability of the heart muscle. It is also known that a lack of potassium and magnesium has a significant effect on the functioning of the heart and, under certain conditions, can lead to heart failure. There is no doubt that some medicinal substances, toxic factors (for example, alcohol) can damage the conduction system of the heart or contribute to disorders contractility myocardium. But, despite the clarity of individual mechanisms of violations normal operation heart, many cases of sudden death are not satisfactorily explained. Let us recall the regularly recurring cases of death of young athletes.

24-year-old French tennis player Mathieu Moncur, who was found dead in his apartment in the suburbs of Paris on the night of Tuesday July 7, 2008, died of cardiac arrest.

As a rule, this group of trained, physically well-developed young people has fairly good medical supervision. It is unlikely that among professional athletes who have managed to achieve extraordinary success through their physical efforts, there are people suffering from serious diseases of the heart and blood vessels. It's even harder to imagine coronary insufficiency in people who regularly undergo enormous physical activity. The relatively high statistics of sudden death among athletes can only be explained by obvious overload or the use of pharmacological agents that increase physical endurance (doping). According to statistics, in young people sudden death is most often associated with sports (about 20%) or occurs during sleep (30%). The high incidence of cardiac arrest during sleep convincingly refutes the coronary nature of sudden death. If not in all cases, then in a significant part of them. Comes during sleep physiological changes rhythm, which are characterized by bradycardia - a decrease in heart rate to 55-60 beats per minute. In trained athletes this frequency is even lower.

V. Turchinsky is an outstanding athlete and simply a beautiful person who promotes and leads healthy image life, suddenly falls and dies before reaching 50 years of age.

Several newspaper lines are awarded to famous athletes, politicians, and artists who suddenly died. But many such disasters also happen to ordinary people who are not written about in the newspapers.

- He was completely healthy! – shocked relatives and friends are amazed for several days. But the inexorable convincingness of what happened soon makes one believe the facts: if he died, it means he was sick.

Sudden death significantly more often overtakes another category of patients - people suffering mental illness. Researchers associate this phenomenon with the use psychotropic drugs, most of which affect the conduction system of the heart.

It is known that alcoholics are susceptible to sudden death. Everything is more or less clear here: ethanol destroys the myocardium and conduction system of the heart. One day, deprived of energy and rhythmic control, the heart simply stops after another binge.

It would seem that now the circle of victims is defined: the risk group consists of people with heart diseases that do not manifest themselves until a certain time, athletes for whom physical overload is part of their lifestyle, numerous representatives of the population who abuse alcohol or drugs.

But in this series, cases of death of young children stand apart - sudden infant mortality syndrome. British scientists who studied 325 such cases came to the conclusion that most often the danger occurs in the 13th week of life. Almost always, the death of an infant occurs during sleep; More often this happens in the cold season and when the baby is lying on his stomach. Some researchers associate sudden death of infants with odors (perfumes, tobacco smoke).

Despite the clarity of the connection between risk factors and tragic cases of sudden death, the majority of people who died suddenly never had these factors. Sudden death has become a habit of visiting completely healthy people.

Other articles by Professor Shirokov E.A.

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Causes of sudden cardiac arrest

The immediate cause of most sudden cardiac arrests is an abnormal heart rhythm. The electrical activity of the heart becomes chaotic, making it impossible to pump blood to the rest of the body.

Conditions that can cause sudden cardiac arrest include:

1. Coronary heart disease. This is the most common reason sudden cardiac arrest in people over 35 years of age

2. Cardiomyopathy. If you have this disease then the heart muscle becomes enlarged or thickened and therefore weakened

3. Long QT syndrome and Brugada syndrome. These disturbances in the heart's electrical system can cause abnormal heart rhythms

4. Marfan syndrome. This hereditary disease may cause some parts of the heart to possibly stretch and become weakened

5. Problems with the structure of the heart that are present at birth. Even if you had surgery to correct a birth defect, you are still at risk and in danger

Other things that can increase your chances of cardiac arrest include:

1. Being male

2. Age - the risk is higher in men after 45 years and in women after 55 years

3. Previous cardiac arrest or heart attack

4. Heredity or presence of cardiovascular diseases

What to do?

