Each of us must know about the signs of sudden cardiac arrest. The causes of this phenomenon, which quickly leads to clinical death, may be different. But no matter what serves as a provoking factor, one must act immediately in such a situation. The main thing to remember: the chances of salvation become less with every minute lost.
Heart stopped beating
Sudden cardiac and respiratory arrest occurs due to the absence of contractions of the ventricles and atria. Against the background of loss of the injection function, myocardial tissues lose their ability to conduct electrical impulses, as a result of which there is an instant violation of metabolic processes. If the heart stops beating, the blood circulation disappears, which poses a serious threat to life.
According to WHO statistics, every week about two hundred thousand people in the world die from heart failure. Moreover, in most cases, the death occurred while at home or in the workplace, which is a confirmation of the lack of awareness and education of the population in matters of first aid.
Regardless of the reasons leading to sudden cardiac arrest, the total number of deaths significantly exceeds the number of people who died from oncology, AIDS, due to fires or car accidents. The urgency of the problem lies also in the fact that it occurs not only among the elderly, but also among children and young people. Sometimes there are signs preceding a sudden cardiac arrest, recognizing which, the danger can be prevented.
How does myocardial arrest
The disorders that cause sudden cardiac arrest have a functional origin. The cessation of myocardial activity occurs due to asystole or fibrillation. The first option is very rare, the second - in 90% of cases.
Asystole is the absence of ventricular contractions at the time of relaxation (diastole). Sometimes the cause of a sudden cardiac arrest is a reflex signal received by the myocardium from other organs during surgery, prolonged medical treatment. With this kind of asystole, the heart muscle remains intact and unharmed, it maintains a satisfactory tone. Also, asystole can develop against the background of hypoxia, carbon dioxide poisoning, acid-base or electrolyte imbalance with a predominance of potassium in the blood and a decrease in calcium.
Cardiac fibrillation is a violation of the connection between cardiomyocytes that prevents muscle contraction. Instead of synchronous contractile function and relaxation, there are many chaotic areas, contracting unsystematically. Doctors call such contractions flutter or ventricular fibrillation. With myocardial fibrillation, the frequency of such contractions can reach up to 600. Blood ceases to be ejected from the atria. A flickering contraction requires a lot of energy, while the pumping of blood does not actually occur. Energy costs are significantly higher than normal, and effective reductions necessary for normal blood circulation do not occur.
Fibrillation can capture only part of the atrium. Then the impulses will flow to the ventricles, and blood circulation will be maintained at a level sufficient for life. Short-term bouts of flickering end on their own, but if they are repeated for a certain time, the ventricles, being in constant tension, will lose the ability to ensure normal hemodynamics.
What causes clinical death
Direct factors that directly affect the work of the heart muscle are conventionally divided into cardiac and extracardiac. The first is a violation that occurred directly in the heart, the second is a consequence of exposure to the heart muscle from the outside. With cardiac and extracardial causes, the symptoms of sudden cardiac arrest do not differ.
May provoke myocardial arrest:
- coronary artery disease;
- pulmonary embolism;
- thrombosis;
- cardiomyopathy;
- a sharp jump in blood pressure;
- atherosclerosis that affects the coronary arteries;
- heart rhythm failure with defect;
- myocardial tamponade;
- pericarditis.
Among extracardiac factors it is worth noting:
- hypoxia - oxygen starvation on the background of anemia, asphyxia that occurs when suffocation or drowning;
- pneumothorax - air reflux between the pleura leaves, which leads to unilateral compression of the lung;
- dehydration with large blood loss, prolonged vomiting and diarrhea;
- acidosis - a change in acid-base balance;
- hypothermia of the body and a decrease in temperature below 30 ° C;
- hypercalcemia;
- anaphylactic shock.
Who is at risk
Indirect causes of cardiac arrest include other unfavorable conditions leading to weakening of the body:
- intense physical activity on the heart for a long time;
- constant lack of sleep, lack of proper rest;
- mature age (over 45 years old);
- maintaining an unhealthy lifestyle;
- hereditary predisposition to arrhythmia, impaired acid-base balance.
The risk of this danger increases with a combination of several reasons. Signs of sudden cardiac arrest cannot be confused with the symptoms of any other disease. You need to act without delay.
Why does the heart stop in young people and children
In the predominant number of cases, the heart arbitrarily stops beating in older people. Moreover, many cases of deaths of young people are known. The causes of sudden cardiac arrest in adolescence and childhood have not yet been exactly studied. So far, experts agree that all of the above factors in combination with injuries, abnormalities of intrauterine development, heart defects and severe arrhythmias can provoke myocardial arrest.
There are other pathologies. For example, sudden cardiac arrest syndrome does not have reliable scientific explanations and is a common cause of death in children of the first year of life. In most cases, no signs of illness or heart failure were observed in the child. The syndrome occurs against the background of absolute external well-being with impaired palpitations and breathing, usually during sleep or at night.
The risk of sudden death of an infant increases when the following conditions are present:
- sleep on an overly soft bed;
- sleep on the stomach;
- poorly ventilated area;
- birth from multiple pregnancy;
- early birth or by caesarean section;
- smoking and other bad habits of the mother during pregnancy.
Abnormalities in the development of the fetus, genetic pathologies, and mother-borne infections during pregnancy (herpes virus, cytomegalovirus, Epsten-Barr virus, rubella, chickenpox, etc.) can cause cardiac arrest in the womb.
Sudden cardiac arrest in young people can occur due to the so-called Commotio Cortis syndrome. As a rule, it leads to instant death. Often found in athletes. The only reason for the causes of sudden cardiac arrest in young people is that this syndrome occurs as a result of a sharp and strong blow to the chest area at the time of diastole. A mechanical effect can provoke dangerous arrhythmia in the form of ventricular fibrillation. That is why martial arts, baseball, hockey, American football are considered unsafe sports that can cause sudden heart failure in young people.
