Instant cause death. The causes of sudden death are heart disease, thrombosis and hereditary factors. Risk factors and groups

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

A major businessman with a typical Georgian surname, one of the heirs to the wealth of the collapsed Soviet Union, 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, A personal doctors They wouldn’t even miss a suspicious murmur in the heart area. 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 again become acute in last years, when carried out World Organization In public health, extensive population-based studies have demonstrated an increasing incidence of sudden death among the adult, and non-adult, population. 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 treated timely assistance such patients can be revived, and in practice this happens quite often. Typically, resuscitation is performed using artificial respiration and closed massage hearts. Sometimes, to restore blood circulation, a punch to the chest, in the area of ​​the heart, is enough. If a disaster occurs in medical institution or in the presence of emergency doctors, a high-voltage discharge is used to restore blood circulation electric current– 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 causes as fresh blood clots in the coronary arteries in sudden cardiac death can be found extremely rarely. With careful examination (it is clear that all cases of sudden death serve as the basis for careful examination), it is almost always possible to detect some pathology. However, this does not make sudden death any less mysterious. After all, all changes in the heart and blood vessels exist and are formed long time, and death occurs suddenly and completely unexpectedly. Latest methods research of cardio-vascular system (ultrasound scanning, spiral CT scan) 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 implementation in clinical practice methods of long-term monitoring of heart function ( ECG registration within hours and days). It became clear that sudden death most often (65-80%) is directly related to ventricular fibrillation.

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

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

As a rule, flutter is followed by complete cardiac arrest due to depletion of its energy reserves. But fibrillation cannot be considered the cause of sudden death; rather, it is its mechanism.
It is generally accepted that the most important causative factor Sudden cardiac death is caused by 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 autonomic tone) can lead to rhythm disruption. It is known for sure that stress contributes to the occurrence of arrhythmia - hormones change the excitability of the heart muscle. It is also known that a lack of potassium and magnesium has a significant effect on the functioning of the heart and, under certain conditions, can lead to heart failure. There is no doubt that some medicinal substances, toxic factors (for example, alcohol) can lead to damage to the conduction system of the heart or contribute to impaired myocardial contractility. But, with all the clarity individual mechanisms violations normal operation heart, many cases of sudden death are not satisfactorily explained. Let us recall the regularly recurring cases of death of young athletes.

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

As a rule, this group of trained, physically well-developed young people has fairly good medical supervision. It is unlikely that among professional athletes who managed to achieve extraordinary success with their physical effort, there are people suffering serious illnesses heart and blood vessels. It is even more difficult to imagine coronary insufficiency in people who regularly endure enormous physical exertion. 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%). High frequency cardiac arrest during sleep convincingly refutes the coronary nature of sudden death. If not in all cases, then in a significant part of them. Comes during sleep physiological changes rhythm, which are characterized by bradycardia - a decrease in heart rate to 55-60 beats per minute. In trained athletes this frequency is even lower.

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

Several newspaper lines are awarded to famous athletes, politicians, and artists who suddenly died. But many similar disasters occur with ordinary people, which are not written about in the newspapers.
- He was completely healthy! – shocked relatives and friends are amazed for several days. But the inexorable convincingness of what happened soon makes one believe the facts: if he died, it means he was sick.

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

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

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

But in this series, the cases of death of young children stand apart - sudden onset syndrome. infant mortality. 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.

When it's quite healthy man dies suddenly, they talk about sudden unexplained death. To the question “why?” Doctors helplessly shrug their shoulders, and relatives shed tears. But in some cases, tragedy can be avoided by winning back several trump cards from evil fate in advance!

3 ways to cheat fate

According to statistics, one person dies suddenly every 40 minutes. In most cases, tragedy happens to men 45-54 years old who have not complained of health, have lived life to the fullest and made bright plans for the future. Death comes quickly, like a lightning strike. For the relatives of the deceased, the incident comes as a shock. However, analyzing similar cases, doctors came to the conclusion that the cause of sudden death is most often cardiac arrest. How does it happen that a heart that has been working without interruption for decades suddenly stops forever?

