Otitis

Acute coronary insufficiency, sudden death. Death from heart attack - types, symptoms, signs

At all times, people have been interested in: why does a person die? In fact, this is quite an interesting question, to answer which we can consider several theories that can shed light on this situation. There are many different opinions on this topic, but in order to understand what death is and why a person is susceptible to it, it is necessary to uncover the mystery of old age. At the moment, a large number of scientists are struggling to solve this problem; completely different theories are being put forward, each of which, one way or another, has the right to life. But, unfortunately, none of these theories have been proven at the moment, and this is unlikely to happen in the near future.

Theories related to aging

As for opinions on the question “Why does a person die?”, they are all as diverse as they are similar. What these theories have in common is that natural death always comes with old age. A certain circle of scientists is of the opinion that old age as such begins at the moment of the emergence of life. In other words, as soon as a person is born, the invisible clock begins its reverse, and when the dial goes to zero, the person’s presence in this world will also cease.

There is an opinion that until a person reaches maturity, all processes in the body proceed in the active stage, and after this moment they begin to fade away, along with this the number of active cells decreases, which is why the aging process occurs.

As for immunologists and some gerontologists who tried to find an answer to the question “Why does a person die?”, then, from their point of view, with age, autoimmune phenomena intensify in a person against the background of a decrease in the reaction of cells, which, in essence, leads to that the body’s immune system begins to “attack” its own cells.

Genetics, naturally, say that the whole problem lies in genes, while doctors argue that human death is inevitable due to body defects that accumulate throughout a person’s life.

Law of nature

Thanks to scientists from the USA who conducted research on this issue, it became known that people die while in the “kingdom of Morpheus”, mainly due to respiratory arrest. This occurs mainly in older people due to the loss of cells that control the breathing process, sending signals to the body to contract the lungs. In principle, such a problem can occur among a lot of people, its name is obstructive apnea, and this problem is the main one. But there cannot be such a cause of death as obstructive apnea. This is due to the fact that a person experiencing oxygen starvation (lack of oxygen) wakes up. And the cause of death is central sleep apnea. It should be noted that a person may even wake up, but still die due to lack of oxygen, which will result from a stroke or cardiac arrest. But, as mentioned earlier, this disease mainly affects older people. But there are also those who die before reaching old age. Therefore, a very reasonable question arises: why do people die young?

Death of the Young

It’s worth starting with the fact that recently, approximately 16 million girls in the age category from 15 to 19 years have become pregnant. At the same time, the risks of infant death are much higher than those of those girls who crossed the 19-year-old barrier. These problems are caused by both physiological and psychological factors.

Not the least reason is poor nutrition, and this is due to both obesity and problems associated with anorexia.

Smoking. Drugs. Alcohol

As for bad habits, such as abuse of alcohol, nicotine, and even more so drugs, this problem every year affects younger and younger segments of the population, who not only put their future children at risk, but also themselves.

Still, the most common cause of death among the young population is unintentional injuries. The reason for this can also be alcohol and drugs, not counting youthful maximalism, which cannot be discounted. Therefore, until teenagers reach adulthood, all responsibility for moral and psychological education lies entirely with the parents.

How does a person feel at the moment of death?

In fact, the question of a person’s feelings after death has worried all of humanity throughout its existence, but only recently have they begun to say with confidence that all people at the moment of death experience definitely the same feelings. This became known thanks to people who experienced clinical death. Most of them claimed that even lying on the operating table, being immobilized, they continued to hear and sometimes see everything that was happening around them. This is possible due to the fact that the brain is the last to die, and this happens mainly due to lack of oxygen. Of course, there are stories about a tunnel at the end of which there is a bright light, but there is virtually no reliability of this particular information.

In conclusion

Having delved into the problem and understood it, we can confidently answer the question: why does a person die? Quite often people ask themselves similar questions, but you shouldn’t devote your entire life to the problem of death, because it is so short that there is no time to spend it on understanding those problems for which humanity is not yet ready.

According to the definition of the World Health Organization, sudden death refers to deaths that occur within 6 hours against the background of the appearance of symptoms of a cardiac disorder in practically healthy people or in people who already suffered from it, but their condition was considered satisfactory. Due to the fact that such death in almost 90% of cases occurs in patients with symptoms, the term “sudden coronary death” was introduced to designate the causes.

Such deaths always occur unexpectedly and do not depend on whether the deceased previously had cardiac pathologies. They are caused by disturbances in ventricular contraction. An autopsy does not reveal diseases of internal organs in such persons that could cause death. When examining the coronary vessels, approximately 95% are diagnosed with narrowings caused by atherosclerotic plaques, which could provoke life-threatening complications. Newly occurring thrombotic occlusions that can impair cardiac activity are observed in 10-15% of victims.

Vivid examples of sudden coronary death can be the deaths of famous people. The first example is the death of a famous French tennis player. The death occurred at night, and a 24-year-old man was found in his own apartment. An autopsy revealed cardiac arrest. The athlete had not previously suffered from diseases of this organ, and other causes of death could not be determined. The second example is the death of a major businessman from Georgia. He was a little over 50, he always bravely endured all the difficulties of business and personal life, moved to live in London, was regularly examined and led a healthy lifestyle. The death occurred completely suddenly and unexpectedly, against the background of complete health. After an autopsy of the man's body, the causes that could have led to his death were not discovered.

There are no exact statistics on sudden coronary death. According to WHO, it occurs in approximately 30 people per 1 million population. Observations show that it occurs more often in men, and the average age for this condition ranges from 60 years. In this article we will introduce you to the causes, possible warning signs, symptoms, methods of providing emergency care and preventing sudden coronary death.

Immediate causes

The cause of 3-4 out of 5 cases of sudden coronary death is ventricular fibrillation.

In 65-80% of cases, sudden coronary death is caused by primary death, in which these parts of the heart begin to contract very often and randomly (from 200 to 300-600 beats per minute). Due to this rhythm disturbance, the heart cannot pump blood, and the cessation of blood circulation causes death.

In approximately 20-30% of cases, sudden coronary death is caused by bradyarrhythmia or ventricular asystole. Such rhythm disturbances also cause severe disturbances in blood circulation, which can lead to death.

In approximately 5-10% of cases, sudden death is provoked. With this rhythm disturbance, these chambers of the heart contract at a speed of 120-150 beats per minute. This provokes a significant overload of the myocardium, and its depletion causes circulatory arrest with subsequent death.

Risk factors

The likelihood of sudden coronary death may increase due to some major and minor factors.

