How unexpectedly he died from... Sudden death from acute coronary insufficiency: how to prevent? Clinical diagnostic criteria

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

Theories related to aging

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

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

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

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

Law of nature

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

Death of the Young

It's worth starting with what Lately approximately 16 million girls in age category from 15 to 19 years old women become pregnant. At the same time, the risks of infant death are much higher than those of those girls who crossed the 19-year-old barrier. These problems are due to physiological factors, and psychological.

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

Smoking. Drugs. Alcohol

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

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

How does a person feel at the moment of death?

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

Finally

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

When a completely healthy person dies suddenly, they speak of 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 the alarm bell in time and start treatment, tragedy can be 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, hand, 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. If you experience burning chest pain, 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.

The blood thickens, clotting processes are disrupted, which contributes to the formation of blood clots - thrombi. 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 - a 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.

It destroys the body, and is based on a 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. Such 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

What pills can cause poisoning? Any medications, if used incorrectly, can lead to severe poisoning and intoxication. IN severe cases may come immediate death. This article discusses an overdose of tablets with a fatal outcome, symptoms of poisoning by various medicines, methods of providing first aid, components of treatment in a hospital setting.

Causes of drug poisoning

Drug overdose can occur for many reasons. It most often develops in people who take medications without consulting a doctor or change the dosage without permission. Below are the main reasons why pill poisoning can develop.

• Self-medication, taking medications not approved by the attending physician. Sometimes people take drugs on the advice of friends, neighbors, or relatives.
• Taking large doses of the drug in critical or emergency situations. For example, when the body temperature rises, people, in an effort to quickly bring it down, drink large doses of medications and combine them with each other. Such uncontrolled use of drugs often leads to fatal poisoning.
• A person taking medications that are contraindicated for him due to his age or health condition. For example, the drug aspirin (acetylsalicylic acid) is deadly for children, it causes Reye's syndrome in them and leads to rapid death from internal bleeding.
• A fatal overdose of pills can occur in children who have eaten pills left behind by adults. Kids love to taste everything, they are interested in everything. All medications available at home should be kept out of the reach of children.
• Overdose of drugs for the purpose of suicide (suicide). Most often, people use sleeping pills and tranquilizers for this purpose. They cause relatively easy death from overdose.
• Drug poisoning due to taking them with alcoholic beverages.
• A dangerous combination of drugs. In the instructions for the drugs, you should carefully read the list of drugs with which they cannot be combined.
• Premeditated murder. Medicines can deliberately poison a person. Some drugs in large doses are potent poisons for a person.

Please note that for each person the lethal dosage of any drug is purely individual. It depends on the person’s weight and age, and whether he or she has any diseases.

Features of the clinical picture of drug overdose

Anyone can be poisoned to death by pills. Death is possible at a certain dose of any drug. Below we will look at the symptoms of poisoning with the most common medications.

Sleeping pills, sedatives

Sleeping pills and sedatives dangerous to human life. You can get an overdose of them unintentionally during some stressful situation. A person, wanting to calm down or sleep after emotional stress, can take a large dose of medicine, trying to achieve fast action drug.

To strong sedatives and sleeping pills relate:

• barked;
• phenobarbital;
• bromital;
• medinal;
• teraligen;
• barbital.

These substances, getting into digestive system, are quickly absorbed and act. They can cause death in 15-30 minutes. Below are the symptoms that develop with an overdose of sleeping pills.

• Increased drowsiness, weakness and lethargy. At the initial stage of poisoning, you can still establish contact with a person, talk, and ask him something. Then develops deep dream, in severe cases - coma. As a rule, when poisoned by these drugs, people die in their sleep.
• A decrease in all reflexes develops due to inhibition of the central nervous system.
• Hyperthermia. Poisoning with sleeping pills is characterized by a rise in body temperature to 40 degrees.
• It is possible to develop vomiting during sleep. Due to a decrease in the severity of the swallowing and gag reflex, aspiration of vomit into the respiratory tract may occur and respiratory arrest may develop.
• Slow breathing. The person begins to breathe slowly and shallowly, with a frequency of less than 10 breaths per minute. This change is associated with depression of the respiratory center in the brain. If you are poisoned by sleeping pills, you can die from respiratory arrest.
• Bradycardia (slow heart rate) and hypotension (decreased blood pressure).
• Convulsions and hallucinations may develop.