Fatigue or a wake-up call?

In most cases, the cause of sudden death is myocardial infarction or severe arrhythmia leading to cardiac arrest. These are manifestations of coronary heart disease (angina) - a condition when the heart muscle lacks oxygen.

A disease like this does not develop suddenly. Fatal manifestations are preceded by months and years. If you hear in time alarm bell and begin treatment, tragedy is avoided. If you give up on the symptoms of malaise, continuing to work without sparing your stomach, sooner or later your heart cannot stand it.

Signs of an impending heart attack may include:

• increasing fatigue, weakness, and decreased performance over 1-2 weeks;
• periodic interruptions in the functioning of the heart, a feeling of fading, increased tremors in the chest;
• shortness of breath, feeling of lack of air;
• chest pain that can spread to the abdomen, back, left shoulder blade, arm, lower jaw;
• numbness of hands.

It is characterized by deterioration of well-being during physical activity (climbing stairs, fast walking), with excitement, and also after smoking.

Such symptoms cannot be attributed to fatigue, age, or magnetic storms. To give up on them means to sign your own death sentence. When discomfort in the area of ​​the heart, you need to sit or lie down, if possible, dissolve a nitroglycerin tablet under your tongue. Immediately after improvement, contact for medical care. Whenever burning pain in the chest, you need to call an ambulance as quickly as possible and swallow ½ aspirin tablet. This is the case when the minute decides fate.

It's not beer that kills people...

According to international studies, alcohol greatly increases the risk of sudden death among men. And everyone can save themselves from this risk! Not only does it lead to fatal consequences. Even a single dose can kill a healthy and strong man in his prime.

Blood thickens, clotting processes are disrupted, which contributes to the formation blood clots- blood clots. In addition, a drunk person usually falls asleep in uncomfortable position, does not feel the need to roll over to the other side or free a numb arm or leg. Compression of blood vessels doubles the risk of thrombosis. Waking up with a hangover, a person rises sharply, the blood clot breaks off and makes its fatal journey from the veins lower limbs into the vessels of the lungs. Blockage of the latter leads to instant death- the person simply suffocates.

In addition to thrombosis, acute alcohol poisoning can cause:

• toxic damage to the heart muscle, which leads to the development of life-threatening arrhythmia and cardiac arrest;
• paralysis respiratory center, then the person falls asleep and never wakes up.

Stress: good or bad

Could this tragedy have been prevented? Probably yes. After all, literally the day before the incident, he promised his wife to finally take a vacation and go to Zheleznovodsk on a voucher. But time was lost, and the man fell victim to nervous overload.

Destroys the body, but the basis is simple chemical reaction. When a person faces difficulty, the adrenal glands produce stress hormones: adrenaline, norepinephrine, cortisol. These substances are a secret weapon, a dope that allows you to perform super tasks when necessary. If the problem is solved, we feel the taste of victory and even some euphoria from success. It is the hormones of joy that are released into the blood: endorphins and enkephalins. Under their influence, we quickly recover and are ready for new achievements.

It is completely different when a person is constantly in a state of anxiety. Accumulating in large quantities, stress hormones have destructive effect on the tissue, constrict blood vessels, make the heart beat faster, and increase blood pressure. A person loses the ability to rejoice, sleeps poorly, becomes aggressive and irritable. Similar nervous exhaustion very often ends in a cardiovascular disaster: stroke or heart attack.

What if our whole life is a continuous overcoming? You can make stress work for you! We need to find a use for stress hormones and release adrenaline. The best way That's what physical education is for. Sports goals can be different: hit the ball in a basketball basket, knock out all the targets at the shooting range, or checkmate a neighbor with a chess. The main thing is that there must be a winner in impromptu competitions!