Main factors:

previously transferred ;
previous severe ventricular tachycardia or cardiac arrest;
decrease in left ventricular ejection fraction (less than 40%);
episodes of unsustained ventricular tachycardia or ventricular extrasystole;
cases of loss of consciousness.

Minor factors:

smoking;
alcoholism;
obesity;
frequent and intense stressful situations;
rapid pulse (more than 90 beats per minute);
increased tone of the sympathetic nervous system, manifested by hypertension, dilated pupils and dry skin);
diabetes mellitus

Any of the above conditions can increase the risk of sudden death. When several factors are combined, the risk of death increases significantly.

At-risk groups

Patients at risk include:

those who underwent intensive care for ventricular fibrillation;
suffering from ;
with electrical instability of the left ventricle;
with severe left ventricular hypertrophy;
with myocardial ischemia.

What diseases and conditions most often cause sudden coronary death?

Most often, sudden coronary death occurs in the presence of the following diseases and conditions:

hypertrophic;
dilated cardiomyopathy;
arrhythmogenic dysplasia of the right ventricle;
aortic stenosis;
coronary artery anomalies;
(WPW);
Burgad's syndrome;
“athletic heart”;
aortic aneurysm dissection;
TELA;
idiopathic ventricular tachycardia;
long QT syndrome;
cocaine intoxication;
taking medications that can cause arrhythmia;
severe disturbance of the electrolyte balance of calcium, potassium, magnesium and sodium;
congenital divercula of the left ventricle;
neoplasms of the heart;
sarcoidosis;
amyloidosis;
obstructive sleep apnea (stopping breathing during sleep).

Forms of sudden coronary death

Sudden coronary death can be:

clinical – accompanied by a lack of breathing, blood circulation and consciousness, but the patient can be resuscitated;
biological - accompanied by a lack of breathing, blood circulation and consciousness, but the victim can no longer be resuscitated.

Depending on the speed of onset, sudden coronary death can be:

instantaneous - death occurs in a few seconds;
fast - death occurs within 1 hour.

According to the observations of specialists, instantaneous sudden coronary death occurs in almost every fourth person who died as a result of such a fatal outcome.

Symptoms

Harbingers

In some cases, 1-2 weeks before sudden death, so-called precursors occur: fatigue, sleep disturbances and some other symptoms

Sudden coronary death rarely occurs in people without heart pathologies and most often in such cases is not accompanied by any signs of deterioration in general health. Such symptoms may not appear in many patients with coronary diseases. However, in some cases, the following signs may become harbingers of sudden death:

increased fatigue;
sleep disorders;
sensations of pressure or pain of a squeezing or oppressive nature behind the sternum;
increased feeling of suffocation;
heaviness in the shoulders;
increased or slow heart rate;
cyanosis.

Most often, the warning signs of sudden coronary death are felt by patients who have already suffered a myocardial infarction. They can appear within 1-2 weeks, expressed both in a general deterioration in well-being and in signs of angiotic pain. In other cases, they are observed much less frequently or are absent altogether.

Main symptoms

Typically, the occurrence of such a condition is in no way connected with previous increased psycho-emotional or physical stress. When sudden coronary death occurs, a person loses consciousness, his breathing first becomes frequent and noisy, and then slows down. The dying person has convulsions and the pulse disappears.

After 1-2 minutes, breathing stops, the pupils dilate and stop responding to light. Irreversible changes in the brain during sudden coronary death occur 3 minutes after the cessation of blood circulation.

Diagnostic measures when the above-described signs appear should be carried out in the very first seconds of their appearance, because In the absence of such measures, there may be no time to resuscitate a dying person.

To identify signs of sudden coronary death, you must:

make sure there is no pulse in the carotid artery;
check consciousness - the victim will not respond to pinches or blows to the face;
make sure that the pupils do not react to light - they will be dilated, but will not increase in diameter under the influence of light;
– when death occurs, it will not be determined.

Even the presence of the first three diagnostic data described above will indicate the onset of clinical sudden coronary death. If they are detected, it is necessary to begin urgent resuscitation measures.

In almost 60% of cases, such deaths do not occur in a medical institution, but at home, at work and other places. This greatly complicates the timely detection of such a condition and the provision of first aid to the victim.

Urgent Care

Resuscitation should be carried out within the first 3-5 minutes after identifying signs of clinical sudden death. To do this you need:

Call an ambulance if the patient is not in a medical facility.
Restore airway patency. The victim should be laid on a hard horizontal surface, tilt his head back and extend his lower jaw. Next, you need to open his mouth and make sure there are no objects interfering with breathing. If necessary, remove vomit with a tissue and remove the tongue if it blocks the airway.
Start mouth-to-mouth artificial respiration or mechanical ventilation (if the patient is in a hospital setting).
Restore blood circulation. This is done in a medical facility. If the patient is not in the hospital, then first a precordial blow should be applied - a blow with a fist to a point in the middle of the sternum. After this, you can begin indirect cardiac massage. Place the palm of one hand on the sternum, cover it with the other palm and begin pressing the chest. If performed by one person, then for every 15 pressures you should take 2 breaths. If 2 people are involved in saving the patient, then take 1 breath for every 5 pressures.

Every 3 minutes it is necessary to check the effectiveness of emergency aid - the reaction of the pupils to light, the presence of breathing and pulse. If the reaction of the pupils to light is determined, but breathing does not appear, then resuscitation measures should be continued until the ambulance arrives. Restoring breathing may become a reason to stop chest compressions and artificial respiration, since the appearance of oxygen in the blood promotes activation of the brain.

After successful resuscitation, the patient is hospitalized in a specialized cardiac intensive care unit or cardiology department. In a hospital setting, specialists will be able to determine the causes of sudden coronary death and draw up a plan for effective treatment and prevention.

Possible complications in survivors

Even with successful cardiopulmonary resuscitation, survivors of sudden coronary death may experience the following complications of this condition:

chest injuries due to resuscitation;
serious deviations in brain activity due to the death of some of its areas;
disorders of blood circulation and heart function.

It is impossible to predict the possibility and severity of complications after sudden death. Their appearance depends not only on the quality of cardiopulmonary resuscitation, but also on the individual characteristics of the patient’s body.

How to avoid sudden coronary death

One of the most important measures to prevent sudden coronary death is giving up bad habits, in particular smoking.

The main measures to prevent the occurrence of such deaths are aimed at the timely identification and treatment of people suffering from cardiovascular diseases, and social work with the population aimed at familiarizing them with the groups and risk factors for such deaths.