Tranquilizers

A severe overdose of tranquilizers often leads to death. These drugs act on the central and peripheral nervous system, as well as breathing and heart function. Tranquilizers are taken strictly according to prescription, and even a slight deviation from the dosage prescribed by the doctor can cause poisoning. Below is a list of drugs in this group:

• Elenium;
• napothon;
• seduxen;
• diazepam;
• oxazepam;
• tazepam;
• eunoctine;
• librium;
• radedorm.

The clinical picture of poisoning with tranquilizers is the same as for poisoning with sleeping pills.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common medications. These drugs include:

• paracetamol (efferalgan, panadol);
• acetylsalicylic acid (aspirin);
• analgin;
• ibuprofen (nurofen);
• ketorolac (ketanov, ketolong);
• nimesulide (nimesil);
• indomethacin

Drugs in this group have analgesic and anti-inflammatory effects. Some reduce body temperature (paracetamol, ibuprofen). Aspirin is used to thin the blood.

Poisoning not to death NSAID drugs most often develops as a result of an overdose in order to accelerate their action. For example, feeling severe pain, the person takes more medicine.

Please note that if used by children acetylsalicylic acid(aspirin) rapid death may occur. Children do not have the enzyme to process this drug. They develop Reye's syndrome. Therefore, this drug is strictly prohibited for children.

Symptoms of poisoning with NSAID drugs resemble intestinal poisoning. The patient has a stomach ache, vomiting and diarrhea, general weakness, dizziness. A decrease in body temperature, development of hand tremors, and a feeling of anxiety and restlessness are also possible. By themselves, medications in this group rarely lead to death. Dangerous are the complications that can be caused by taking these drugs in large dosages, namely:

• gastrointestinal bleeding. All NSAIDs irritate the mucous membrane of the stomach and duodenum. If you take a lot of these drugs, damage to the integrity may develop vascular wall in the submucosal ball of these organs. Gastrointestinal bleeding is manifested by dark vomit, black stools (melena), pale and bluish skin, severe weakness, drowsiness, increased heart rate and decreased blood pressure. A person may die due to large blood loss;
• acute pancreatitis – non-infectious inflammation pancreas, in which necrotic death of its tissue develops. This pathology can be caused by an overdose of NSAIDs. The patient develops severe abdominal pain, nausea, vomiting, flatulence and diarrhea. Small purple hemorrhagic spots may appear on the skin of the abdomen. Body temperature rises to 39 degrees. This is a disease without surgical intervention leads to death;
• acute liver failure may develop due to taking a large number of drugs that the liver is not able to neutralize. The patient's skin, mucous membranes and sclera of the eyes turn yellow, and pain appears in the right hypochondrium. Consciousness may be impaired. Death may occur due to liver failure;
• kidney failure, in which the kidneys are unable to cope with their function and cleanse the blood. This pathology can occur due to toxic damage to the nephrons (structural units of the kidneys) by anti-inflammatory drugs.

Antibiotics

Antibiotics are drugs that are widely used in the treatment of bacterial infectious diseases. They are prescribed by a doctor, who discusses with the patient the rules for both administration and dosage.

The table below shows the features clinical picture in case of overdose of various antibacterial agents.

Antihistamines

Antihistamines are used for allergic pathologies. They can be prescribed for allergic dermatitis, urticaria, atopic dermatitis etc. These drugs block the production of histamine, the main mediator that triggers allergic reactions. Some drugs also have a mild hypnotic effect. When treating them, a person is prohibited from driving a car.

Drugs in this group include:

• loratadine;
• suprastin;
• diphenhydramine;
• diazolin;
• pipolfen.

Symptoms of poisoning antihistamines appear in 15-30 minutes. If a lethal dose is consumed, a person can die within an hour.