The second important step is to learn to enjoy life in all its manifestations. By noticing pleasant little things, you accumulate the same hormones of joy that help strengthen your failing health. Laughter, kindness, love, chocolate and good old comedy - this is a simple recipe for dealing with stress!

And of course, the third way to drive the “bony” away is to monitor your health. Excess weight, poor nutrition, smoking, mistrust of the doctor and refusal timely treatment can play a bad joke even on the most zealous optimist!

Natalya DOLGOPOLOVA,
doctor
city ​​"Stoletnik" No. 23, 2013

Sudden death due to cardiac causes: from acute coronary insufficiency and others

Sudden cardiac death (SCD) is one of the most severe cardiac pathologies, which usually develops in the presence of witnesses, occurs instantly or in a short period of time and has as the main cause the coronary arteries.

The factor of surprise plays a decisive role in making such a diagnosis. As a rule, in the absence of signs of an impending threat to life, instantaneous death occurs within a few minutes. A slower development of the pathology is also possible, when arrhythmia, heart pain and other complaints appear, and the patient dies in the first six hours from the moment of their occurrence.

The greatest risk of sudden coronary death observed in persons 45-70 years old who have certain forms of disorders in the blood vessels, heart muscle, and its rhythm. Among young patients, there are 4 times more men; in old age, men are susceptible to pathology 7 times more often. In the seventh decade of life, gender differences are smoothed out, and the ratio of men and women with this pathology becomes 2:1.

Most patients with sudden cardiac arrest occur at home; a fifth of cases occur on the street or in public transport. In both places there are witnesses to the attack who can quickly call an ambulance, and then the likelihood of a positive outcome will be much higher.

Saving a life may depend on the actions of others, so you cannot simply walk past a person who has suddenly fallen on the street or lost consciousness on a bus. You need to at least try to carry out the basic - indirect massage hearts and artificial respiration, having first called doctors for help. Cases of indifference are not rare, unfortunately, and therefore the percentage of unfavorable outcomes due to late resuscitation occurs.

Causes of sudden cardiac death

the main cause of SCD is atherosclerosis

The causes that can cause acute coronary death are very numerous, but they are always associated with changes in the heart and its blood vessels. The lion's share of sudden deaths is caused when fatty tissues form in the coronary arteries, obstructing blood flow. The patient may not be aware of their presence and may not make any complaints as such; then they say that a completely healthy person suddenly died of a heart attack.

Another cause of cardiac arrest may be acutely developed, in which proper hemodynamics are impossible, the organs suffer from hypoxia, and the heart itself cannot withstand the load and.

The causes of sudden cardiac death are:

• Cardiac ischemia;
• Congenital anomalies of the coronary arteries;
• arteries with endocarditis, implanted artificial valves;
• Spasm of the arteries of the heart, both against the background of atherosclerosis and without it;
• for hypertension, defect,;
• Metabolic diseases (amyloidosis, hemochromatosis);
• Congenital and acquired;
• Heart injuries and tumors;
• Physical overload;
• Arrhythmias.

Risk factors have been identified when the likelihood of acute coronary death becomes higher. The main such factors include ventricular tachycardia, a previous episode of cardiac arrest, cases of loss of consciousness, previous cardiac arrest, and a decrease in the left ventricle to 40% or less.

Secondary, but also significant conditions, in which the risk of sudden death is increased, is considered concomitant pathology, in particular, diabetes, obesity, myocardial hypertrophy, tachycardia more than 90 beats per minute. Smokers, those who neglect physical activity and, conversely, athletes are also at risk. With excessive physical exertion, hypertrophy of the heart muscle occurs, a tendency to rhythm and conduction disturbances appears, so death from a heart attack is possible in physically healthy athletes during training, a match, or competitions.

Diagram: distribution of causes of SCD at a young age

For more careful monitoring and targeted examination groups of people with high risk VSS. Among them:

1. Patients who have undergone resuscitation due to cardiac arrest or;
2. Patients with chronic failure and cardiac ischemia;
3. Persons with electric;
4. Those diagnosed with significant cardiac hypertrophy.