How to understand that a person's heart stopped
Signs of sudden cardiac arrest are in many ways similar to signs of clinical death. Within a few minutes after the last reduction, you can try to resuscitate the victim. This period is considered a reversible phase, but the success of resuscitation measures depends on the knowledge of the person who was nearby. There is only a few seconds to think. Regardless of the causes of sudden cardiac arrest, the signs of this phenomenon are always the same.
The first thing that should cause suspicion of a cessation of cardiac activity is a loss of consciousness. The victim does not react to braking, shouting, movement. According to medical data, brain cells die within seven minutes after stopping the myocardium - this is an average indicator, which can be less or more, and range from 2 to 11 minutes. The brain suffers from hypoxia caused by a lack of blood circulation and the cessation of metabolic processes. If the heart fails to start, the brain will die within a few minutes. It is important to begin resuscitation as soon as possible - this will increase the chances of survival and minimize the likelihood of irreversible processes.
Another confirmation sign is the lack of a pulse on the carotid artery. However, not every person knows how to correctly feel the pulsation. If there is no practical experience and knowledge, you can try to directly listen to the cardiac contractions, putting your ear to the victim’s bare chest. Moreover, his breathing may be completely absent or impaired: after a cardiac arrest a person breathes noisily and rarely, the intervals between breaths can be 30-90 seconds.
A sign of sudden cardiac arrest due to asystole or fibrillation is an increase in redness and blueness of the skin. Two minutes after the cessation of blood flow, the pupils expand, which do not react to bright light, that is, do not narrow. Separate muscles can cramp.
Emergency First Aid
Sometimes the myocardium stops contracting within a few seconds, after which the person regains consciousness without any consequences. Help with sudden cardiac arrest should be provided immediately if the condition of the victim has not stabilized. First of all, you need to call a team of doctors, however, you do not need to sit back, waiting for their arrival. Remember, the chances of resuscitating a person are great only in the first minutes after a cardiac arrest!
Before you begin to provide first aid for sudden cardiac arrest, you must make sure that the person is in a swoon. You do not need to shake his head, beat on the cheeks and water the victim. It’s enough to stir him up, turn to him, ask an elementary question. If no reaction follows, you must immediately begin resuscitation.
So, making sure that there are no signs of life and cardiac activity, you must:
- Lay the patient on a firm, level surface. Best on floor or asphalt.
- Get down on the victim’s knees and free his chest from clothes.
- Put the palm of your right hand in the center of the sternum, with your fingers pointing towards the head.
- Put your left hand perpendicularly over your right hand.
- Perform an indirect heart massage, doing pushing translational movements with both hands.
It is necessary to press on the chest with all your weight, while you can not bend them at the elbow. The recommended depth of pressure is 5 cm. Often in people who have experienced sudden cardiac arrest, rib fractures are found after resuscitation because of a strong effect on the chest. In one minute, you need to do about as many shocks as how many times per minute the heart of a healthy person contracts, that is, 60-100 pressures.
Resuscitation must be carried out until the patient comes to his senses or medical help arrives. If the victim does not wake up after half an hour of indirect heart massage and the doctors do not have time to arrive, the rescue manipulation is stopped. After this time, biological death is recorded.
Further treatment
Ambulance doctors immediately upon arrival begin the defibrillation procedure to start the myocardium. Professional assistance is carried out in several stages, starting in the conditions where the victim is located, then continuing in the car and in the intensive care unit of the institution.
First of all, doctors introduce synthetic analogues of the human hormones adrenaline and dopamine, other drugs that support the work of the myocardium. If resuscitation measures do not give a result, they begin an electrical "reset" of the heart - defibrillation. This manipulation is part of electropulse therapy for heart rhythm disturbances. If the heartbeat and breathing did not resume, the onset of biological death is noted.
What to do after resuscitation
If the patient managed to escape and survive a sudden cardiac arrest, first of all he needs to undergo a comprehensive examination and find out what caused this dangerous violation. After a clinical death, the victim must reconsider his lifestyle and change his attitude to his health.
In the case of diagnosing severe life-threatening cardiac arrhythmias or dangerous myocardial defects that can provoke a second attack of asystole, the patient is prescribed surgical treatment. Heart surgery can be expensive and require organ transplantation, but the most common intervention involves installing a pacemaker - an artificial implant that supports the rhythm of the heart.
A person who has experienced a cardiac arrest should lead a healthy lifestyle, which means:
- rational and balanced nutrition;
- compliance with the regime of the day;
- good rest and sleep;
- rejection of bad habits;
- control over blood pressure indicators;
- limitation of physical activity.
A patient who has had cardiac arrest should regularly take medications prescribed by a doctor in a strictly prescribed dosage,
and periodically examined - take blood tests, undergo an ECG. In addition, it is important to learn how to independently determine the heart rate in order to call an ambulance in time in case of repeated heart rhythm disturbance, which can occur with a high degree of probability.
Consequences of clinical death
The most dangerous consequence of prolonged oxygen deficiency amid cessation of cardiac activity are foci of ischemic damage in the brain. After clinical death, you may experience:
- partial or complete memory impairment;
- loss of vision and hearing;
- partial paralysis of the body;
- hallucinations, convulsions.
In addition, during cardiac arrest, other organs suffer from hypoxia - kidneys, liver, pneumothorax develops. According to statistics, resuscitation measures help to achieve actual recovery in 30% of cases, but complete restoration of brain functions is quite rare. The cause of the irreversible effects is the delayed first aid.