Patients who are at risk of sudden coronary death are recommended to:

Timely visit to the doctor and implementation of all his recommendations for treatment, prevention and clinical observation.
Quitting bad habits.
Proper nutrition.
Fighting stress.
Optimal work and rest regime.
Compliance with recommendations on maximum permissible physical activity.

Patients at risk and their relatives must be informed about the likelihood of such a complication of the disease as sudden coronary death. This information will make the patient more attentive to his health, and those around him will be able to master the skills of cardiopulmonary resuscitation and will be ready to perform such activities.

calcium channel blockers;
antioxidants;
Omega-3, etc.

implantation of a cardioverter-defibrillator;
radiofrequency ablation of ventricular arrhythmias;
operations to restore normal coronary circulation: angioplasty, coronary artery bypass grafting;
aneurysmectomy;
circular endocardial resection;
extended endocardial resection (can be combined with cryodestruction).

To prevent sudden coronary death, other people are recommended to lead a healthy lifestyle and regularly undergo preventive examinations (, Echo-CG, etc.), which make it possible to identify heart pathologies at the earliest stages. In addition, you should promptly consult a doctor if you experience discomfort or pain in the heart, arterial hypertension and pulse irregularities.

Of no small importance in the prevention of sudden coronary death is the awareness and training of the population in cardiopulmonary resuscitation skills. Its timely and correct implementation increases the chances of survival of the victim.

Cardiologist Sevda Bayramova talks about sudden coronary death:

Dr. Dale Adler, a cardiologist at Harvard, explains who is at risk for sudden coronary death:

- this is asystole or ventricular fibrillation that occurs against the background of the absence of a history of symptoms indicating coronary pathology. The main manifestations include the absence of breathing, blood pressure, pulse in the great vessels, dilated pupils, lack of reaction to light and any types of reflex activity, marbling of the skin. After 10-15 minutes, the appearance of a cat's eye symptom is noted. The pathology is diagnosed on site based on clinical signs and electrocardiography data. Specific treatment is cardiopulmonary resuscitation.

ICD-10

I46.1 Sudden cardiac death, so described

General information

Sudden coronary death accounts for 40% of all causes of death in people over 50 but under 75 years of age without known heart disease. There are about 38 cases of SCD per 100 thousand population annually. With timely initiation of resuscitation in the hospital, survival is 18% and 11% for fibrillation and asystole, respectively. About 80% of all cases of coronary death occur in the form of ventricular fibrillation. Middle-aged men with nicotine addiction, alcoholism, and lipid metabolism disorders are more likely to suffer. Due to physiological reasons, women are less susceptible to sudden death from cardiac causes.

Reasons

Risk factors for VCS do not differ from those for ischemic disease. Provoking influences include smoking, eating large amounts of fatty foods, arterial hypertension, and insufficient intake of vitamins. Non-modifiable factors – older age, male gender. Pathology can occur under the influence of external influences: excessive force loads, diving into icy water, insufficient oxygen concentration in the surrounding air, and acute psychological stress. The list of endogenous causes of cardiac arrest includes:

Atherosclerosis of the coronary arteries. Cardiosclerosis accounts for 35.6% of all SCDs. Cardiac death occurs immediately or within an hour after the onset of specific symptoms of myocardial ischemia. Against the background of atherosclerotic lesions, AMI is often formed, which provokes a sharp decrease in contractility, the development of coronary syndrome, and flicker.
Conduction disorders. Sudden asystole is usually observed. CPR measures are ineffective. Pathology occurs when there is organic damage to the conduction system of the heart, in particular the synatrial, atrioventricular node or large branches of the His bundle. As a percentage, conduction failures account for 23.3% of the total number of cardiac deaths.
Cardiomyopathies. Detected in 14.4% of cases. Cardiomyopathies are structural and functional changes in the coronary muscle that do not affect the coronary artery system. Found in diabetes mellitus, thyrotoxicosis, and chronic alcoholism. May be of a primary nature (endomyocardial fibrosis, subaortic stenosis, arrhythmogenic pancreatic dysplasia).
Other states. The share in the overall morbidity structure is 11.5%. Includes congenital anomalies of the cardiac arteries, left ventricular aneurysm, and cases of VCS for which the cause could not be determined. Cardiac death can occur with pulmonary embolism, which causes acute right ventricular failure, accompanied by sudden cardiac arrest in 7.3% of cases.

Pathogenesis

Pathogenesis directly depends on the causes of the disease. With atherosclerotic lesions of the coronary vessels, complete occlusion of one of the arteries by a thrombus occurs, the blood supply to the myocardium is disrupted, and a focus of necrosis is formed. The contractility of the muscle decreases, which leads to acute coronary syndrome and cessation of cardiac contractions. Conduction disturbances provoke a sharp weakening of the myocardium. Near residual contractility causes a decrease in cardiac output, stagnation of blood in the chambers of the heart, and the formation of blood clots.

In cardiomyopathies, the pathogenetic mechanism is based on a direct decrease in myocardial performance. In this case, the impulse spreads normally, but the heart, for one reason or another, reacts poorly to it. The further development of the pathology does not differ from the blockade of the conduction system. With pulmonary embolism, the flow of venous blood to the lungs is disrupted. The pancreas and other chambers are overloaded, and blood stagnation is formed in the systemic circulation. A heart overflowing with blood under conditions of hypoxia is unable to continue working and it suddenly stops.

Classification

Systematization of SCD is possible based on the causes of the disease (AMI, blockade, arrhythmia), as well as on the presence of previous signs. In the latter case, cardiac death is divided into asymptomatic (the clinical picture develops suddenly against the background of unchanged health) and having previous signs (short-term loss of consciousness, dizziness, chest pain an hour before the development of the main symptoms). The most important for resuscitation measures is the classification according to the type of cardiac dysfunction:

Ventricular fibrillation. Happens in the vast majority of cases. Requires chemical or electrical defibrillation. It is a chaotic disordered contraction of individual fibers of the ventricular myocardium, unable to provide blood flow. The condition is reversible and can be easily managed with resuscitation measures.
Asystole. Complete cessation of heart contractions, accompanied by a cessation of bioelectrical activity. More often it becomes a consequence of fibrillation, but it can develop primarily, without previous flicker. Arises as a consequence of severe coronary pathology, resuscitation measures are ineffective.