Depending on how quickly death occurred, instant cardiac death and rapid death are distinguished. In the first case, it occurs in a matter of seconds and minutes, in the second - within the next six hours from the onset of the attack.

Signs of sudden cardiac death

In a quarter of all cases of sudden death of adults, there were no previous symptoms; it occurred without obvious reasons. Other One to two weeks before the attack, patients noted a deterioration in their health in the form of:

• More frequent pain attacks in the heart area;
• Rise ;
• A noticeable decrease in performance, feelings of tiredness and fatigue;
• More frequent episodes of arrhythmia and interruptions in cardiac activity.

Before cardiovascular death, pain in the heart area increases sharply, many patients manage to complain about it and experience strong fear, as happens with myocardial infarction. Psychomotor agitation is possible, the patient grabs the heart area, breathes noisily and frequently, gasps for air, sweating and redness of the face are possible.

Nine out of ten cases of sudden coronary death occur outside the home, often against the background of strong emotional distress or physical overload, but it happens that the patient dies from acute coronary pathology in his sleep.

With ventricular fibrillation and cardiac arrest against the background of an attack, severe weakness, the head begins to spin, the patient loses consciousness and falls, breathing becomes noisy, convulsions are possible due to deep hypoxia of the brain tissue.

On examination, pale skin is noted, the pupils dilate and stop responding to light, heart sounds cannot be heard due to their absence, the pulse is large vessels also not defined. In a matter of minutes, clinical death occurs with all its characteristic signs. Since the heart does not contract, the blood supply to everyone is disrupted. internal organs, therefore, within a few minutes after loss of consciousness and asystole, breathing disappears.

The brain is most sensitive to a lack of oxygen, and if the heart is not working, then 3-5 minutes are enough for irreversible changes to begin in its cells. This circumstance requires immediate resuscitation measures, and the sooner chest compressions are provided, the higher the chances of survival and recovery.

Sudden death due to accompanying atherosclerosis of the arteries, then it is more often diagnosed in older people.

Among young such attacks can occur against the background of spasm of intact blood vessels, which is facilitated by the use of certain narcotic drugs(cocaine), hypothermia, overwhelming exercise stress. In such cases, the study will show no changes in the vessels of the heart, but myocardial hypertrophy may well be detected.

Signs of death from heart failure in acute coronary pathology will be pallor or cyanosis of the skin, rapid enlargement of the liver and neck veins, possible pulmonary edema, which is accompanied by shortness of breath up to 40 breathing movements per minute, severe anxiety and convulsions.

If the patient has already suffered from chronic organ failure, but edema, cyanosis of the skin, an enlarged liver, and expanded borders of the heart during percussion may indicate a cardiac origin of death. Often, when the ambulance team arrives, the patient’s relatives themselves indicate the presence of a previous chronic illness; they can provide doctors’ records and hospital extracts, then the diagnostic issue is somewhat simplified.

Diagnosis of sudden death syndrome

Unfortunately, cases post-mortem diagnosis sudden death is not uncommon. Patients die suddenly, and doctors can only confirm the fact of a fatal outcome. At autopsy they did not find any pronounced changes in the heart, which could cause death. The unexpectedness of what happened and the absence traumatic injuries speak in favor of the coronarogenic nature of the pathology.

After the arrival of the ambulance team and before the start of resuscitation measures, the condition of the patient, who by this time is already unconscious, is diagnosed. Breathing is absent or too rare, convulsive, the pulse cannot be felt, heart sounds cannot be detected on auscultation, the pupils do not respond to light.

The initial examination is carried out very quickly, usually a few minutes are enough to confirm the worst fears, after which doctors immediately begin resuscitation.

Important instrumental method Diagnosis of SCD is an ECG. With ventricular fibrillation, erratic waves of contractions appear on the ECG, the heart rate is above two hundred per minute, and soon these waves are replaced by a straight line, indicating cardiac arrest.

