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Types of cardiac arrest and the main causes of an attack in the victim. Sudden cardiac arrest What happens if the heart stops

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Heart failure(heart failure) - clinical syndrome associated with sudden and complete cessation efficient work hearts. A person retains contractions of the ventricles, but the pumping function of the organ is disrupted, the heart does not push blood into the blood vessels, blood circulation stops, which poses a threat to life. Sudden stop heart disease is accompanied by absence of pulse, dilated pupils, respiratory depression and loss of consciousness. The patient may be completely absent or retain the bioelectrical activity of the heart. Immediate medical care in case of cardiac arrest, increases the chances of successful resuscitation of the patient.

According to WHO statistics, about 200,000 people on our planet have heart failure every week. Moreover, 90% of victims die before the ambulance arrives, at home or in the office, since there were no people nearby who know how first aid should be provided. The population dies more often from a serious clinical syndrome than from AIDS, cancer, fires, road accidents or gunshot wounds. Cardiac and respiratory arrest can develop not only in the elderly, but also in completely healthy young people, as well as in infants and schoolchildren.

Anatomy and physiology of the heart

The heart (Greek cardia) is a developed muscular hollow organ that, like a pump, ensures the delivery of blood throughout the body through arteries, arterioles and capillaries, and then, with the help of veins and venules, lifts it back. In just 1 minute, up to 6 liters of blood are pumped through the heart. The weight, shape and size of the organ are different and individual. The heart is located to the left of the chest at the level of 4-8 vertebrae, in the pericardial sac. This fibroserous sac insulates the organ. The heart walls consist of a thin outer layer - the epicardium, a thick middle layer - the myocardium, consisting of striated muscles, and the endocardium - inner shell consisting of epithelial tissues.

The heart is divided into 4 separate chambers: right atrium, left atrium, right ventricle, left ventricle. The right and left halves are separated by partitions. Two vena cava (superior and inferior) flow into the right atrium; venous blood is present here; the pulmonary trunk opens from the right ventricle. Arterial blood is present in the left half of the heart; the right atrium contains 4 hollow veins, the aortic mouth departs from the left ventricle. The atria are separated from the ventricles by valves. On the right is a tricuspid valve, on the left is a bicuspid valve. The ventricles are separated from the large arteries by semilunar valves. The valves are attached to the skeleton of the heart and allow blood to flow.

During the diastole, or relaxation, phase, blood from the pulmonary and vena cava flows into the right atrium. During the systole phase, or contraction of the atria, the leaflet valves open and blood is pumped into the ventricles. Then ventricular systole occurs, blood flows into the aorta and pulmonary trunk. After a pause, the semilunar valves close and the leaflet valves open; due to the pressure difference, blood collects in the atria.

Mechanism of cardiac arrest

When acute cardiac arrest occurs, cardiac fibrillation occurs when the organ loses its ability to perform its functions effectively because the heart muscles contract inconsistently. Ventricular and atrial fibrillation are distinguished. In addition, sudden cardiac arrest syndrome can be caused by asystole, or cessation of bio electrical activity heart, leading to organ failure. Also, cardiac arrest can be caused by electromechanical dissociation, when blood circulation stops due to the cessation of the mechanical activity of the organ.

Causes of heart failure

When cardiac arrest occurs, the causes may vary. There are estracardial and cardiac factors. Cardiac causes are associated with impaired conduction function or automaticity, decreased contractility myocardium, injuries and damage to the organ.

Cardiac factors include:

  • Coronary artery disease, myocardial infarction, diseases in which the supply of oxygen to the heart muscle is disrupted and nutrients. Cardiac arrest may occur during surgery, when lifting heavy objects, due to overwork and emotional stress.
  • Diseases of the coronary arteries, their spasm, thrombosis, embolism (blockage), angina pectoris.
  • Blockage of the pulmonary arteries, dissections and ruptures of the arteries. Cardiac arrest can occur during sleep.
  • Infectious lesions of the membranes of the heart, myocarditis, endocarditis, as well as cardiomyopathies.
  • Cardiac tamponade, leading to compression of its cavities, dysfunction of the valves.
  • Various arrhythmias and electrolyte imbalance.
All conditions accompanied by oxygen deficiency are classified as extracardiac factors:
  • Any exogenous poisoning, alcohol and drug intake, drug overdose when taking drugs that cause cardiac arrest.
  • Obstruction of the airways or disruption of their patency, the occurrence of various embolisms, the development of acute respiratory failure. Timely diagnosis and professional assistance saves the patient’s life.
  • Reflex failure of the heart, which can be reversible or irreversible, occurs with hypothermia, increased sexual stress, strong blows. For example, boxers know how to perform a cardiac arrest leading to a knockout.
  • Shock states, heart injuries, choking, exposure electric current.


Indirect causes of cardiac arrest:

  • chronic alcoholism;
  • old age;
  • genetic predisposition.

Modern drugs that cause cardiac arrest

It is believed that drugs are to blame in 2% of all cases of sudden cardiac arrest.

Dangerous pills that cause cardiac arrest:

  • Medicines that normalize cardiac activity. For example, there is evidence that anaprilin can worsen the patient’s condition when taken in therapeutic doses. Especially if the patient is not treated for the underlying disease, but is focused only on arrhythmia and other individual symptoms.
  • Antibiotics wide range actions (Clathromycin, etc.).
  • The gastroenterological drug Domperidon, which is prescribed to treat heartburn.
  • Medicines for schizophrenia, psychotropic drugs(haloperidol, etc.).
Dangerous combination therapy when incompatible drugs are prescribed that transform, cause arrhythmias, and can cause cardiac arrest. Great harm Self-medication can harm your health, since not every person understands which pills cause cardiac arrest.