Symptoms of sudden cardiac death

40-60 minutes before the arrest develops, previous signs may appear, which include fainting lasting 30-60 seconds, severe dizziness, loss of coordination, a decrease or increase in blood pressure. Characteristic pain behind the sternum is of a compressive nature. According to the patient, it feels like the heart is being squeezed in a fist. Precursor symptoms are not always observed. Often the patient simply falls while doing some work or physical exercise. Sudden death in sleep without prior awakening is possible.

Cardiac arrest is characterized by loss of consciousness. The pulse is not detected in both the radial and main arteries. Residual breathing can persist for 1-2 minutes from the moment the pathology develops, but inhalations do not provide the necessary oxygenation, since there is no blood circulation. On examination, the skin is pale and bluish. Cyanosis of the lips, earlobes, and nails is noted. The pupils are dilated and do not react to light. There is no reaction to external stimuli. During blood pressure tonometry, Korotkoff sounds are not heard.

Complications

Complications include the metabolic storm that occurs after successful resuscitation efforts. Changes in pH caused by prolonged hypoxia lead to disruption of the activity of receptors and hormonal systems. In the absence of the necessary correction, acute renal or multiple organ failure develops. The kidneys can also be affected by microthrombi formed during the onset of disseminated intravascular coagulation syndrome, myoglobin, which is released during degenerative processes in the striated muscles.

Poorly performed cardiopulmonary resuscitation causes decortication (brain death). In this case, the patient’s body continues to function, but the cerebral cortex dies. Restoring consciousness in such cases is impossible. A relatively mild variant of cerebral changes is posthypoxic encephalopathy. It is characterized by a sharp decrease in the patient’s mental abilities and impaired social adaptation. Possible somatic manifestations: paralysis, paresis, dysfunction of internal organs.

Diagnostics

Sudden cardiac death is diagnosed by a resuscitator or other specialist with a medical education. Trained representatives of emergency response services (rescuers, firefighters, police), as well as people who happen to be nearby and have the necessary knowledge, can determine circulatory arrest outside the hospital. Outside the hospital, the diagnosis is made solely on the basis of clinical signs. Additional techniques are used only in ICU settings, where their application requires minimal time. Diagnostic methods include:

Hardware tutorial. On the cardiac monitor to which each patient in the intensive care unit is connected, large-wave or small-wave fibrillation is noted, and there are no ventricular complexes. An isoline may be observed, but this rarely happens. Saturation levels quickly decrease, blood pressure becomes undetectable. If the patient is on assisted ventilation, the ventilator signals that there are no attempts to inhale spontaneously.
Laboratory diagnostics. It is carried out simultaneously with measures to restore cardiac activity. Of great importance is a blood test for acid base acid and electrolytes, which indicates a shift in pH to the acidic side (a decrease in the pH value below 7.35). To exclude an acute infarction, a biochemical study may be required, which will determine increased activity of CPK, CPK MB, LDH, and an increase in the concentration of troponin I.

Urgent Care

The victim is assisted on the spot, and transported to the ICU after the heart rhythm is restored. Outside health care facilities, resuscitation is carried out using the simplest basic techniques. In a hospital or ambulance setting, it is possible to use complex specialized techniques of electrical or chemical defibrillation. The following methods are used for revival:

Basic CPR. It is necessary to place the patient on a hard, flat surface, clear the airways, tilt the head back, and extend the lower jaw. Pinch the victim's nose, place a cloth on his mouth, cover his lips with yours and exhale deeply. Compression should be performed using the entire body weight. The sternum should be pushed out by 4-5 centimeters. The ratio of compressions and breaths is 30:2, regardless of the number of resuscitators. If the heart rate and spontaneous breathing are restored, you need to lay the patient on his side and wait for the doctor. Self-transportation is prohibited.
Specialized assistance. In a medical institution, assistance is provided in a comprehensive manner. If ventricular fibrillation is detected on the ECG, defibrillation is performed with discharges of 200 and 360 J. It is possible to administer antiarrhythmics against the background of basic resuscitation measures. For asystole, adrenaline, atropine, sodium bicarbonate, and calcium chloride are administered. The patient must be intubated and transferred to artificial ventilation, if this has not been done previously. Monitoring is indicated to determine the effectiveness of medical actions.
Help after rhythm restoration. After restoration of sinus rhythm, mechanical ventilation is continued until consciousness is restored or longer if the situation requires it. Based on the results of the acid-base balance analysis, the electrolyte balance and pH are corrected. 24-hour monitoring of the patient's vital activity and assessment of the degree of damage to the central nervous system are required. Restorative treatment is prescribed: antiplatelet agents, antioxidants, vascular drugs, dopamine for low blood pressure, soda for metabolic acidosis, nootropic drugs.

Prognosis and prevention

The prognosis for any type of SCD is unfavorable. Even with timely CPR, there is a high risk of ischemic changes in the tissues of the central nervous system, skeletal muscles, and internal organs. The likelihood of successful rhythm restoration is higher with ventricular fibrillation; complete asystole is less prognostically favorable. Prevention consists of early detection of heart disease, avoiding smoking and drinking alcohol, and regular moderate aerobic exercise (running, walking, jumping rope). It is recommended to avoid excessive physical activity (weightlifting).

According to world statistics, among all the causes from which people die, death from heart disease leads. In turn, of the total number of deaths in this group, up to 35% are due to sudden cardiac death. This is a death that occurs as a result of situations not related to violence and external adverse factors.

In persons who did not consider themselves sick and who are in satisfactory condition, fatal symptoms occurred within 24 hours from the onset of fatal symptoms. In contrast to coronary heart disease and its characteristic sudden coronary death, for which this time is determined to be 6 hours (lately this interval has been reduced to 2 hours).

In addition to the time criterion, according to the World Health Organization, sudden cardiac death must be, above all, unexpected. That is, death occurs as if against the background of complete well-being. Today we will talk about what is sudden cardiac death and how to avoid it?

Sudden cardiac death - causes

The category of sudden death includes those who died who, during the last month of their life, were not under the supervision of doctors due to problems with the functioning of the heart, their health was externally normal, and they led their usual lifestyle.

Of course, it is difficult to agree with the statement that these people were initially absolutely healthy. As you know, with cardiovascular diseases there is a risk of fatal complications without visible external manifestations.

In many medical treatises and from the personal observations of practicing doctors, including pathologists, it is known that in 94% of cases, sudden cardiac death occurs within one hour from the onset of the pain symptom.

Most often in the first hours of the night, or on Saturday afternoon, when there are changes in atmospheric pressure and geomagnetic activity. The critical months are January, May, November. In the ratio of men and women, the predominance fluctuates towards men.