With ventricular flutter, the ECG recording resembles a sinusoid, gradually giving way to random waves of fibrillation and an isoline. Asystole characterizes cardiac arrest, so the cardiogram will show only a straight line.

Upon successful resuscitation prehospital stage, already in a hospital setting the patient will face numerous laboratory examinations, starting with routine urine and blood tests and ending toxicological study for some drugs that can cause arrhythmia. Will definitely be held daily monitoring ECG, ultrasound examination heart, electrophysiological study, stress tests.

Treatment of sudden cardiac death

Since sudden cardiac death syndrome causes cardiac arrest and respiratory failure, the first step is to restore the functioning of life support organs. Emergency care should be started as early as possible and includes cardiopulmonary resuscitation and immediate transportation of the patient to the hospital.

At the prehospital stage, resuscitation options are limited; it is usually carried out by specialists emergency care who find the patient in the most different conditions– on the street, at home, in the workplace. It’s good if at the time of the attack there is a person nearby who knows her techniques - artificial respiration and chest compressions.

Video: Performing basic cardiopulmonary resuscitation

Ambulance team after diagnosis clinical death begins indirect cardiac massage and artificial ventilation lungs with an Ambu bag, provides access to a vein into which medications can be administered. In some cases, intratracheal or intracardiac administration of drugs is practiced. It is advisable to administer drugs into the trachea during intubation, and the intracardiac method is used most rarely - when it is impossible to use others.

In parallel with the main resuscitation actions, an ECG is taken to clarify the causes of death, the type of arrhythmia and the nature of the heart’s activity in this moment. If ventricular fibrillation is detected, then the most the best method its relief will become, and if the necessary device is not at hand, then the specialist delivers a blow to the precordial area and continues resuscitation measures.

defibrillation

If cardiac arrest is determined, there is no pulse, and there is a straight line on the cardiogram, then during general resuscitation the patient is given any accessible way adrenaline and atropine at intervals of 3-5 minutes, antiarrhythmic drugs, cardiac pacing is established, after 15 minutes sodium bicarbonate is added intravenously.

After the patient is admitted to the hospital, the fight for his life continues. It is necessary to stabilize the condition and begin treatment of the pathology that caused the attack. May need surgery, the indications for which are determined by doctors in the hospital based on the results of examinations.

Conservative treatment includes the administration of drugs to maintain blood pressure, heart function, and normalize disorders electrolyte metabolism. For this purpose, beta blockers, cardiac glycosides, antiarrhythmic drugs, antihypertensive drugs or cardiotonics, infusion therapy:

• Lidocaine for ventricular fibrillation;
• Bradycardia is treated with atropine or isadrine;
• Hypotension is a reason for intravenous administration dopamine;
• Fresh frozen plasma, heparin, aspirin are indicated for DIC syndrome;
• Piracetam is administered to improve brain function;
• For hypokalemia - potassium chloride, polarizing mixtures.

Treatment in the post-resuscitation period lasts about a week. At this time it is likely electrolyte disturbances, DIC syndrome, neurological disorders, so the patient is placed in the department for observation intensive care.

Surgery may involve radiofrequency ablation of the myocardium - for tachyarrhythmias, the effectiveness reaches 90% or higher. If there is a tendency to atrial fibrillation, a cardioverter-defibrillator is implanted. Diagnosed atherosclerosis of the heart arteries as a cause of sudden death requires valvular heart surgery.

Unfortunately, it is not always possible to provide resuscitation measures within the first few minutes, but if it was possible to bring the patient back to life, then the prognosis is relatively good. As research data show, the organs of people who have suffered sudden cardiac death do not have significant and life-threatening changes, therefore maintenance therapy in accordance with the underlying pathology allows them to live for a long time after coronary death.

Prevention of sudden coronary death is needed for people with chronic diseases cardiovascular system, which can cause an attack, as well as those who have already survived it and were successfully resuscitated.