In case of overdose antihistamines The nervous system is primarily affected. Symptoms of poisoning with these drugs include:

• feeling severe dryness in the mouth and eyes, thirst;
• increase in body temperature to 38-39 degrees;
• nausea followed by vomiting;
• first, general excitement develops, which sharply changes to inhibition;
• hand trembling;
• seizures of the epilepsy type;
• tachycardia, possible heart rhythm disturbance;
• change in blood pressure, at first it rises sharply, and then also quickly decreases to critical numbers;
• loss of coordination, staggering;
• increased drowsiness;
• gradual descent into a deep coma.

Medicines to lower blood pressure

Poisoning from heart pills is very common among the population. If you have a heart attack or a sharp rise in blood pressure, a person can drink a lot different drugs, fearing for his life.

Also, an overdose of such drugs can develop in older people, who may forget that they took the drug and take it again.

Please note that when taking beta blockers (for example, anaprilin) ​​by people who are sick bronchial asthma, rapid death may develop.

Names of popular antihypertensive drugs:

• captopril;
• lozap;
• enalapril;
• amiodarone;
• anaprilin;
• magnesium sulfate;
• metoprolol;
• nebivolol;
• nifedipine.

In case of poisoning antihypertensive drugs The patient's blood pressure drops sharply, nausea and vomiting may develop, and consciousness is impaired. This condition is fatal and can lead to respiratory and cardiac arrest.

What to do in case of drug overdose

At the slightest suspicion of an overdose of any medicine you need to urgently call an ambulance. By phone, inform the dispatcher about what happened, list the patient’s symptoms and accurately state your location.

Remember that trying to cure a person from a drug overdose on your own is very dangerous. He may die in your arms, and you will not be able to help him. In order not to endanger his life, seek medical help immediately.

What to do while waiting for doctors? The arrival time of the EMS team depends on many factors (for example, traffic congestion, availability of doctors at the time of the call). While waiting for the EMS team, you need to start providing first aid to the poisoned person. first aid at home. The prognosis for the patient’s life may depend on it. Its main components are presented below.

In order to clear the stomach of the remainder of the drugs taken, you need to drink a liter of water in one gulp and induce vomiting. For best result This washing should be repeated several times.

This procedure is not carried out if:

• impaired consciousness of the patient;
• the appearance of black or bloody vomit.

There is no need to add a solution of potassium permanganate or any other components to the gastric lavage solution. You cannot know what chemical reaction they will enter into with the drugs that poisoned the person.

Cleansing enema

The enema is done using ordinary boiled water. The temperature of the colonic lavage fluid should be neutral (room temperature).

Sorbents

These medications will help bind and remove medications that remain in the digestive tract.

Sorbents that are taken in liquid form (for example, smecta or atoxyl) act faster. But if you don’t have these at home, give the patient any other sorbent, even activated carbon will do.

Before giving the drug to a person, read the dosage rules that are described in the instructions for it.

Drink

The liquid will reduce the concentration of the drug in the blood and accelerate its excretion by the kidneys, reducing dehydration. You can drink mineral water or plain water, tea with sugar.

Actions in case of loss of consciousness

If the patient loses consciousness, you need to monitor him until the doctors arrive so that he does not choke on vomit or his tongue. Turn his head to the side; in this position, the risk of aspiration is minimal.

To improve blood flow to the head and heart, raise his legs and fix them in this position.

Before doctors arrive, monitor his pulse and breathing. If they stop, start carrying out indirect indoor massage hearts.

What to do if you develop seizures

The only thing you can do is hold the person’s head so that he doesn’t hit it on the floor.

Remember that a person during a seizure should not put anything in his mouth, especially his fingers.

Medical treatment

Doctors from the ambulance, upon arriving at the call, will conduct a quick examination and assessment of the condition of the poisoned person. Show them the drug he took and tell them as accurately as possible the number of pills he took. You should also describe the amount of assistance that you managed to provide to the victim yourself.

Doctors will try to stabilize the victim’s condition and take him to the nearest hospital. In case of drug poisoning, treatment is carried out in the toxicology department. Patients in critical condition are hospitalized in the intensive care unit (resuscitation).