Symptoms of cardiac arrest

A person cannot feel a pulse in the carotid arteries, there is a dull sound of cardiac arrest, or heart sounds disappear. In the next few seconds, breathing stops, pallor develops, consciousness is lost, and muscle cramps are possible. Impaired cerebral circulation leads to dilation of the pupils, and their reaction to light is absent. When a clinical syndrome develops, help should be provided immediately. In the absence of help, oxygen starvation occurs in organs and tissues, and clinical death occurs.

Diagnosis of cardiac arrest

Diagnosis of cardiac arrest should be made within a few minutes. Conventional measures that take too much time are not suitable here. The patient is not given a cardiogram, blood pressure is not changed, time is not spent looking for pulsations in peripheral vessels and listening to heart sounds. Urgent Care in cardiac arrest, it begins immediately after the doctor has determined that there is no pulsation in the common carotid artery, which is located between the muscles of the neck and the larynx, or in femoral artery. The determination is carried out on average and index fingers, pressure on the artery is carried out gently, by the pads of the phalanges.

No more than 5 seconds are allowed to palpate the pulse so that resuscitation can be carried out in time. The resuscitator must be able to distinguish between bradycardia, or slow heart rate. Another important diagnostic sign is the assessment of pupil dilation and their reaction to light after the onset of resuscitation care during cardiac arrest. The very first signs of heart failure - respiratory arrest and loss of consciousness, as a rule, go unnoticed, except when the patient is under constant supervision.

Competent first aid in case of cardiac arrest

Primary resuscitation skills allow you to provide first aid to injured people before the arrival of the resuscitation team. After the patient has a feeling of cardiac arrest, he loses consciousness and stops breathing. First you need to make sure there is nothing in the way normal breathing, and clean the oral cavity - the victim’s tongue may become stuck and vomit may accumulate in the mouth. The patient must be placed on a hard surface and begin performing cardiac massage and mouth-to-mouth artificial respiration. The pressure should be sharp, the massage is done with straightened arms. Up to 12 cycles are done within a minute. If the chest begins to rise, this is a sign that the lungs are filling with oxygen and life is being restored after cardiac arrest. It is rational to stop resuscitation measures 20-30 minutes after they begin, when a person develops clinical death.

Medical care for heart failure

Basic resuscitation actions:
  • External cardiac massage and artificial ventilation are necessary in all cases when cardiac arrest is diagnosed. If there is no effect, tracheotomy, intubation are performed, and special drugs are used to ensure the safety and patency of the respiratory tract.
  • At the initial stage, electrical stimulation of the heart, or emergency defibrillation, is also performed. The chest is exposed to discharge energy, which restores ventricular function. The effectiveness of defibrillation decreases with every minute that cardiac arrest continues - the consequences may vary. The electrical activity of the myocardium is checked using a cardioscope.
  • Surgical interventions. When cardiac arrest occurs, surgery is usually performed due to narrowing of the airways.
  • Catheterization of central veins, allowing procedures to be performed on patients in critical condition.
  • Drug therapy. Medicines are administered intracardiacally or intravenously to treat cardiac arrest - adrenaline - the main drug of resuscitators, norepinephrine, antiarrhythmic drugs, atropine, sodium bicarbonate solutions, etc.

Further life after cardiac arrest

Most people who have cardiac arrest are treated in intensive care units. Patients survive if the heart can be started within 5-6 minutes after stopping. Eat rare cases in practice, when people were able to return to a full life 30 and 39 minutes after heart failure. At the end of the resuscitation period, constant monitoring of the patient's condition is necessary. Cardiac activity and other functions may be impaired, and the patient often requires prolonged cardiac resuscitation.

The patient is given an x-ray because the chest may have been damaged during cardiac arrest. In addition, biochemical tests are ordered, diuresis is monitored, and other tests are performed that can detect the development of dangerous complications. In case of prolonged heart failure, nootropic support is prescribed, which is necessary for the full restoration of the brain.

Cardiac arrest is the process by which an organ stops functioning. Various factors can cause this, and the result will be clinical, and then biological death of a person. It occurs due to cessation of blood circulation, which leads to oxygen starvation body. If you don't get help and get your heart beating within the first seven minutes, the victim will be brain dead. Stoppage can occur in both young people and the elderly.

Heart disease

Causes of heart pathology

Every person can experience cardiac arrest, and its causes lie in heart disease and diseases of other organs. The following factors cause cardiac arrest:

  1. Cardiac. This category of pathologies is responsible for 90% of heart attacks. It includes:
  • rhythm disturbances;
  • Brugada syndrome;
  • ischemia;
  • heart attack;
  • thromboembolism of the pulmonary arteries;
  • rupture of aneurysm in the aorta, acute heart failure;
  • arrhythmogenic and cardiogenic shock.

“Obstructive sleep apnea syndrome” as an example. Because of this syndrome, a person experiences short stop hearts. It is caused by abnormal cardiac activity.

  1. The second reason is cardiac risk factors, which increase the likelihood of sudden arrest in people with a diseased cardiovascular system. Factors include:
  • age from 50 years;
  • smoking;
  • frequent drinking;
  • overweight;
  • physical exhaustion of the body;
  • stress, hypertension;
  • diabetes;
  • high cholesterol.
  1. Extracardiac – non-cardiac pathologies and do not directly affect the heart, but can cause cardiac arrest. Pathologies include:
  • asphyxia;
  • old age;
  • late stages of severe chronic pathologies;
  • various types of shock (caused by injury or burn);
  • poisoning with alcohol, drugs or medications;
  • violence, drowning, injuries, etc.

Reflex cardiac arrest is an example of a violent cause. Reflex cardiac arrest can be caused by a shock or occur due to electrical trauma.