The mechanisms of development and causes of occurrence are divided into the following groups:

In young people involved in sports.
In young people under 30 years of age during physical overload.
With anomalies in the development of valves, subvalvular structures, blood vessels and the conduction system of the heart.
In the presence of atherosclerosis of the heart vessels and hypertension
For cardiomyopathies.
For alcoholic illness (chronic and acute form).
For focal metabolic damage to the heart muscle and necrosis not related to the vessels of the heart.

Sudden death during exercise

Perhaps the most tragic is the death of young, well-trained people involved in sports. The official definition of “sudden death in sports” includes the occurrence of death during physical activity, as well as within 24 hours from the onset of the first symptoms that forced the athlete to reduce or stop training.

Outwardly healthy people may have pathologies that they were not aware of. Under conditions of intense training and acute overstrain of the entire body and myocardium, mechanisms are triggered that lead to cardiac arrest.

Exercise causes the heart muscle to consume large amounts of oxygen by increasing blood pressure and heart rate. If the coronary arteries are unable to fully supply the myocardium with oxygen, then a chain of pathological metabolic disorders (metabolism and energy in the cell) of the heart muscle is triggered.

Hypertrophy (increase in the volume and mass of cells, under the influence of various factors) and dystrophy (structural changes in cells and intercellular substance) of cardiomyocytes develops. Ultimately, this leads to the development of electrical instability of the myocardium and fatal arrhythmias.
The causes of death during sports are divided into two categories.

Not related to physical overload:

hereditary diseases (congenital anomaly of the left coronary artery, Marfan syndrome, congenital defects, mitral valve prolapse);
acquired diseases (obstructive hypertrophic cardiomyopathy, myocarditis, conduction disorders, weakness of the sinus node);

inadequate use of the functional capabilities of a person during physical activity (non-coronarogenic myocardial microinfarctions develop in the myocardium);
sinus node failure or complete atrioventricular block;
extrasystoles that occur as a reaction to thermal and psycho-emotional stress.

The immediate cause of death is ventricular fibrillation, and after exertion. Pathologies that are asymptomatic are of particular importance.

Sudden cardiac death and abnormal development of cardiac tissue

With the increase in the number of deaths for no apparent reason, in recent decades, work has appeared aimed at an in-depth study of heart defects associated with abnormal development of connective tissue. The term dysplasia (from the Greek “dis” - disorder, “plasia” - form) refers to the abnormal development of tissue structures, organs or parts of the body.

Congenital connective tissue dysplasias are diseases that are inherited and are characterized by impaired development of tissues underlying the structure of the heart. The failure occurs during intrauterine development and early after the birth of the child. They were conditionally divided into two groups.

The first are developmental defects that are quite well known and manifest themselves not only in disturbances in the structure of the heart, but also in other organs and parts of the body. Their symptoms and manifestations are well known and studied (Marfan syndrome, Ehlers-Danlos syndrome, Holt-Omar syndrome).

The second ones are called undifferentiated, they are manifested by disturbances in the structure of the heart, without clear specific symptoms. This also includes developmental defects, defined as “minor cardiac anomalies.”

The main mechanism of dysplasia of the tissue structures of the cardiovascular system is genetically determined deviations in the development of the components of the connective tissue that make up the valves, parts of the conduction system of the heart and myocardium.

Young people in whom such disorders can be suspected are distinguished by a thin physique, funnel chest, and scoliosis. Death occurs as a result of electrical instability of the heart.

There are three leading syndromes:

Arrhythmic syndrome- various rhythm and conduction disorders with the occurrence of fatal arrhythmias.
Valve syndrome- anomaly of the development of the main heart valves with expansion of the aorta and main pulmonary arteries, mitral valve prolapse.
Vascular syndrome- disruption of the development of vessels of various diameters from the aorta to the irregular structure of small coronary arteries and veins. Changes concern the diameter of blood vessels.
Abnormal chords- accessory or false ligaments, in the cavities of the heart, closing the valve leaflets.
Aneurysms of the sinuses of Valsava- This is an expansion of the aortic wall near the semilunar valves. The pathogenesis of this defect involves the flow of additional blood into the chambers of the heart, which leads to overload. Boys get sick more often.

According to various publications, death from mitral valve prolapse is 1.9 cases per 10,000 population.

Coronary heart disease

Coronary heart disease is an extremely common disease in the human population and is the main cause of death and disability in the developed countries of the world. This is a syndrome that develops in the cardiac form of atherosclerosis and hypertension, which lead to absolute or relative failure of cardiac activity.

The term IHD was first coined in 1957 and defined the discrepancy between the need and blood supply of the heart. This discrepancy is due to blockage of the lumen of blood vessels by atherosclerosis, high blood pressure and spasm of the vascular wall.

As a result of insufficient blood circulation, heart attacks or local limited death of the muscle fibers of the heart develop. IHD has two main forms:

The chronic form (angina) is periodic attacks of pain in the heart caused by relative transient ischemia.
Acute form (acute cardiac infarction) is acute ischemia with the development of a local focus of myocardial necrosis.

Acute myocardial necrosis (infarction) is a form of ischemic heart disease that most often leads to death. There are several signs by which acute necrosis of the heart muscle is classified. Depending on the extent of the lesion, there are:

large-focal myocardial infarction;
small focal myocardial infarction.

According to the time interval from the onset of symptoms to death:

The first two hours from the onset of necrosis (the most acute period);
From the time of onset of the disease to 10 days (acute period);
from 10 days to 4-8 weeks (subacute period);
from 4-8 weeks to 6 months (scarring period).

The likelihood of death is very high in the acute period and with extensive damage.

Acute damage to the vessels supplying the heart muscle - ischemic changes in the myocardium for up to 40 minutes, previously interpreted as acute coronary, accounts for up to 90% in the structure of sudden cardiac death. The predominant number of patients with acute vascular insufficiency die from ventricular fibrillation.

Currently, it is considered as acute coronary syndrome.

The term “acute coronary syndrome” appeared in publications in the 80s of the twentieth century and was isolated from coronary heart disease and myocardial infarction as an independent clinical and morphological unit due to the needs of emergency care and one of the main causes of sudden cardiac death.

According to the definitions of foreign cardiologists, this term includes any signs that may indicate an incipient heart attack or an attack of unstable angina.

The need to distinguish acute coronary syndrome is due to the fact that it is at this stage that the mortality rate of patients with myocardial infarction is highest and the prognosis and outcome of the disease depend on the nature of the treatment tactics. This term is used in medicine in the first hours from the onset of an acute heart attack until an accurate diagnosis is determined.