To prevent a heart attack, a cardioverter defibrillator may be implanted, which is especially effective for serious arrhythmias. IN right moment the device generates necessary for the heart impulse and does not allow him to stop.

Requires medication support. Beta blockers, calcium channel blockers, and omega-3 supplements are prescribed fatty acid. Surgical prophylaxis consists of operations aimed at eliminating arrhythmias - ablation, endocardial resection, cryodestruction.

Nonspecific measures to prevent cardiac death are the same as for any other cardiac or vascular pathology- healthy lifestyle, physical activity, refusal bad habits, proper nutrition.

Video: Presentation on Sudden Cardiac Death

Video: lecture on the prevention of sudden cardiac death

Myocardial infarction is ischemic necrosis of the heart muscle, which is caused by acute insufficiency blood circulation directly to the heart. Death occurs within a few hours after the first signs appear.

Heart attack mortality statistics

Heart attack is at the top of the list of causes of death. In women, this condition occurs five times less often than in the stronger sex. Up to 70% of patients diagnosed with a heart attack are people over 55 years of age, but in recent years cases are not uncommon when ischemic disease heart disease is diagnosed in people aged 30-35 years. Death from myocardial infarction occurs in 20% of registered cases, an indicator fatal outcome among those admitted to the hospital is about 35%.

Classifications of heart attacks

There are three types of heart attacks. Below are their characteristics. In addition, the table shows the organs in which necrotic processes begin against the background of impaired blood circulation.

Note: If two main human organs are affected - the brain and heart, the probability of death is up to 90%.

In the classification of myocardial infarction, the following types are distinguished:

• painful;
• painless;
• abdominal;
• cerebral;
• combined;
• atypical.

Depending on the depth of damage to the heart muscle, a heart attack occurs:

• subendocardial (in the deep layers of the myocardium);
• subepicardial (in the outer layers);
• intramural (in the thickness of the muscular walls of the myocardium);
• transmural infarction (on the anterior wall of the heart).

Depending on the affected area, focal or extensive infarctions are distinguished. Focal infarction leads to shallow necrosis and affects minor areas. Areas of necrosis subsequently become scarred. With timely assistance provided, there is no serious threat to the patient’s life.

At extensive heart attack the zone of necrosis extends to all layers of the heart muscle and affects large areas. The condition is complicated by cardiac ruptures, painful shock, thromboembolism, symptoms of " acute abdomen", pericarditis. Most of the heart cells die and are no longer restored. This leads to the patient's postmortem diagnosis of “death from a heart attack” in 80% of cases.

Factors of occurrence

The main cause of a heart attack is a disruption in the functioning of the circulatory system. This can be influenced by several factors, which include:

1. Abrupt cessation of inflow arterial blood along the coronary vessel (when the lumen of the vessel is closed).
2. A discrepancy between the need of the myocardium (the middle muscular layer of the heart) for oxygen and the ability of the coronary vessels to provide this necessary need. IN normal conditions the myocardium takes 70-75% of the oxygen contained in the blood from the blood. For comparison: muscle oxygen demand is about 25-30%. That is why the heart depends so much on the ability of the coronary arteries to adequately respond to changes in workloads in the myocardium itself.
3. Arterial hypertension - when high blood pressure makes the heart work faster, which means the wear and tear on the muscles and blood vessels increases significantly.
4. Thrombophlebitis.
5. Stagnation and accumulation of fluids of various etiologies between the membranes of the heart muscle.
6. Heart damage due to injury or poisoning.

If it is not possible to quickly restore blood circulation, then there will be a threat to life, and everything may end in the death of the patient.

• pathology of lipid metabolism, when the amount of fat, cholesterol and triglycerides in the blood increases. This helps to reduce the lumens of blood vessels, which leads to poor circulation.
• decline motor activity. In patients who are bedridden, death from a heart attack occurs more often.
• the patient is overweight.
• diseases endocrine system(diabetes).
• presence of bad habits (alcoholism, smoking).
• hypertension.
• burdened heredity.
• history of prolonged or short-term loss of consciousness.
• previously previous operations on the heart muscle.
• heart failure.
• increased tone of the nervous system.
• high heart rate (90 beats per minute), etc.