  1. SIDS. This sudden infant death syndrome requires separate consideration. It manifests itself when the child has not yet lived even a year. This mainly occurs at the age of 3 months. Cardiac arrest occurs during sleep at night. At the same time, the signs of cardiac arrest themselves do not appear in advance. There are factors that increase the risk of developing pathology:
  • how the baby lies on his stomach at night;
  • bed too soft;
  • sleeping in a hot and stuffy room;
  • maternal smoking;
  • prematurity of the child;
  • multiple pregnancy;
  • intrauterine hypoxia;
  • the fetus has developmental delay;
  • family predisposition;
  • in the first months after birth there was a severe infection.

These are the causes of cardiac arrest in humans.


Heart attack

Heart Attack Symptoms

It is important to know the symptoms of cardiac arrest. Sudden cardiac arrest is an unpredictable pathology, as it is difficult to notice. As the pathology develops, the patient feels well, experiencing slight discomfort.

The condition worsens suddenly, the person grabs his heart and falls, losing consciousness. This is where it is important to know the symptoms, because they will allow you to distinguish cardiac arrest from ordinary fainting, which has similar symptoms.

Symptoms of pathology:

  • no pulse can be felt in the arteries;
  • there is no breathing or within 2 minutes it manifests itself in the form of convulsive wheezing;
  • the pupil does not constrict when exposed to light;
  • the body acquires an unnaturally pale, bluish color.

You can determine cardiac arrest by symptoms if you know them and be able to notice them. Taken together, the condition looks like this: the patient falls, loses consciousness, turns pale, lips turn blue, and does not respond to braking or screams. If first aid is not provided to the victim within seven minutes, biological death will occur.

In a dream, death occurs differently from cardiac arrest. The person simply does not wake up and outwardly looks as if he is sleeping.

Types of cardiac arrest such as sudden death and death in sleep are very dangerous. Both require attention, because otherwise first aid will not be provided on time and the person will die.


Sudden cardiac arrest

Diagnosis of pathologies

How to determine cardiac arrest? How to make a diagnosis? Most people do not know the answers to these questions. And this is bad, since almost 70% of such cardiac arrests occur outside the walls of medical institutions.

Mostly, cardiac arrest causes people to feel ill at home, on the street or at work. Become witnesses ordinary people, not having medical education and unable to provide qualified assistance.

However, knowing the basic actions, when every minute counts, a person will not get confused and will do everything right. The procedure is as follows:

  1. If a person suddenly loses consciousness, you need to lightly hit him on the cheeks, shake him up and call him loudly. This will allow you to understand how a person feels and whether he simply fainted.
  2. The next step is a breath test. Place your ear to the victim's chest or tilt his head back and extend his jaw, then place your cheek against the patient's nostrils. This will allow you to feel and hear breathing, if any. Such methods are the most effective and allow you to do without improvised means and complicated ways. For example: using a mirror brought to the mouth to detect breathing.
  3. Pulse check. To do this, find the carotid artery, located between the neck muscle, larynx and angle of the lower jaw. If you do not feel a pulse, you need to start chest compressions.

Heart rate

The arteries located in the wrist are not reliable indicator. The severity of the patient's condition must be assessed during the first 20 seconds from the moment cardiac activity stops. Therefore, looking for a pulse on the wrist is not only useless, but also harmful.

Treatment

As soon as the diagnosis is made and an ambulance is called, first aid should begin. The victim should be placed on a hard surface. Next, the resuscitation measures of the ABC algorithm come into effect.

ABC consists of three points.

  1. Ensure airway patency. To do this, the person’s head is tilted back, and lower jaw put forward. After which, with a finger wrapped in a cloth, the oral cavity is cleared of vomit or mucus.
  2. Create artificial ventilation lungs. This is done in two ways: “mouth to mouth” and “mouth to nose”. For the first method, pinch the victim's nose with two fingers and blow air into the mouth. To avoid contact with the patient's saliva, cover with a scarf or napkin.
  3. Perform a closed cardiac massage. However, the heart must receive a precordial beat as soon as it stops. It is applied from a distance of approximately 25 cm with a fist to the sternum area, before starting a cardiac massage. It is effective only in the first half a minute after cardiac arrest and only in case of ventricular fibrillation.

These three steps, done correctly, will help save human life. Particular attention should be paid to the order in which they are performed. The sequence is due to the fact that the brain prioritizes blood supply rather than ventilation of the lungs.

Heart massage

For cardiac massage to have an effect, it must be certain actions in the correct order.

First, find lower third sternum. Then measure up a distance from its bottom edge equal to two transverse fingers. Clasp your hands so that one hand is on top of the other. Straighten your arms to rest them on your lower third.

When pressing, it is important to keep your arms straight. This will avoid rib fractures, and the pressure applied will be optimal. To achieve a greater effect, it is recommended to bend the patient’s legs and raise them 35° above the floor.


Massage

Ambulance

What medications are administered to the patient first? The medical team uses special means to start the heart. One such drug most commonly used for cardiac arrest is epinephrine. There are also several other means for this: Atropine, Norepinephrine and others. All of them stimulate cardiac activity.

Then the heartbeat is diagnosed or an electrocardiogram is done. A defibrillator is then used to start the heart. The defibrillator has electrodes that are placed on the patient's chest. An electrical discharge is sent through them, which should start the heart.

The defibrillator is already used on the move in the ambulance. This is necessary for the patient to survive to the intensive care unit of the hospital. The defibrillator can also be used in the clinic.

Medicines for the heart

It is worth considering in detail the medications (Lidocaine, Adrenaline and others), their purpose and properties. After all, even though the defibrillator takes on the main function of starting the heart muscle, a much greater result is achieved in combination with the necessary drugs.

Necessary drugs - Adrenaline, Atropine, Lidocaine, sodium bicarbonate, magnesium sulfate and calcium:

  • Adrenaline is used to make the heart beat faster and stronger.
  • Atropine is excellent for asystole.
  • Lidocaine helps fight arrhythmia.
  • Sodium bicarbonate is used in cases of prolonged arrest, especially if there has been acidosis or hyperkalemia.
  • Magnesium sulfate stabilizes and stimulates heart cells.
  • Calcium helps cope with hyperkalemia.