If you quickly and promptly provide help to a person, then he will certainly survive. Cardiopulmonary resuscitation should begin immediately and, of course, an automated external defibrillator should be activated and used for several minutes. Every second counts.

An ambulance should be called if you have symptoms such as:

1. Chest pain

2. Discomfort in one or both arms, back, neck, or jaw

3. Unexplained shortness of breath

If you notice a person showing signs of sudden cardiac arrest, call 911 immediately or have someone call you. Be calm if the person is able to respond to you. Start artificial respiration immediately if he is unconscious and not breathing. If the person begins to breathe, you can stop and wait for an emergency medical care.

While you perform CPR, have someone find an automated external defibrillator and use it immediately. AED is portable device which sends electric current through the chest to the heart when necessary. The current can restore normal heart rhythm. AEDs are available in many public places, such as shopping centers, airports, hotels and schools.

If you are at risk, you need to talk to your doctor. There are steps you can take to reduce your risk of cardiac arrest. Your doctor may recommend medications, surgery, lifestyle changes, or other treatments.

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Causes of cardiac arrest

Such a dangerous condition can occur due to heart disease, and then it is called sudden cardiac death, or diseases of other organs.

1. Cardiac (heart) diseases that can lead to cardiac arrest are its cause in 90% of all cases. These include:

- life-threatening disorders heart rate– paroxysmal ventricular tachycardia, frequent ventricular extrasystole, ventricular asystole (lack of contractions), electromechanical dissociation of the ventricles (single non-productive contractions),
- Brugada syndrome,
- coronary heart disease - about half of patients with ischemic heart disease experience sudden cardiac death,
- acute myocardial infarction, especially with developed complete blockade of the left bundle branch,
- pulmonary embolism,
- rupture of aortic aneurysm,
- acute heart failure,
- cardiogenic and arrhythmogenic shock.

2. Risk factors that increase the likelihood of sudden cardiac arrest in persons with existing cardiovascular diseases:

- age over 50 years, although cardiac arrest can also develop in young people,
- smoking,
- alcohol abuse,
— overweight,
- excessive physical activity,
- overwork,
- strong emotional experiences,
- arterial hypertension,
— diabetes mellitus,
- increased cholesterol in the blood.

3. Extracardiac (non-cardiac) diseases:

- severe chronic diseases late stages (oncological processes, respiratory diseases, etc.), natural old age,
- asphyxia, suffocation as a result of foreign body entering the upper respiratory tract,
- traumatic, anaphylactic, burn and other types of shock,
- poisoning with medications, drugs and alcohol substitutes,
- drowning, violent causes of death, injuries, severe burns, etc.

4. Special attention deserves sudden infant death syndrome (SIDS), or the death of an infant “in the cradle.” This is the death of a child under the age of one year, usually around 2–4 months, caused by cardiac arrest and breathing at night during sleep, without any previous serious problems health problems that can lead to death. Factors that increase the risk of sudden infant death include:

- position during night sleep on the stomach,
- sleeping on a bed that is too soft, on fluffy linen,
- sleep in a stuffy, hot room,
- mother's smoking
- prematurity, premature birth with low fetal weight,
- multiple pregnancy,
- intrauterine hypoxia and fetal growth retardation,
- family predisposition if other children in the same family died for the same reason,
— past infections in the first months of life.

Symptoms of cardiac arrest

Sudden cardiac death develops against the background of general wellness or slight subjective discomfort. A person can sleep, eat, or go to work. Suddenly he feels bad, he grabs his left chest with his hand, loses consciousness and falls. The following signs distinguish cardiac arrest from ordinary loss of consciousness:

— no pulse on the carotid arteries in the neck or on the femoral arteries in the groin,
— lack of breathing or agonal type of respiratory movements for several seconds after cardiac arrest (no more than two minutes) - rare, short, convulsive, wheezing sighs,
— lack of pupillary response to light, normally the pupil constricts when light enters it,
— severe pallor of the skin with the appearance of a bluish discoloration on the lips, face, ears, limbs or throughout the body.