Treatment may consist of hemodialysis, the introduction of antidotes, IVs, drugs to support breathing and heart function. What will happen to a person and what result to expect from treatment, only a doctor can say after examining the patient and objective assessment his condition.

Drug poisoning can be fatal. Treatment for this condition is carried out in a hospital setting. Forecast depends on quantity taken drug, active substance, timeliness of seeking medical help. You cannot treat a drug overdose on your own.

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

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

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

Sudden cardiac death - causes

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

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

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

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

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

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

Sudden death during exercise

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

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

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

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

Not related to physical overload:

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

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

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

Sudden cardiac death and abnormal development of cardiac tissue

With the increase in the number of deaths without visible reasons, V last decades Work has appeared aimed at an in-depth study of heart defects associated with abnormal development of connective tissue. The term dysplasia (from the Greek “dis” - disorder, “plasia” - form) refers to the abnormal development of tissue structures, organs or parts of the body.

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

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

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

The main mechanism of dysplasia of tissue structures of cardio-vascular system, is a genetically determined deviation in the development of the components of the connective tissue that makes up the valves, parts of the conduction system of the heart and myocardium.

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

There are three leading syndromes:

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

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

Cardiac ischemia

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

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

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

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

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

• large-focal myocardial infarction;
• small focal infarction myocardium.

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

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

The probability of death is very high in the acute period and when extensive damage.

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

Currently, it is considered as acute coronary syndrome.

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

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

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

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

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

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

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

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

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

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

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

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

Based on the causes of occurrence, they are distinguished:

• cardiomyopathy of unknown origin;
• secondary or acquired dilated cardiomyopathies caused by viral infection, including AIDS, alcohol intoxication, lack of microelements

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

Alcohol myocardial damage

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

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

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

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

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

Hypertension and its role in the development of sudden cardiac death

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

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

Other causes of sudden death

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

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

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

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

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

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

Why do men die more often?

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

This is due to several factors:

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

Signs and precursors of sudden cardiac death

Painting clinical manifestations sudden death develops very rapidly. In most cases, a tragic situation occurs on the street or at home, and therefore a qualified urgent Care it turns out it's too late.

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

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

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

Symptoms appearing immediately before death:

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

Treatment of sudden cardiac death

The only treatment for sudden death is urgent implementation resuscitation measures.

Resuscitation consists of several stages:

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

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

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

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

How to avoid sudden death

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

Regular medical examination

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

Rejection of bad habits

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

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

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

Normalization of diet and the fight against obesity

Excess body weight is a factor that plays an important role in the development of heart and vascular diseases and the occurrence of sudden cardiac death. Statistically, people suffering overweight bodies are more often susceptible to hypertension and atherosclerosis.

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

Normal weight is considered:

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

Results are variable and depend on structural features skeletal system. Moderate consumption is recommended table salt and animal fats.

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

Healthy foods for the heart

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

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

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

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

Active lifestyle and physical culture

Regularly dosed physical exercise with an emphasis on "cardio training":

1. Running on fresh air.
2. Bicycle rides.
3. Swimming.
4. Cross-country skiing and skating.
5. Yoga class.
6. Morning exercises.

Conclusion

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

Heart health is an indisputable condition for long life, quality life. Pay more attention to yourself, do not destroy your body with bad habits and poor nutrition- This is the basic principle of every educated, sensible person.

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

Sudden death is the leading cause of death from cardiovascular diseases. coronary death. It occurs when the heart suddenly stops functioning. Sudden death is defined as death that occurs instantly or occurs within a few hours after an exacerbation of the main symptoms.

Not in medicine single reason such death, since the factors of occurrence are different. All over the world, hundreds of thousands of people die this way every year, most often men over 35 years of age.

In children, sudden death due to heart disease occurs in exceptional cases and is recorded very rarely.

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Yet doctors say the most common cause of death is heart attack. Every year the number of deaths around the world does not decrease, and their age is becoming older.

Sudden death from myocardial infarction (heart attack) is a medical problem, but in our country there is a noticeable decrease in its level due to the improvement of comprehensive measures, including treatment with anticoagulants, spa therapy and subsequent monitoring of the employment of patients.