Symptoms

• strong sudden pain in the chest or behind the breastbone, which radiates to the arms, back, stomach, neck, shoulders or even jaw;
• the patient does not have enough air, he begins to inhale forcefully;
• dizziness appears, appears cold sweat, the skin turns pale;
• a feeling of extreme fatigue increases;
• Nervousness, feelings of anxiety, and causeless panic increase.

Noticing that a person is in similar condition, it is necessary to urgently call a team of doctors. When talking to the dispatcher, it is necessary to inform that the patient is suspected of having a heart attack. A fully equipped ambulance with a cardiograph and appropriate medications will be sent to such a call.

Often myocardial infarction does not have persistent symptoms. This is explained by different zones of localization of necrosis and, depending on this, varying intensity arisen pain symptom. This state of affairs makes diagnosis difficult. Often the patient and his environment do not have time to adequately respond to heart attack: Absence of heart rhythms occurs very quickly. Sudden cardiac arrest can occur when complete absence any symptoms. Absence characteristic features complicates urgent hospitalization of the patient. That is why, with a massive heart attack, people die suddenly at home, and often there is no person nearby who can recognize the pathological process and provide first aid.

Help with sudden cardiac arrest

However, if you discover that a person has suffered cardiac arrest, you should immediately call " Ambulance”, informing the operator that the person was in cardiac arrest. It is advisable to independently perform chest compressions and carry out artificial ventilation using the mouth-to-mouth breathing technique. This will allow the body to hold out until the doctors arrive.

In the clinic, in the intensive care unit, measures to bring the patient back to life will include defibrillation of the heart using electric current pulses, intubation of the lungs, and administration of special medications that nourish the heart muscle. If everything is done correctly, and most importantly, quickly, the patient will have a chance to survive.

Important! In women, the symptoms of a heart attack may be vague. It can be confused with the flu or severe fatigue. You should pay attention to heartbeat and provide immediate assistance, since death from a heart attack occurs very quickly.

What does death from a heart attack look like?

Any cause of death due to myocardial infarction is associated with malfunction circulatory system. Pathological process in the heart muscle leads to irreversible processes, and, as a rule, death.

Processes in the body

Violation of the blood supply to the heart muscle of any etiology, which is the cause of death from a heart attack, is manifested by the following symptoms:

By some signs you can understand that a person is no longer a tenant.

They show what death that occurs from a heart attack looks like. In these cases it is stated following symptoms impending death:

• tachycardia or bradycardia;
• decrease in blood pressure indicators: ;
• the skin gains bluish tint, lips turn blue especially quickly;
• Fluid stagnation occurs in the lungs and;
• loss of consciousness;
• convulsions;
• – reaction to light is almost completely lost;
• breathing is initially noisy and frequent, then becomes rarer, until it stops completely (apnea is recorded).
• absence of a curve on the electrocardiogram.

Important! Irreversible processes in the body develop 3-5 minutes after clinical death is declared. Only about 3-4% of patients emerge from clinical death without consequences. Other patients do not recover all body functions afterwards.

External signs of death from a heart attack are no longer reflected in dead body sick. Rigor mortis and discoloration skin death occurs within the same time frame as in patients who died from other causes.

Who is at risk of a heart attack

• resuscitated after cardiac arrest, clinical death;
• people with acute heart failure (the contraction function of the heart muscle is not fully restored);
• persons with a history of myocardial ischemia (reduced blood flow to certain areas of the heart);
• patients with pronounced hypertrophy (thickening) of the left ventricle, which is visible during examination;
• patients with congenital or or having irreversible anatomical changes in the heart (valve prolapse, “ sports heart», congenital anomalies V coronary vessels, sarcoidosis);
• patients with any neoplasms of the myocardium;
• suffering from apnea (stopping breathing) during sleep.