When used correctly, Atropine, Lidocaine and other drugs give excellent results, greatly increasing the patient’s chances of survival.

Resuscitation and consequences

After delivering the patient by ambulance and injections (Lidocaine, Atropine, etc.), he should certain time be in intensive care. Surgery may be required. In this case, during the operation, a pacemaker is implanted in the heart, which will maintain the heart rhythm.

Even after discharge, the patient must strictly follow the doctors’ instructions: refuse bad habits, drink necessary pills and undergo periodic heart screenings.

Using glycosides and leading a healthy lifestyle, you can avoid a recurrence of this situation. And then the chance to live to see old age will increase significantly.

The consequences of cardiac arrest can be very serious. These include memory loss, hallucinations, seizures, headaches, blurred vision and hearing.


Help

Myths

Now on the Internet there are many myths associated with cardiac arrest. They feature cognac, SCP 001, a dream book, and the like. Let's try to dispel at least some of them.

Dreams

Let's start with the dream book. Many lovers of traditional medicine firmly believe that it is possible to predict and prevent cardiac arrest if you correctly interpret your dreams.

It is believed that stopping will occur if you see the heart from the outside in a dream. And you can prevent it if you take control of your sleep and present a different picture in accordance with the description in the book.

The result of such self-hypnosis is death. Therefore, you should not risk your health by relying on a book about dreams, but seek help from a doctor.

SCP 001

SCP 001 is a myth about a mysterious file containing terrible secrets. If you believe the data on the site, then when you visit it, a person will be faced with unique protection. If you scroll down the page and read the text of SCP 001, after a few seconds his heart stops.

Many people believe in SCP 001 and are seriously worried about it. However, so far there are no casualties, and, apparently, this is another joke in the series of “damned chain letters”

Cognac and heart

The myth about cognac. Many people who survived the shutdown love cognac. And many of them are sure that it is good for the heart. And that’s why they often use it more often than medications.

Cognac does not heal, but can lead to cardiac dysfunction. Therefore, its use leads to failures that will cause cardiac arrest.

So people suffering from heart disease should avoid consuming it.

You will find even more information about cardiac arrest in the video:

What do you need to know to provide first aid for cardiac arrest?

Clinical death can quickly become biological if certain first aid steps are not taken. In order to provide this very assistance, you need to know the signs of cardiac arrest, their manifestations and coordination of actions to resuscitate a person. The importance of such knowledge is confirmed by statistics according to which about 200 thousand people die from cardiac arrest per week worldwide, while 90% of deaths could be reversible with proper first aid.

Why does the heart stop beating?

The cause of cardiac arrest is often impaired functional abilities of this body. Medicine identifies two main ways leading to clinical death:

  1. Ventricular fibrillation accounts for 90% of recorded cases of clinical death. In this condition, the heart muscles succumb to rapid chaotic contraction, which is not accompanied by the release of blood flow.
  2. Asystole accounts for only 5%, in which the heart muscles stop contracting completely. This leads to initial oxygen starvation of the cells, followed by clinical death.
  3. The remaining 5% includes electromechanical dissociations and damage to the heart muscles, which lead to cardiac arrest during an accident, surgery, etc.
    It should be noted that the following factors significantly increase the risk of myocardial arrest:
  • old age;
  • bad habits (smoking, alcohol);
  • excess weight;
  • prolonged exposure to stress;
  • presence of hypertension or hypotension;
  • diabetes mellitus

Learn more about cardiac arrest during sleep

It happens that cardiac arrest occurs during sleep. Often the cause of clinical death in a dream is pathology cardiovascular system, but it happens that the heart skips a beat and healthy people. In medicine, such “microdeath” is called obstructive sleep apnea syndrome. According to studies that were conducted in the 70s, the duration of nocturnal cardiac arrest (in 68% of subjects with respiratory arrest) can reach up to 13 seconds, while the person does not show any signs of myocardial arrest, but the body cells experience oxygen starvation.

Particular attention should be paid to sudden infant death syndrome, which is popularly called “cradle death of a baby.” The age group susceptible to this syndrome is infants 2–4 months old, whose heart stops at night without any previous health problems. Factors that increase the risk of such a tragedy include:

  • baby sleeps in a prone position;
  • increased temperature and stuffiness in the room where a small child sleeps;
  • prematurity of the baby;
  • the presence of intrauterine hypoxia in a child;
  • transfer infectious disease in the first months of life.

Signs of cardiac arrest

Cardiac arrest is preceded by characteristic features, by which it can be determined that the body is susceptible to irreversible processes.

  1. The man faints. In an unconscious state, short-term convulsions of the whole body or limbs may occur.
  2. Breathing becomes agonal (up to two minutes there are rare breathing movements in the form of short, sharp, convulsive wheezing) or absent altogether.
  3. The pulse in the main blood vessels cannot be felt.
  4. There is no reaction of the pupils to light stimulation. It is checked by shining a flashlight into the pupil; during cardiac arrest, they are dilated and do not narrow when exposed to direct light.
  5. The skin of the face takes on a bluish-gray color as blood circulation stops.

Since only 5–7 minutes are allotted to restore the functioning of the myocardium, seeing the first signs of cardiac arrest, it is necessary to quickly assess the person’s condition, for this you should:

  • call out, pat on the cheeks;
  • if there is no reaction, feel the heartbeat and pulse;
  • check for breathing;
  • Be sure to call an ambulance.

What first aid should be provided in case of cardiac arrest and lack of breathing?

If a person has the above-described signs indicating myocardial dysfunction, then first aid should be provided for cardiac and respiratory arrest. This assistance is divided into:

  • emergency pre-hospital;
  • medical.

First aid in case of clinical death

If a person in your presence faints or is found unconscious, and checking the signs indicates clinical death, then the following resuscitation actions should be taken, since a life can be saved only within 5-7 minutes after the end of the functioning of the heart muscles.