Acute coronary syndrome is divided into two types, based on ECG readings:

Acute coronary syndrome without ST interval elevation and is characterized by unstable angina.
Acute coronary syndrome with ST interval elevation is an early myocardial infarction.

Based on the mechanism of formation of coronary syndrome, the following types are distinguished:

Endogenous type - cessation of blood flow as a result of the closure of the vessel lumen by an atherosclerotic plaque and thrombotic masses formed on it.

This type of coronary syndrome is typical for young people with high mortality

Exogenous type - as a result of spasm of the arteries with and without the formation of blood clots. The second type of coronary death is typical for older people with a long course of chronic myocardial ischemia.

One of the most common sudden cardiac arrests is cardiomyopathies. This term refers to a group of diseases of the heart muscle of various origins that are associated with mechanical or electrical dysfunction.

The main manifestation is thickening of the muscle fibers or expansion of the chambers of the heart. There are:

Hypertrophic cardiomyopathy- a genetically determined disease that affects the heart muscle. The process progresses steadily and with a high degree of probability leads to sudden death. This type of cardiomyopathy, as a rule, is familial in nature, that is, close relatives in the family are sick, however, isolated cases of the disease occur. In 15-20% there is a combination of coronary atherosclerosis and hypertrophic cardiomyopathy
Dilated cardiomyopathy- a lesion characterized by abnormal expansion of the heart cavity and impaired contractility of the left ventricle or both ventricles, which leads to changes in heart rate and death. Typically, dilated cardiomyopathy manifests itself at the age of 30-40 and more often affects men. Women are affected three times less than men.

Based on the causes of occurrence, they are distinguished:

cardiomyopathy of unknown origin;
secondary or acquired dilated cardiomyopathies caused by viral infections, including AIDS, alcohol intoxication, and micronutrient deficiencies

Restrictive cardiomyopathy is a rare form characterized by thickening and proliferation of the inner lining of the heart.

Alcohol myocardial damage

Alcohol damage to the heart is the second leading cause of sudden heart failure. According to statistics, up to 20% of patients with chronic alcohol disease die from cardiac pathology.

In young patients with alcoholic heart disease, death occurs suddenly or suddenly in 11%, of which 41% of suddenly deceased people are under 40 years of age.

There is no clear pattern between the amount of alcohol consumed and the duration of intoxication and the degree of damage to the heart muscle. The sensitivity of the myocardium to ethanol is individual for each person.

A connection has been established with the development of high blood pressure and alcohol consumption. This mechanism is carried out by increasing vascular tone and the release of adrenaline into the blood. Heart rhythm disturbances with possible fibrillation appear.

Consequently, long-term consumption of excessive amounts of alcohol contributes alone, or in combination with myocardial ischemia, electrical instability of the heart and sudden cardiac death.

Hypertension and its role in the development of sudden cardiac death

In people suffering from a systematic increase in blood pressure, hypertrophy develops as a compensatory-adaptive reaction (increase in heart mass due to thickening of the muscle layer). This increases the risk of ventricular fibrillation and impaired blood circulation.

Arterial hypertension aggravates the development of atherosclerosis in the lumen of the coronary vessels. The incidence of hypertension in people who die suddenly reaches 41.2%.

Other causes of sudden death

Focal damage to the myocardium, as a result of disturbances in local metabolism in muscle fibers, includes dystrophic and irreversible changes in cardiomyocyte cells, without damage to the vessels supplying the heart.

The ability to contract the myocardium can be impaired as a result of changes in the structure of cells with disruption of their vital functions. The reasons for this phenomenon are extremely varied:

disturbance of nervous regulation;
changes in hormonal levels;
disturbed electrolyte balance;
damaging effects of viruses and bacterial toxins;
action of autoimmune antibodies;
influence of human metabolic products (nitrogen bases);
the effect of ethanol and drugs.

The development of acute heart failure can occur in the acute period of the disease, during recovery, and even in the absence of toxic substances in the blood.

The connection between stress and sudden cardiac death is widely known. Under the influence of physical and psychological stress, cardiac arrhythmias and episodes of sudden, persistent loss of consciousness that lasts more than one minute (fainting) often occur. At the final stage of stress reactions, hormones such as adrenaline, glucocorticoids and catecholamines are released.

This leads to an increase in blood glucose and cholesterol levels and an increase in pressure in the arteries. All this leads to disruption of myocardial metabolism and becomes the basis for the so-called “biological suicide”

Why do men die more often?

If we summarize all of the above, we can conclude that men are more likely than women to suffer from one or another heart disease with a fatal outcome.

This is due to several factors:

Most genetically determined pathologies are transmitted according to an autosomal dominant mode of inheritance. This implies the transmission of symptoms and diseases from father to son.
In a woman's body, the sex hormones estrogens are present in greater quantities, which have a beneficial effect on the development of atherosclerosis and arterial hypertension.
Men are more involved in heavy physical work and are thus more susceptible to overload.
The prevalence of alcoholism and drug addiction among men is greater than among women.
The cost of living of men in all countries of the world is lower than that of women.

Signs and precursors of sudden cardiac death

The picture of clinical manifestations of sudden death develops very rapidly. In most cases, a tragic situation occurs on the street or at home, and therefore qualified emergency assistance is provided too late.

In 75% of cases, shortly before death, a person may experience chest discomfort or a feeling of shortness of breath. In other cases, death occurs without these signs.

Ventricular fibrillation or asystole is accompanied by severe weakness and presyncope. After a few minutes, loss of consciousness occurs due to lack of blood circulation in the brain, then the pupils dilate to the limit and do not respond to light.

Breathing stops. Within three minutes after circulatory arrest and ineffective myocardial contractions, brain cells undergo irreversible changes.

Symptoms appearing immediately before death:

convulsions;
noisy, shallow breathing;
the skin becomes pale with a bluish tint;
pupils become wide;
The pulse in the carotid arteries cannot be felt.

Treatment of sudden cardiac death

The only treatment for sudden death is immediate resuscitation.

Resuscitation consists of several stages:

Ensuring free passage of air through the respiratory tract. To do this, it is necessary to place the dying person on an elastic, hard surface, tilt his head back, extend the lower jaw, open his mouth, free the oral cavity from existing foreign objects and remove the tongue.
Carry out artificial ventilation using the mouth-to-mouth method.
Restoration of blood circulation. Before starting an indirect cardiac massage, you need to perform a “precordial blow.” To do this, sharply strike with your fist in the middle of the sternum, but not in the area of the heart. Next, place your hands on the person’s chest and perform chest compressions.