It roughly looks like this: a person fell unconscious, not responding to shouts or braking, turned pale and blue, wheezed and stopped breathing. After 6–7 minutes, biological death will develop. If a person's heart stops in his sleep, he appears to be sleeping peacefully until he discovers that he cannot be awakened.

The second option is more unfavorable, since others may mistakenly believe that the person is simply sleeping, and, accordingly, do not consider it necessary to take any measures to save the person’s life. The same thing happens with small children, whose mothers see that the child is sleeping peacefully in his crib, while biological death has already occurred.

Diagnostics

About 2/3 of all cases of cardiac arrest occur outside the walls of medical institutions, that is, in everyday life. Therefore, witnesses to such a dangerous condition are in most cases ordinary people, not directly related to medicine. However, anyone should know how to recognize cardiac arrest and what measures to take. By doing this, you may save the life not only of your relative, but also of a stranger on the street.

If you see that a person has lost consciousness, you need to conduct a quick examination:

- Lightly hit him on the cheeks, call out loudly, shake him by the shoulder, and evaluate whether he reacts to it. It is quite possible that the person simply fainted.

- It should be assessed whether there is an independent normal breathing, to do this, simply put your ear to the chest and listen to whether he is breathing, or bring your cheek to the patient’s nostrils, after throwing his head back and extending his jaw, in order to feel or hear his breathing, or see the movements of the chest. You should not waste precious time looking for a mirror in order to put it to the victim’s lips and see if it fogs up from the air exhaled from the patient’s mouth, as indicated in some manuals for providing first aid.

- Feel the carotid artery in the neck between the angle of the lower jaw, larynx and neck muscle or femoral artery in the groin. If there is no pulse, begin chest compressions. You should not waste time looking for peripheral arteries in the wrist; a reliable criterion for cardiac arrest is the absence of a pulse only in the large arteries.

All actions must be carried out clearly, smoothly and quickly. Assessment of the severity of the condition and initiation of resuscitation measures should be carried out within 15 – 20 seconds. At the same time, you need to call for help and ask the people present nearby to call ambulance by phone "03".

First aid and treatment

Providing first emergency first aid in case of cardiac arrest

The victim is placed on a hard surface. After establishing the fact of cardiac arrest, you must immediately begin resuscitation measures according to the ABC algorithm:

— A ( air open the way)– restoration of airway patency. To do this, the person providing assistance needs to wrap a piece of cloth around the finger and push it out. lower jaw the victim forward, tilting his head back and try to eliminate possible foreign bodies in the oral cavity (vomit, mucus, remove a sunken tongue, etc.).

— B (breath support)- artificial ventilation of the lungs using the “mouth to mouth” or “mouth to nose” method. With the first technique, you should pinch the patient's nose with two fingers and start blowing air into it. oral cavity, monitoring the effectiveness by movements of the chest - raising the ribs when filling with air and lowering when the patient passively “exhales”. It is acceptable to use a thin napkin or handkerchief placed on the victim’s lips to exclude direct contact with his saliva. According to the latest recommendations, the person providing assistance has the right not to contact biological fluids the victim, such as saliva, blood in the oral cavity, in order to avoid harm to the health of the person providing assistance, for example, the threat of infection with tuberculosis, HIV infection in the presence of blood in the oral cavity, etc. Moreover, for the brain it is more important to quickly provide blood access to its vessels using heart massage than to start ventilation of the lungs.

— With (circulation support)– closed cardiac massage. Before starting a cardiac massage, specialists apply a precordial blow to the sternum with a fist from a distance of 20–30 cm. However, it is effective only during the first 30 seconds from the moment the heart stops and is dangerous for breaking the ribs and sternum. Therefore, it is better not to deliver a precordial blow to a person who is not a physician. Moreover, Western resuscitation doctors believe that a shock is useful only in case of ventricular fibrillation, and in case of asystole it can be dangerous.