  1. Place the person on a hard, flat surface. Call an ambulance.
  2. Monitor airway patency. To do this, you need to carefully tilt the patient's head back, but before doing this, check to see if there is any vomit in the mouth, since it is quite possible that the loss of consciousness was preceded by a gag reflex.
  3. Perform indirect cardiac massage. During this exercise, your arms should be straight and not bent at the elbows. Place your left (the weaker) hand on the right side of your chest, palm down. Place your palm perpendicularly right hand. After placing your hands in a “cross”, you need to make five pressures with straightened arms. You should not press too hard, as there is a risk of breaking ribs, which will further worsen the person’s condition. Normally, 100 presses should be made in 60 seconds.
  4. Perform artificial respiration. To do this, after ensuring the airway is open, you should place a clean cloth (handkerchief or napkin) on the victim’s mouth/nose. There are two methods of performing the procedure: mouth-to-mouth and mouth-to-nose. Holding your mouth or nose (depending on the chosen method), blow air through your mouth into the lungs of the lying person.
  5. Actions to pre-hospital resuscitation involve combination artificial respiration and indirect cardiac massage. Ideally, they are performed by two people, one of whom inhales air into the lungs after the fifth pressure of the second person. If one person is engaged in resuscitation, then after fifteen compressions you need to take one breath into the lungs, then return to indirect massage again.

First aid

Resuscitation efforts should continue until the ambulance arrives. Doctors will inject the victim with drugs that help “wind up” the myocardium and try to induce a heartbeat through an electrical discharge. Next, the patient is taken into an ambulance, followed by hospitalization and treatment.

Main symptom heart attack is sharp pain in the chest, pain may radiate to the left arm and shoulder or to 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.

Chest pain can usually be caused by physical activity 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 with 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 that respiratory tract free. - Keep the patient warm and immobile. — Prepare a saliva ejector and a vacuum cleaner in case of vomiting. — Be ready to begin resuscitation actions, to support life important 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 collapse. It may be a consequence of angina pectoris.

Signs of cardiac arrest:

    — sudden loss consciousness; - lack of breathing and pulse; - dilated pupils; — skin depending on the cause of cardiac arrest there may be: a) bluish color; b) gray; c) very pale.

Call an ambulance immediately.

Begin and continue resuscitation actions aimed at maintaining vital body functions until the arrival of the ambulance team.

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 . 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 illness cardiovascular system, but more often it is severe myocardial infarction or thromboembolism pulmonary artery. 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 a blood circulation level of up to 25% of normal, however, indirect cardiac massage, which is most often used when it stops, provides only 5% of normal flow.

That's why key role The speed of restoration of normal heartbeat plays a 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;
  • cramps are enough frequent consequences cardiac arrest, usually the 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.

Sudden death occurs in completely healthy people

According to the definition of the World Health Organization, to sudden death include cases of death of practically healthy persons 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 everyday 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 us to classify it as a vascular disaster.

A large businessman with a typical Georgian surname, from among the heirs of the wealth of the collapsed Soviet Union, he had already endured all the hardships of the division of property and lived in London healthy and right life. 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. Such obvious reasons as fresh blood clots in coronary arteries with sudden cardiac death it is extremely rare to find. 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. The latest methods for studying the cardiovascular system (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 recording over 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– increased 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, fluttering is followed by complete cardiac arrest due to its exhaustion 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 drugs and toxic factors (for example, alcohol) can lead to damage to the conduction system of the heart or contribute to impaired myocardial contractility. But, despite the clarity of the individual mechanisms of disturbances in the normal functioning of the heart, many cases of sudden death do not receive a satisfactory explanation. 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 use of pharmacological agents, increasing 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. During sleep, physiological changes in rhythm occur, 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, an outstanding athlete and simply a beautiful person who promotes and leads a healthy lifestyle, suddenly falls and dies before reaching the age of 50.

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 reliably 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. Here everything is more or less clear: ethyl alcohol destroys the myocardium and the 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.

Cardiac arrest represents serious threat human life. When the heart stops beating, there is no pulse and death occurs within minutes. During cardiac arrest, every minute is important for a person, which takes about 10% of his life. If sudden cardiac arrest occurs and proper care is provided within the first minute, the survival rate is about 90%. When assistance is provided after 9 minutes, less than 10% of people survive; after 10 minutes, the survival rate is zero. It is impossible to save a person after this time.

According to statistics, people die every day from cardiac arrest. more people than due to cancer, traffic accidents, etc. This happens because many people do not know how to help a person whose heart has suddenly stopped. People nearby call an ambulance, which, unfortunately, is unlikely to arrive in the short amount of time when it is still possible to save the patient. People's hearts can stop of different ages- newborns, young and old.

Reasons

The main causes of cardiac arrest are disturbances in the functioning of the heart muscle caused by a number of factors. In particular, the following types of cardiac arrest are distinguished:

  1. Ventricular fibrillation. In most cases, it is this pathology that causes cardiac arrest. Ventricular fibrillation is an irregular and ineffective contraction of muscle fibers that disrupts the pumping function of the heart.
  2. Ventricular asystole is the second most common cause of cardiac arrest. During this disorder, the electrical activity of the heart muscle completely stops.
  3. Ventricular paroxysmal tachycardia is characterized by the absence of pulse in the large arteries.
  4. As a result of electromechanical dissociation, cardiac arrest can also occur: due to the lack of mechanical activity of the organ while maintaining electrical activity.

The heart can stop for a reason genetic predisposition- Romano-Ward syndrome. There are other factors that can provoke a malfunction of the heart muscle and lead to the development of extremely adverse consequences.