For an effective resuscitation process, the ratio of air inhalations into the patient’s mouth and rhythmic pressure on the chest should be:

inhalation for 15 pressures, if one person is resuscitating;
1 breath and 5 pressures if two people are resuscitating.

Immediately transport the person to a hospital to provide qualified professional assistance.

How to avoid sudden death

Every person should consciously and responsibly treat the health of his heart, and know how he can harm his heart and how to protect it.

Regular medical examination

First of all, these are systematic visits to the doctor, examinations and laboratory tests. If someone in the family has a pathology of the cardiovascular system, immediately inform the doctor to eliminate the risk of manifestations of genetically inherited diseases.

Quitting bad habits

Fundamental cessation of smoking, drug addiction, and excessive alcohol consumption. Moderate consumption of drinks with the effect of stimulating the nervous system (coffee, tea, energy drinks).

Tobacco smoke reduces the percentage of oxygen in the blood, which means the heart works in oxygen starvation mode. In addition, nicotine increases blood pressure and promotes spasm of the vascular wall.

The tonic effect in these drinks leads to an increase in heart rate and increases blood pressure.

Normalization of diet and the fight against obesity

Excess body weight is a factor that plays an important role in the development of heart and vascular diseases and the occurrence of sudden cardiac death. According to statistics, people who are overweight are more likely to suffer from hypertension and atherosclerosis.

Extra pounds make it difficult not only for the heart, but also for other organs. To know your ideal physiological weight, there is a formula: body mass index BMI = existing weight: (height in meters x 2).

Normal weight is considered:

if you are between 18 and 40 years old - BMI = 19-25;
from 40 years old and over - BMI = 19-30.

The results are variable and depend on the structural features of the skeletal system. Moderate consumption of table salt and animal fats is recommended.

Products such as lard, fatty meat, butter, pickles and smoked foods lead to the development of atherosclerosis and increased blood pressure.

Healthy foods for the heart

Proper nutrition is the key to health and longevity; support your body with heart-healthy foods.

Red grape juice.
Low-fat milk.
Fresh vegetables and fruits (legumes, bananas, carrots, pumpkin, beets, etc.).
Sea fish.
Lean meat (chicken, turkey, rabbit).
Nuts.
Vegetable oils.

A healthy lifestyle is the answer to the question, how to avoid sudden death?

There are many diets designed to strengthen and maintain good heart condition. Regular exercise will strengthen the body and make you feel more confident and healthier.

Active lifestyle and physical culture

Regular dosed physical activity with an emphasis on “cardio training”:

Running in the fresh air.
Bicycle rides.
Swimming.
Cross-country skiing and skating.
Yoga class.
Morning exercises.

Conclusion

Human life is very fragile and can end at any moment due to reasons beyond our control.

Heart health is an indisputable condition for a long, quality life. Paying more attention to yourself, not destroying your body with bad habits and poor nutrition is the basic principle of every educated, sane person.

The ability to respond correctly to stressful situations, to be in harmony with yourself and the world, to enjoy every day you live, reduces the risk of sudden cardiac death and leads to a happy long life.

Diseases of the cardiovascular system are one of the most common causes of sudden death. Acute coronary death accounts for 15-30% of the structure of all conditions; this condition is dangerous because it does not make itself felt for a long time. A person can live without even knowing that he has heart problems. Therefore, everyone should know why death occurs. And also have an idea of providing first aid to the victim. This is exactly what the article will discuss.

What is this condition?

The World Health Organization defines sudden, or acute, coronary death as death a maximum of 6 hours after the first symptoms of the disease. Moreover, this condition develops in people who considered themselves healthy and did not have any problems with the cardiovascular system.

A pathology of this nature is classified as one of the varieties with an asymptomatic course. Sudden death in acute coronary insufficiency develops in 25% of patients with “silent” ischemic heart disease.

In the International Classification of Diseases, this pathology is located in the section “Diseases of the circulatory system”. The ICD-10 code for acute coronary death is I46.1.

Main reasons

There are a number of causes of acute coronary death. These include the following fatal changes in heart rhythm:

ventricular fibrillation (70-80%);
paroxysmal ventricular tachycardia (5-10%);
slow heart rate and ventricular asystole (20-30%).

Trigger or starting causes of death in acute coronary insufficiency are separately identified. These are factors that increase the risk of developing fatal heart and vascular diseases. These include:

Acute myocardial ischemia. It is observed when they are blocked by a blood clot.
Excessive activation of the sympathoadrenal system.
Electrolyte imbalance in cardiac muscle cells. Particular attention is paid to reduced concentrations of potassium and magnesium.
The effect of toxins on the myocardium. Taking certain medications can have an adverse effect on the heart muscle. For example, antiarrhythmic drugs of the first group.

Other causes of sudden death

The most common cause of sudden death is acute coronary insufficiency, which also occurs with various types of arrhythmias.

But sometimes patients die suddenly, never having had any rhythm disturbances or any other heart disease. And at autopsy it is not possible to find damage to the heart muscle. In such cases, the cause may be one of the following diseases:

hypertrophic or dilated cardiomyopathy - heart pathology with thickening of the myocardium or enlargement of organ cavities;
dissecting aortic aneurysm - sac-like bulging of the vessel wall and its further rupture;
pulmonary embolism - blockage of pulmonary vessels with blood clots;
shock - a sharp decrease in blood pressure, accompanied by a deterioration in the supply of oxygen to tissues;
food entering the respiratory tract;
acute circulatory disorders in the vessels of the brain.

Autopsy data

When examining the body by a pathologist, in 50% of cases the presence of atherosclerosis of the coronary arteries is determined. This condition is characterized by the formation of fatty plaques on the inner wall of the heart vessels. They block the lumen of the artery, preventing normal blood flow. Myocardial ischemia occurs.

Also characteristic is the presence of scars on the heart that appear after a heart attack. Possible thickening of the muscle wall - hypertrophy. Some people experience massive growth of connective tissue in the muscle wall - cardiosclerosis.

In 10-15% of cases, blockage of the vessel by a fresh blood clot is possible. However, there is a small part of the deceased whose autopsy fails to determine the cause of death.

Main symptoms

Often sudden death in acute coronary insufficiency does not come so suddenly. It is usually preceded by some symptoms.

According to relatives, many patients before their death noted a deterioration in their general health, weakness, poor sleep, and breathing problems. Some experienced severe attacks of ischemic pain. This pain appears sharply, it seems to compress the chest, radiating to the lower jaw, left arm and shoulder blade. But ischemic pain is a rare symptom before death from acute coronary insufficiency.