Heart massage carried out like this. Need to be visually determined lower third sternum, measuring the distance two transverse fingers above its lower edge, clasp the fingers of the hands in a lock, placing one hand on top of the other, place the straightened hands on the found third of the sternum and begin rhythmic compression of the chest with a frequency of 100 per minute. If there is one resuscitator, the frequency of compressions on the sternum and the frequency of air blowing into the lungs is 15:2, and if there are two resuscitators - 5:1. IN the latter case The resuscitator performing compressions on the sternum should count the number of compressions out loud, after every fifth - the first resuscitator performs one air injection.

Important: the arms should be kept straight, and compression should be applied in such a way as to avoid accidental fracture of the ribs, as this negatively affects intrathoracic pressure, which has a decisive role in the effectiveness of cardiac massage. To increase passive flow to the heart, bend at the groin lower limbs can be raised 30 - 40° above the surface.

The described measures continue until a pulse appears in the carotid arteries, spontaneous breathing appears, or until the patient comes to his senses. If this does not happen, the victim should continue to be resuscitated until the ambulance arrives or within 30 minutes, since after this time biological death occurs.

Medical care for cardiac arrest

Upon arrival of the medical team, an introduction is carried out medicines(adrenaline, norepinephrine, atropine, etc.), taking an electrocardiogram or diagnosing heart contractions using a monitor when applying defibrillator electrodes and performing defibrillation - an electrical discharge in order to start and restore the heart rhythm. The activities carried out end up in the ambulance on the way to the intensive care unit of the hospital.

Further lifestyle

A patient who has suffered cardiac arrest and survived must remain in intensive care for some time and then be carefully examined in the cardiology department of the hospital. At this time, the cause that caused the cardiac arrest is established, the optimal treatment is selected to prevent a recurrence of this condition, and the issue of the need for implantation of an artificial pacemaker in the presence of cardiac arrhythmias is also decided.

After discharge from the hospital, the patient must be careful in everyday life - give up bad habits, eat right, avoid stress and excessive physical activity, and constantly take medications prescribed by the doctor.

To prevent sudden infant death syndrome, parents infant must fulfill the following recommendations- put the baby to sleep at night in a well-ventilated room, on a bed with a firm mattress, without pillows, duvets and without toys in the crib. You should not swaddle your baby tightly at night, as this restricts his movements, prevents him from taking a comfortable position during sleep, and prevents him from waking up when breathing stops during sleep (sleep apnea). You should not put your baby to sleep on his stomach. Some experts are confident that co-sleeping significantly reduces the risk of death in the cradle, since the baby feels his mother nearby, and tactile sensations on the skin have a beneficial effect on his respiratory and cardiovascular centers in the brain. Of course, parents should not smoke, drink alcohol or use drugs, so as not to lose vigilance and sensitivity during the baby's night sleep.

Complications of cardiac arrest

The possibility of developing consequences after cardiac arrest depends on the time during which the brain was in a state acute shortage oxygen. So, if recovery vital functions was carried out within the first 3.5 minutes, the functions and subsequent activity of the brain will most likely not be affected. In the case of a longer period of brain hypoxia (6 - 7 minutes or more), neurological symptoms may develop, from mild degree to severe brain damage in post-resuscitation illness.

TO lung disorders and moderate degrees include memory loss, decreased vision and hearing, persistent headaches, convulsive syndrome, hallucinations.

Post-resuscitation illness develops in 75–80% of cases of successful resuscitation after cardiac arrest. In 70% of patients with this disease, there is an absence of consciousness for no more than 3 hours, and then complete restoration of consciousness and mental functions. Some patients experience severe brain damage, coma and subsequent vegetative state.

Forecast

The prognosis for cardiac arrest is unfavorable, since about 30% of patients survive, and only in 10% is it possible to fully restore body functions without adverse consequences.

The patient's chances of survival are significantly increased if first aid is provided in a timely manner and cardiac activity is restored within the first three minutes after cardiac arrest.

General practitioner Sazykina O.Yu.

www.medicalj.ru

Reasons

Cardiac arrest is associated with diseases of the heart and other human organs. In this case, sudden death occurs. The causes of cardiac arrest can be different.