The heart can stop in the background:

  • hypothermia of the body, as a result of vascular spasm;
  • electrical injuries;
  • misuse medical supplies- cardiac glycosides, adrenergic blockers, analgesics and drugs used in anesthesia;
  • stopping breathing when diving under water;
  • lack of air, asphyxia;
  • coronary heart disease;
  • atherosclerosis;
  • high blood pressure, left ventricular hypertrophy;
  • anaphylactic and hemorrhagic shock;
  • smoking (an indirect factor that negatively affects cardiovascular activity);
  • due to advanced age.

Some medications for arrhythmia, antibacterial drugs, and medications for schizophrenia can lead to cardiac arrest. Alcohol poisoning or intoxication of the body due to overdose medicines may provoke the onset of clinical death.

If there are predisposing factors for the development of sudden cardiac arrest, then you need to carefully protect your body, give up bad habits and regularly undergo examination by a doctor. You monitor your organ with the help of a cardiovisor - a device that you can independently attach to your legs and arms and find out your electrocardiogram.

Symptoms

Signs of cardiac arrest will allow you to distinguish the disorder from other pathologies in which it is prohibited to use certain manipulations to restore the functioning of the heart muscle. There are some signs that may indicate cardiac arrest. First of all, this is loss of consciousness. A person passes out a few seconds after the heart stops, making convulsive twitches for 20 seconds.

The skin turns pale, and the lips, tip of the nose and earlobes acquire a blue tint. Breathing slows down and is almost inaudible. After 2 minutes it stops completely. When palpated, there is no pulse in the wrist and neck area. Main sign- absence of heartbeat behind the sternum. During cardiac arrest, the pupils are dilated, without the slightest reaction to light.

2-3 minutes after the main organ stops, a person experiences clinical death, after which the organs and tissues undergo irreversible hypoxic changes. If the correct resuscitation actions are not performed in time, clinical death will turn into biological.

After the heart has stopped, the brain continues to live for another 9 minutes. The death of brain cells occurs from the 7th minute; if you manage to resuscitate the heart after this time, the person may remain incapacitated for life. It is possible to preserve the health of the victim only in the first 2-5 minutes from the onset of clinical death.


A person may have no symptoms during cardiac arrest. More precisely, he will not be able to perceive them due to a suddenly developing clinical situation. Some report severe, unbearable pain in the chest. Cardiac arrest can occur so suddenly that others simply do not notice it. It is especially dangerous when this happens in a dream, and then for a long time everyone will think that the person is just sleeping. This is how cardiac arrest occurs in infants - abruptly, suddenly, and only a timely reaction can bring the baby back to life.

Diagnostics and first aid

It is necessary to diagnose cardiac arrest very quickly, based on external signs and during an examination. In this case, the patient is not prescribed conducting an ECG and other procedures, since in the case of his resuscitation, every minute is important. First of all, the doctor feels the pulse, listens to breathing, looks at the pupils (in the process of resuscitation).

If suddenly something bad happens to a loved one or a passer-by, you must urgently call an ambulance and try to resuscitate the patient yourself. To do this, you need to lay him on a flat and hard surface, unbutton his shirt collar or free his neck from other clothes, check the oral cavity for possible availability vomit or sunken tongue and begin performing cardiac massage. Cardiac massage itself may well perform unprepared person, without special medical education.

It is necessary to press on the heart area with two straightened arms, alternating cardiac massage with artificial respiration.


This resuscitation procedure must be performed within 30 minutes. If the chest begins to rise, this means that the lungs are filled with air and life is returning to the person. Upon arrival, the doctor can inject adrenaline into the heart and continue the resuscitation procedure.

Further treatment will be prescribed after the patient is hospitalized, depending on the cause that caused the cardiac arrest and the changes in the body that occurred after the attack.
Sometimes, in addition to medications, surgical intervention is required, which can increase the patient’s chances of life. Very rarely, after returning to life, the patient manages to avoid severe consequences, and as a result, you have to undergo therapy in a hospital setting for a long time.

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Among reasons There are several types of causes of cardiac arrest.

  • Ventricular fibrillation is multidirectional, scattered contractions of individual bundles of myocardial fibers (the muscular layer of the heart) of the ventricles of the heart, about 90% of all cases of sudden death.
  • Ventricular asystole. Termination of electrical activity of the heart (about 5% of all cases of cardiac arrest).
  • Ventricular paroxysmal tachycardia (suddenly beginning and suddenly ending attack of increased ventricular contractions up to 150-180 beats per minute) with absence of pulse in large vessels.
  • Electromechanical dissociation. Absence of mechanical activity of the heart in the presence of electrical activity.

Risk factors .

  • Coronary heart disease (a disease caused by insufficient blood supply to the myocardium (muscle layer of the heart)).
  • Myocardial infarction (death of heart muscle tissue due to insufficient blood supply).
  • Alcohol consumption by a patient with coronary disease heart (15–30% of cases of cardiac arrest).
  • Arterial hypertension (persistent increase in blood pressure above 140/90 mmHg).
  • Old age.
  • Hypertrophy (increase in volume) of the left ventricle.
  • Smoking.
  • Overdose of certain drugs:
    • barbiturates (highly effective sleeping pills);
    • anesthetics, narcotic painkillers;
    • b - adrenergic blockers (drugs that lower blood pressure);
    • phenothiazine derivatives (drugs used in psychiatry that have a sedative effect);
    • cardiac glycosides (drugs that increase and decrease (they become rare) heart contractions).
  • Shock: anaphylactic (developing to an object that causes an allergy), hemorrhagic (arising as a result of acute massive blood loss).
  • Hypothermia (decrease in body temperature below 28 ° C).
  • Pulmonary embolism (PE) - blockage blood clot pulmonary artery.
  • Cardiac tamponade (a condition in which fluid accumulates between the layers of the pericardium (the sac around the heart), which leads to the impossibility of full heart contractions due to compression of the cavities of the heart).
  • Pneumothorax (air entering the pleural cavity (a cavity formed by two membranes covering the lungs and chest walls)).
  • Electrical injury (electric shock, lightning strike).
  • Asphyxia (breathing difficulty).