Differences between sudden cardiac arrest and attack

The terms "cardiac arrest" and " heart attack” are often used, mistakenly synonymizing them. In fact we're talking about O various diseases. They are connected by one circumstance - a heart attack can aggravate the situation, which will ultimately lead to sudden cardiac arrest.

Heart attack - bigger problem circulatory system, in which blood flows to the heart in a smaller volume or its access is not possible at all. This may be due to the formation of clots or sharp narrowing artery - in both cases it becomes blocked.

If blood does not flow to the heart muscle, it forms oxygen deficiency, and it is damaged, which more often occurs as an irreversible process.

Similar changes can occur against the background of coronary heart disease. Walls blood vessels become covered with plaques that narrow the artery. When a plaque breaks off, a clot forms in the damaged area, which blocks blood flow.

Sudden cardiac arrest is expressed as a sudden cessation of heart function. The cause is usually cardiac dysfunction due to electrical disturbance. Abrupt change The heart beats (too often) causes the ventricles to flutter (fibrillation), and blood no longer flows into the body.

The pumping of blood stops, and this leads to the stoppage of all organs. The body experiences such a strong shock that the patient can almost immediately lose consciousness. First aid in this case must be provided immediately, otherwise death is guaranteed in 90-95% of cases.

In case of cardiac arrest, manual cardiac resuscitation can be achieved by applying pressure to the chest and blowing air into the lungs.

It is necessary to ensure the flow of oxygen to the brain until the heart rhythm resumes, including with the help of a defibrillator. This is a device that affects the heart using an electrical impulse.

Symptoms

The symptoms of a heart attack are such that they cannot be ignored.

You should pay attention to the following signs:

• long-lasting and with full dedication top part bodies;
• a feeling of tightness and pressure in the chest;
• lack of pain response to stabilizing drugs (nitroglycerin);
• paleness, increased sweating, and the skin becomes cold and clammy;
• dizziness, fainting,
• feeling of fullness in the stomach, vomiting;
• difficulty breathing;
• An anxious state reaching the point of panic for no apparent reason.

But this does not happen in all cases. In a quarter of cases, especially in women, the symptoms are vague. This may be a flu-like condition or fatigue. Sometimes abdominal pain and shortness of breath appear.

Such atypicality is very dangerous, since the patient may not pay attention specifically to the disturbance in heart rhythm and may not qualify his condition as a heart attack. If there is no immediate response in the form of assistance or calling an ambulance, you can die within a few hours or days.

As for sudden cardiac arrest, symptoms may include rapid heartbeat or dizziness. These signs indicate serious problems heart rate.

Most often, a person and the people around him do not have time to react; everything happens very quickly. But usually sudden stop heart disease is not accompanied by any symptoms.

After myocardial infarction there is a mass, but the greatest danger is cardiac arrest and the onset of clinical death. By virtue of various reasons blood flow stops, all organs begin to die.

There are only a few minutes for resuscitation, otherwise the processes occurring in the body, especially in the brain, will become irreversible and biological death will occur.

Many tissues and organs survive clinical death quite normally for a long time. But in the brain, in the absence of oxygen, harmful substances very quickly accumulate, which affect its viability in the future. It can be concluded that the consequences of clinical death during a heart attack, their severity, may depend on the speed with which resuscitation was carried out.

The external signs of death from a heart attack are no different from the signs that accompany sudden death - the skin becomes very pale as the blood flow stops functioning.

Causes of death from heart attack

In medicine, the main cause of death due to myocardial infarction is identified as abnormal heart rhythm.

It can be expressed in the following manifestations:

Risk factors

Sudden cardiac arrest can occur for some time after a myocardial infarction. This may provoke whole list, which are headed by hereditary heart disease, addiction to cigarettes and high cholesterol.

It is also worth keeping the following factors in mind:

• heart failure, in which the heart has difficulty pumping blood;
• diabetes;
• overweight;
• presence of drug addiction;
• the presence of cardiac anomalies and diseases, including congenital ones;
• previous cases of cardiac arrest, loss of consciousness (even among relatives);
• congenital pathologies of blood vessels;
• taking medications whose action is aimed at suppressing arrhythmia.