Heart (cardiac) diseases: disturbances in the rhythm of heart contractions, coronary artery disease, thromboembolism, myocardial infarction, Brugada syndrome, rupture of aortic aneurysm, heart failure.
Factors that increase the likelihood of cardiac arrest in people with heart and vascular diseases: old age, abuse of bad habits, overweight, stress and overwork, intense physical activity, hypertension, high blood sugar and cholesterol.
Extracardiac (extracardiac) diseases: severe chronic diseases, asphyxia, anaphylactic, post-traumatic and burn shock, acute poisoning, violent influence.

In some cases, cardiac arrest occurs in the fetus while still in the womb. Fetal death occurs under the influence of several factors.

Insufficient oxygen supply. Most often this occurs in the presence of concomitant cardiovascular diseases of the mother. Lack of oxygen in the fetus can also develop with tuberculosis, emphysema, pneumonia, and signs of anemia.
Insufficient blood flow. The problem arises when the knots on the umbilical cord are tightened during childbirth, as well as during intrauterine development of the fetus. Cardiac arrest and fetal death can occur due to placental abruption or uterine convulsions.
Dysfunction of the fetal central nervous system. Asphyxia occurs due to skull injuries (compression, cerebral edema, fetal development abnormalities).
Airway obstruction in the fetus. If amniotic fluid or mucus comes into contact with cervical canal into the oral cavity of the fetus, asphyxia develops, leading to cardiac arrest of the child.

Much attention should be paid to sudden infant death syndrome (SIDS). Cardiac arrest in children aged 2-4 months (not older than one year) and death during sleep without visible reasons And serious illnesses. Risk factors for SIDS include: fetal hypoxia, multiple pregnancies, prematurity, bad habits mothers, a soft baby bed with a pillow, incorrect body position during sleep, past infectious diseases.

According to research, up to 90% of cases of cardiac arrest are associated with ventricular fibrillation, in which muscle fibers begin to contract in a chaotic manner. The second most important cause of sudden cardiac arrest is considered to be ventricular asystole (complete cessation of myocardial activity).

Warning signs

The clinical manifestation of cardiac arrest occurs with a deterioration in general health. The syndrome occurs suddenly, the patient loses consciousness. At the same time, there are following symptoms cardiac arrest:

absence of pulse in large arteries (neck, thigh, groin area);
complete cessation of breathing or signs of agonal (death) noisy breathing for two minutes;
pallor and blueness of the skin;
the appearance of convulsions (15-30 seconds after loss of consciousness);
dilation of the pupils when exposed to light (after two minutes).

After 6-7 minutes, in the absence of assistance to the victim, biological death occurs.

Diagnostics

Sudden cardiac arrest must be diagnosed immediately, because the patient is in emergency condition. Most often, trouble happens outside of hospital settings, so every person should know how to assess the condition of the victim and how to provide first aid.

First of all, a quick external examination of the unconscious person is performed. It is necessary to find out whether there was a simple fainting. By shaking the shoulder and lightly hitting the cheeks, you can determine whether the victim is conscious. If there are no signs of fainting and the person is still unconscious, then it is necessary to check his breathing. The pulse in the carotid artery is also felt. If there is no breathing or pulse, you must immediately begin chest compressions. At the same time, an ambulance is called.

In a hospital setting, cardiac arrest can be diagnosed during an external examination of the patient, as well as using an electrocardiogram (ECG). The ECG machine records the absence of cardiac activity.

Depending on the examination results, the following types of cardiac arrest are distinguished:

asystole (straight line on the ECG, most often in diastole);
ventricular fibrillation (uncoordinated contraction of muscle fibers);
electromechanical dissociation - ineffective heart (single peaks on the ECG, lack of myocardial contraction).

First aid and treatment

Sudden cardiac arrest requires immediate assistance to the victim; any delay will cause his death. To do this, a person lies down on a hard, flat surface, and the following actions are performed:

push the victim’s lower jaw forward, throw his head back, and try to eliminate everything with a finger wrapped in a cloth. foreign objects in the mouth (sunken tongue, mucus, vomiting);
artificial ventilation (mouth-to-mouth or mouth-to-nose method);
indirect cardiac massage, starting with a precordial blow to the chest area (such a blow is contraindicated when assisted by an unqualified specialist).