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How the heart works. What is cardiac arrest and how is it different from a heart attack?

To understand the mechanism of cardiac arrest, it is necessary to understand how the heart works. The heart has an internal electrical system that controls the speed and rhythm of the heartbeat. Problems with the electrical system cause an abnormal heart rhythm called an arrhythmia.


The heart, unlike other muscles of the human body that obey nerve connections, has its own electrical stimulator - a special group of cells called " sinus node" It is located in the right atrium and generates electrical impulses that travel through the heart to synchronize the heart rate and coordinate the redirection of blood from the heart to the rest of the body.

In a person with normal healthy heart An abnormal heart rhythm does not occur without an external stimulator, such as electric shock, drugs, or trauma to the chest.

There are many types of arrhythmias. During an arrhythmia, the heart may beat too fast, too slow, or with an irregular rhythm. Some arrhythmias can cause the heart to stop sending blood to organs. This is the same type of arrhythmias that causes sudden cardiac arrest.

Cardiac arrest is not the same as a heart attack. The latter occurs when blood flow to the heart muscle is only partially blocked, rather than completely. During a heart attack, the heart does not suddenly stop beating. However, this condition can occur during or after a heart attack or stroke.

People with cardiovascular disease are at increased risk of sudden cardiac arrest. However, often this state Occurs in people who appear healthy and have no known heart disease or other risk factors. Timely provision of assistance in this condition plays a decisive role in saving a person’s life.


Figure 1. Cardiac arrest

The electrical system of the heart is a structure that can be stimulated in a certain way and “start” the heart again. When blood is not pumped from the heart to the organs and brain, the condition can be compared to a power outage in the house. The heart's "electricity" must be reconnected, and this is usually done with the help of an ordinary electric current.

A heart attack, known as a myocardial infarction (MI), affects how the heart works. Its cause lies in the blockage blood vessels, which blocks the flow of blood to the heart muscle. This area of ​​the heart may die. In addition, after a heart attack, the heart must be "cleansed" with medications or surgical intervention in order to continue supplying blood to all parts of the body.

Two thirds of cardiac arrests occur suddenly, without any prerequisites or symptoms, while a heart attack is accompanied mainly by a variety of symptoms and health problems.

Sudden cardiac death- this is a condition that differs from cardiac arrest in that the patient eventually experiences a cessation of vital activity, the heart stops beating and it is not possible to restore its normal function. Cardiac arrest with successful cardiac recovery is not sudden cardiac death, but may be temporarily classified as such (until recovery of cardiac function).

Causes of cardiac arrest

In most cases, sudden cardiac arrest is caused by ventricular fibrillation. In this condition, the lower chambers of the heart do not function as they should - they contract quickly and irregularly. When ventricular fibrillation occurs, the heart pumps too little or no blood. Ventricular fibrillation causes cardiac arrest, which is fatal if not treated within minutes.

Other problems with electrical conduction can also lead to cardiac arrest, for example due to the speed at which electrical signals are conducted too slowly. The heart then begins to beat too slowly and stops.

Another reason: the lack of response of the heart muscle to electrical signals.

What factors cause disturbances in the electrical conductivity of the heart?

These include:

  • coronary heart disease, which reduces blood flow to the heart;
  • heavy physical activity, which increases the risk of abnormal electrical activity in the heart;
  • hereditary disorders, having which a person is predisposed to disruptions in the electrical activity of the heart;
  • structural changes in the heart that cause abnormal propagation of electrical signals.

Coronary heart disease

CAD occurs when excessive deposits accumulate in the coronary arteries. These arteries supply oxygen-rich blood to the heart muscle. The deposits narrow the arteries and reduce blood flow to the heart muscle. As a result, plaques lead to rupture of the artery and the formation of clots (thrombi). The clot can partially or completely block the flow of oxygen-rich blood to the part of the heart muscle supplied by the artery. This causes a heart attack.

During a heart attack, some cells die and are replaced by scar tissue. This damages the heart's electrical system. Scar tissue can cause electrical signals to travel abnormally throughout the heart.

Certain types of exercise can be harmful because they lead to conditions such as:

  • decrease in hemoglobin;
  • intense lack of oxygen;
  • excessive release of adrenaline;
  • decreased levels of potassium and magnesium in the blood.

Hereditary disorders

The tendency to have arrhythmia can be inherited. An example of such a disease is long QT syndrome (LQTS). This syndrome is caused by disturbances in the electrical activity of the heart as a result of small holes in the surface of the heart muscle cells.

Structural heart disorders

Change normal size or structure of the heart can affect its electrical system. Examples of such changes are:

  • increase in heart size;
  • reduction in heart size;
  • tissue abnormalities.

Valvular heart disease

Narrowing or regurgitation of the heart valves leads to stretching or thickening of the heart muscle, or both. When the chambers of the heart become enlarged or weakened due to stress caused by hardening or regurgitation of the valve, an arrhythmia is likely to develop.

Congenital heart defect

It is often diagnosed based on the fact that the heart is functioning abnormally. Present from birth, but may appear when unfavorable conditions not necessarily in childhood, but in adolescence or adulthood.

Symptoms of sudden cardiac arrest

Typically, the first symptom of sudden cardiac arrest is loss of consciousness (fainting).

Other symptoms are:

  • lack of pulse;
  • lack of heartbeat.

Preliminary symptoms are:

  • dizziness;
  • weakness;
  • dry mouth;
  • pulse surges;
  • nausea;
  • dyspnea;
  • chest pain;
  • vomit.

Signs of a stroke (slurred speech, dizziness, loss of spatial orientation, inability to remember recent events, paralysis of one side of the body/face) may precede cardiac arrest.

Sharp pain, a feeling of chest tightness - signs of a heart attack - can occasionally be a harbinger of cardiac arrest.