Many patients suffered from high blood pressure or mild coronary heart disease.

In 60% of cases, death due to heart disease occurs at home. It has nothing to do with emotional shock or physical stress. There have been cases of sudden death during sleep from acute coronary insufficiency.

Diagnostic methods

If a person who was at risk of death from acute coronary insufficiency has been resuscitated, he is subjected to a series of examinations. This is necessary to prescribe appropriate treatment that will eliminate the threat of relapse.

For this, the following diagnostic methods are used:

electrocardiography (ECG) - it is used to record the contractility of the heart muscle and the conductivity of impulses in it;
phonocardiography - it characterizes the functioning of the heart valves;
echocardiography - ultrasound examination of the heart;
ECG with stress tests - to identify angina pectoris and decide on the need for surgical intervention;
Holter monitoring - ECG, which is recorded 24 hours a day;
electrophysiological study.

The importance of electrophysiological testing

The latter method is the most promising in diagnosing heart rhythm disturbances. It involves stimulation of the inner lining of the heart with electrical impulses. This method not only allows you to establish the cause of the threat of death, but also makes it possible to predict the likelihood of a relapse of the attack.

In 75% of survivors, persistent ventricular tachycardia is determined. This result in an electrophysiological study suggests that the probability of a repeat attack of the threat of death is about 20%. This is provided that the tachycardia is controlled with antiarrhythmic medications. If the rhythm disturbance cannot be eliminated, a repeated threat of death occurs in 30-80% of cases.

If ventricular tachycardia cannot be induced by pacing, the likelihood of a recurrence is about 40% in the presence of heart failure. With preserved heart function - 0-4%.

Emergency care: basic concepts

First aid for acute coronary death is Basic resuscitation techniques that everyone should know in order to be able to provide assistance to a person before the ambulance arrives.

There are three main stages:

A - ensuring airway patency;
B - artificial respiration;
C - indirect cardiac massage.

But before starting to take any action, they check the victim’s consciousness. To do this, they call him loudly several times and ask how he feels. If a person does not answer, you can lightly shake him by the shoulders several times and lightly hit him on the cheek. Lack of reaction indicates that the victim is unconscious.

After this, the pulse in the carotid artery and spontaneous breathing are checked. Only if there is no pulsation of blood vessels and breathing can you begin to provide first aid.

Emergency care: stages

Stage A begins with cleansing the victim’s mouth of saliva, blood, vomit, and other things. To do this, you need to wrap two fingers with some kind of cloth and remove the contents of the oral cavity. Afterwards, the patency of the upper respiratory tract is ensured. I put one hand on the patient’s forehead and throw his head back. The second I lift my chin and push out my lower jaw.

If there is still no breathing, proceed to stage B. The palm of the left hand still lies on the victim’s forehead, and the fingers close the nasal passages. Next, you need to take a normal breath, cover the victim’s lips with your lips and exhale air into his mouth. To ensure personal hygiene, it is recommended to place a napkin or cloth over the patient’s mouth. Inhalations are carried out at a frequency of 10 - 12 per minute.

In parallel with artificial respiration, an indirect cardiac massage is performed - stage C. Hands are placed on the sternum between its middle and lower parts (just below the level of the nipples). The hands lie one on top of the other. Afterwards, presses are made at a frequency of 100 times per minute, to a depth of 4-5 cm. The elbows should be straightened, and the main emphasis should be on the palms.

If there is only one resuscitator, presses and breaths alternate with a frequency of 15 to 2. When two people provide assistance, the ratio is 5 to 1. Every two minutes, you need to monitor the intensity of resuscitation by checking the pulse in the carotid artery.

Primary prevention

Any disease is easier to prevent than to cure. And most often, when symptoms appear before death from acute heart (coronary) failure, it is too late to do anything.

All preventive measures are divided into two large groups: primary and secondary:

Primary prevention of acute coronary death is to prevent the development of coronary heart disease.
Secondary measures are aimed at treating it and preventing complications.

First of all, you need to modify your lifestyle. Change your diet by giving up fried and fatty foods, smoked foods and spices. Preference should be given to vegetable fats and vegetables with a high fiber content. Limit your intake of coffee and chocolate. It is mandatory to give up bad habits - smoking and alcohol.

Overweight people need to lose weight, as excessive weight increases the risk of diseases of the cardiovascular and endocrine systems.

Dosed physical activity is also important. At least 1-2 times a day you need to do exercises or walk in the fresh air. Swimming and short distance jogging are shown, but not weightlifting.

Secondary prevention

Secondary prevention of sudden death involves taking medications that slow the progression of coronary heart disease. The most commonly used groups of drugs are:

beta blockers;
antiarrhythmic;
antiplatelet agents;
anticoagulants;
potassium and magnesium preparations;
antihypertensive.

There are also surgical ways to prevent sudden cardiac death. They are used in people at high risk. These methods include:

aneurysmectomy - removal of an artery aneurysm;
myocardial revascularization - restoration of the patency of the coronary vessels;
radiofrequency ablation - destruction of the source of abnormal heart rhythm using electric current;
implantation of an automatic defibrillator - a device is installed that automatically regulates the heart rhythm.

The importance of regular medical examination

Every person should undergo a medical examination and blood test at least once a year. This will allow the disease to be detected at an early stage, before symptoms appear.

If you have high blood pressure, you should consult your doctor. He will prescribe the necessary medications. The patient should take them regularly, and not just when blood pressure increases.

If the level of cholesterol and low-density lipoproteins in the blood is elevated, consultation with a specialist is also indicated. He will help you find a way to control this condition using diet alone or by prescribing additional medications. This will prevent the development of atherosclerosis and blockage of coronary vessels with fatty plaques.

Regular blood testing is a simple method of preventing coronary artery disease, and therefore acute coronary death.

Forecast

The likelihood of the patient being revived depends on the timing of first aid. It is important to organize specialized resuscitation ambulance teams, which arrive at the scene of the event within 2-3 minutes.

The survival rate among those successfully resuscitated in the first year of life is 70%. It is mandatory to find out the cause of death and eliminate it. If specific therapy is not carried out, the probability of relapse is 30% in the first year and 40% in the second year. If antiarrhythmic therapy or surgical treatment is performed, the probability of relapse is 10 and 15%, respectively.

But the most effective way to prevent an episode of acute coronary death is to install a pacemaker. It reduces the risk of this condition to 1%.