For massage, the lower part of the chest is determined (at a distance of two fingers above the lower edge of the sternum), the fingers are crossed in a lock. Rhythmic pressure is applied to the chest with a frequency of 100 compressions in 60 seconds. After every fifth pressure, air is blown into the victim. Throughout the massage, the arms remain straight, and the pressure force should not be too great, the patient’s legs are raised 30-400 from the floor.

First aid is provided until the victim exhibits a pulse and spontaneous breathing. If the person does not regain consciousness, then resuscitation measures continue until the ambulance arrives.

To restore heart rhythm, doctors use pulse therapy(defibrillation), mechanical artificial respiration and admission pure oxygen through an endotracheal tube or oxygen mask.

To urgent medications These include drugs to improve the conduction of impulses, increase the number of heart contractions, and drugs for arrhythmia.

Surgical intervention for cardiac arrest consists of collecting fluid from the pericardium (in case of cardiac tamponade), and puncture pleural cavity(in the presence of pneumothorax).

Cardiac arrest is the complete cessation of effective cardiac activity.

Cardiac arrest: how to recognize

Cardiac arrest has fairly clear clinical symptoms, knowledge of which can allow urgent resuscitation measures to be carried out in a timely manner.

Remember, resuscitation measures should be carried out as early as possible, but nevertheless not before you are sure that in front of you there really is a person with cardiac arrest.

Options and causes of cardiac arrest

It is customary to identify several main causes of cardiac arrest.

Ventricular asystole. During asystole, there is no electrical activity of the heart—a straight line is recorded on the monitor or ECG film. The cause of asystole can be any serious disease of the cardiovascular system, but more often it is pulmonary embolism. Other causes of asystole include: electrical trauma (including from a lightning strike), overdose of cardiac glycosides, intracardiac manipulation, anesthesia and serious metabolic disorders.
Ventricular fibrillation. The most common type of cardiac arrest: up to 90% of cases occur. With this pathology, individual muscle fibers of the ventricles of the heart begin to contract asynchronously and very quickly, which is a completely ineffective option from a hemodynamic point of view - the heart stops pumping blood. Rapid and erratic contraction quickly depletes the heart's reserves, and it stops all activity. The causes of fibrillation are similar to those presented above.
Electromechanical dissociation. A variant of stopping the mechanical activity of the heart while maintaining its electrical activity. This pathology occurs in severe metabolic disorders - hyperkalemia, acidosis, hypoxia, as well as in cases of suffocation, drowning, chest trauma (for example, valvular pneumothorax), cardiac tamponade, overdose or an unacceptable combination of a number of cardiac drugs.

Cardiac arrest: consequences

Despite the fact that the spinal cord and brain together make up no more than 2-3% of body weight, they account for about 15% of cardiac output.

Existing regulatory processes make it possible to preserve the functions of the central nervous system at a blood circulation level of up to 25% of normal, but chest compressions, which are most often used when it stops, provide only 5% of normal flow.

That is why the speed of restoration of normal heartbeat plays a key role: the sooner cardiac activity is resumed, the less likely it is to develop complications.

Among the consequences from the central nervous system are:

amnesia - memory impairment of various types (possible loss of all events preceding the injury or only partial loss of memory for events occurring immediately before cardiac arrest);
blindness - occurs due to damage to the visual part of the brain; in some cases, the function of the damaged part of the brain is taken over by other parts and vision is restored;
convulsions are fairly common consequences of cardiac arrest, usually convulsions are isolated in nature, for example, periodic repeated spasms of the limb or involuntary chewing movements;
hallucinations - may accompany seizures; visual, auditory and other types of hallucinations are possible.

The prognosis for cardiac arrest depends on the time elapsed from the moment of cardiac arrest to the successful outcome of cardiopulmonary resuscitation. Thus, with a five-minute cardiac arrest and half-hour resuscitation, complete recovery after cardiac arrest is observed in approximately 50% of cases.

If the time of cardiac arrest exceeded 6 minutes, and resuscitation lasted longer than 15 minutes, the chances of restoring the person’s vital functions are extremely low.