Cardiac arrest is characterized by restoration of cardiac activity after resuscitation measures. However, this process is very delicate and requires immediate medical attention and a prompt response to the problem, otherwise the patient risks dying very quickly.

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Causes of heart failure

Throughout life, the heart constantly and tirelessly works, sending oxygen-rich blood into the vessels. A sudden stop of the pumping function becomes the cause of a reversible condition - clinical death, the duration of which is no more than 7 minutes. If in this short period of time it was not possible to get the heart to work, then an irreversible state of biological death occurs. All causative factors of cardiac arrest are divided into 2 groups:

  1. Heartfelt
  • coronary heart disease;
  • myocardial infarction;
  • pathology heart rate and conductivity (fibrillation, ventricular asystole, complete blockade);
  • cardiogenic shock;
  • rupture of a cardiac aneurysm;
  • pulmonary embolism.

In the vast majority of cases (90%), it is cardiac factors and diseases that provoke the main types of cardiac arrest, therefore any episode of cardiac pathology requires medical supervision and careful diagnostic studies. Prevention and timely treatment of myocardial infarction are the best preventive measures that help preserve human health and life.

  1. Extracardiac

Cardiac arrest and cessation of breathing may occur under the influence of external factors and against the background of severe pathology of internal organs. Main extracardiac causes:

  • shock of any origin (anaphylactic, post-traumatic, burn, septic, surgical);
  • late stages of cancer;
  • heavy and rapid bleeding from large vessels (rupture of an aortic aneurysm);
  • acute respiratory failure (severe lung disease, foreign formation in the respiratory tract);
  • diseases of internal organs with the development of renal and hepatic failure;
  • poisoning or negative impact medicines;
  • injuries or conditions incompatible with life (drowning, suffocation, electrical trauma);
  • reflex cardiac arrest caused by an unexpected and precise blow to certain places on the human body - reflexogenic zones (sinocarotid zone, solar plexus, perineal area).

Sometimes it is impossible to identify the cause of cardiac arrest, especially if it is cardiac arrest during sleep in a person in the absence of serious pathology. In these situations, it is necessary to look for and take into account predisposing factors:

  • long history of smoking;
  • alcohol abuse;
  • metabolic syndrome (obesity, high blood cholesterol, blood pressure fluctuations);
  • diabetes mellitus without constant monitoring and treatment;
  • acute psycho-emotional stress.

Sudden infant death syndrome is especially prominent when healthy baby before the age of 1 year, dies unexpectedly for no apparent reason. This extremely unpleasant and sad situation can occur against the background of the following factors:

  • undiagnosed pathology of internal organs;
  • prematurity and immaturity of the baby’s organs and systems;
  • latent infection;
  • incorrect position in bed (sleeping on your stomach, buried in a soft pillow);
  • violation of thermoregulation in a hot and stuffy room;
  • mother's inattention.

Regardless of the causative factors, circulatory arrest is not only a complete mechanical cessation of the heart pump, but also a type of cardiac activity that is unable to provide the minimum required blood flow in organs and tissues.

Variants of the pathological condition

The cardiac cycle consists of 2 stages:

  • systole (sequential contraction of the atria and ventricles);
  • diastole (relaxation of the heart).

Most often, the cycle stops in the second stage, which leads to cardiac asystole. External signs sudden circulatory arrest are typical, but with electrocardiography, all types of cardiac arrest can be divided into 3 options:

  • primary ventricular asystole;
  • secondary ventricular asystole;
  • ventricular fibrillation.

If the cause of sudden death is myocardial infarction or complete atrioventricular block, then this will be manifested by ventricular fibrillation. Reflex cardiac arrest is primary asystole on the ECG, which looks like a straight line.

The main symptoms of cessation of blood circulation

All symptoms of cardiac arrest can be limited to the following typical signs:

  • sudden loss of consciousness;
  • absence of pulsation of large arterial trunks;
  • cessation of breathing movements;
  • dilated pupils;
  • pallor and cyanosis of the skin.

To quickly assess the situation and diagnose the fact of clinical death, the first three typical signs are sufficient. In this case, it is necessary to look for the pulse near the larynx in the neck, where the carotid arteries. There is no need to focus on changes in the pupils and skin as symptoms of cardiac arrest: the appearance of these signs is secondary and largely depends on general condition body.

Diagnostic principles

The time factor in the diagnosis of acute cessation of blood flow plays a critical role. 7-10 minutes after the heartbeat stops, irreversible changes V nerve cells what causes biological death brain. Treatment of asystole should begin immediately after signs of lack of vital activity are detected. The first step in the event of loss of consciousness is to evaluate the pulse in the carotid arteries. To do this, you need to place the 2nd and 3rd fingers of your hand on the side surface of the larynx and, slowly moving your fingers to the side, try to feel the beat large vessel. The absence of pulsation is an indication for primary emergency assistance.

It is much easier to assess the situation and make an accurate diagnosis when a sick person is in the hospital. Or when cardiac arrest occurs during surgery. On the cardiac monitor, the doctor will see a straight line, immediately starting to perform all emergency resuscitation measures.

Emergency treatment tactics

The sooner treatment is started from the moment of sudden death, the greater the chance for the person to return to a full life. The following are the most important and mandatory stages of emergency assistance:

  • checking airway patency;
  • performing artificial respiration;
  • cardiac massage to restore blood flow;
  • use of electrical defibrillation.

It is necessary to create conditions for the resumption of vital work important organs to restore blood flow. An important condition for successful therapy is the use of special medications (Adrenaline, Atropine, potassium and calcium preparations).

Forecast for life

Even a short episode of clinical death does not pass without a trace, especially if emergency measures were carried out by a non-professional. The prognosis is more favorable for a patient who received primary care in a hospital when, within minutes of determining death, the doctor began performing standard resuscitation techniques using a defibrillator. The prognosis for life is unfavorable in situations where help comes 10 minutes after the sudden cessation of heart function.

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