How to determine cardiac arrest. Sleep cardiac arrest. What is sudden cardiac arrest

And yet, when its symptoms appear, it is better not to postpone a visit to the doctor.

Skip the line

Usually people who are faced with this problem complain that their heart seems to stop for a few seconds. In some cases, this may be accompanied by a feeling of heart jolt, a feeling of lack of air. The reason for this is extrasystoles - extraordinary heart contractions. An impulse arises in the heart, due to which one beat occurs earlier than necessary, and the next - at the right time. Accordingly, the pause between contractions lengthens - this causes unpleasant symptoms.

Extrasystole is the most common type of arrhythmia. Extraordinary contractions of the heart periodically occur in 70-80% of people over 50 years of age. They also happen to young people, including athletes with a trained heart. Because of this, many people think that such rhythm failures are not dangerous. However, this is not quite true. Extrasystoles can be caused various reasons and therefore have different consequences. Based on this, they make a decision on the study.

To treat or not to treat?

● Therapy is not needed. If interruptions in the rhythm are single, they rarely occur and at the same time the person has no other problems with the heart, it is really not necessary to treat extrasystole. In this case, it is called functional. She can be called overuse coffee or alcohol, stress. In women, cases of extrasystoles are often observed during menstruation. Prone to the appearance of extrasystoles people with vegetovascular dystonia. By the way, they are especially hard to endure extraordinary heartbeats.

AT this case it is enough for a person to lead a healthy lifestyle, to be less nervous, to give up stimulants like coffee and alcohol - and everything will return to normal by itself. Foods rich in magnesium and potassium will also help in this: cereals, lettuce, persimmon, dried apricots, citrus fruits.

● Medication is necessary if "fading" occurs with an already existing heart disease: other types of arrhythmia, coronary disease or heart disease, cardiomyopathy, etc. Harmless, at first glance, extrasystoles in this case can seriously aggravate the course of the underlying disease and even pose a risk to life, leading to atrial fibrillation or ventricular heart. Therefore, they must be eliminated as far as possible.

As a rule, treatment is also necessary if a person has more than 200 extrasystoles per day.

Even if there are no heart lesions, such frequent interruptions can worsen a person's quality of life. In addition, with extrasystoles, the release of blood from the heart decreases, and because of this, the blood supply to many organs, including the brain, worsens.

● It is necessary to treat, but not the heart. Sometimes, in itself, heart failure does not require treatment, but is a sign of another ailment, which in turn requires therapy. For example, extrasystoles often occur with hyperthyroidism - increased function thyroid gland. Her hormones, produced in excess, poison the body, and the heart reacts to this.

Small disruptions in rhythm are a reason to think about osteochondrosis of the cervical spine, they can be a sign of neurosis. In this case, it is enough to eliminate the main problem: to compensate for violations in thyroid gland, remove muscle clamps in cervical region take a course of sedatives. After that, the heart, as a rule, begins to beat evenly.

To avoid confusion

As you can see, there are many options, and it is rather problematic to determine on your own whether interruptions in the heart are dangerous. Cardiologists agree on one thing: if you periodically feel heart tremors and pauses following them, it is better not to guess, but to go for a consultation with a specialist. This is also important because not everything that is perceived as a sinking heart is actually extrasystoles. For example, many people often confuse intercostal pain with heart pain (which almost always indicates a problem requiring treatment) or intercostal neuralgia.

A banal ECG will help eliminate confusion - with frequent extrasystoles, such an examination will be enough to detect them. If fading occurs less frequently or, for example, only in the evening, it makes sense to conduct a 24-hour Holter monitoring. A compact device that is attached to the body and captures the rhythm of the heart will give answers to all questions.

"Man is mortal, but his main trouble is that he is suddenly mortal," these words, put into Woland's mouth by Bulgakov, perfectly describe the feelings of most people. Probably, there is no person who would not be afraid of death. But along with the big death, there is a small death - clinical. What is it, why people who have experienced clinical death often see the divine light, and is it not a delayed path to paradise - in the material of the site.

Clinical death from the point of view of medicine

Study problems clinical death as a borderline state between life and death remain one of the most important modern medicine. Unraveling many of its mysteries is also difficult because many people who have experienced clinical death do not fully recover, and more than half of patients with a similar condition cannot be resuscitated, and they die for real - biologically.

So, clinical death is a condition accompanied by cardiac arrest, or asystole (a condition in which various parts of the heart stop contracting first, and then cardiac arrest occurs), respiratory arrest and deep, or beyond, cerebral coma. With the first two points, everything is clear, but about whom it is worth explaining in more detail. Usually doctors in Russia use the so-called Glasgow scale. According to the 15-point system, the reaction of opening the eyes, as well as motor and speech reactions, is evaluated. 15 points on this scale correspond to clear consciousness, and minimum score– 3, when the brain does not respond to any kind of external influence, corresponds to transcendental coma.

After stopping breathing and cardiac activity, a person does not die immediately. Almost instantly, consciousness is turned off, because the brain does not receive oxygen and it comes oxygen starvation. But nevertheless, in a short period of time, from three to six minutes, he can still be saved. Approximately three minutes after breathing stops, cell death begins in the cerebral cortex, the so-called decortication. The cerebral cortex is responsible for the higher nervous activity and after decortication, although resuscitation may be successful, a person may be doomed to a vegetative existence.

After a few minutes, cells of other parts of the brain begin to die - in the thalamus, hippocampus, cerebral hemispheres. The state in which all parts of the brain have lost functional neurons is called decerebration and actually corresponds to the concept biological death. That is, the revival of people after decerebration is in principle possible, but a person will be doomed for the rest of his life to be on artificial lung ventilation and other life-sustaining procedures for a long time.

The fact is that the vital (vital - site) centers are located in the medulla oblongata, which regulates breathing, heartbeat, cardiovascular tone, as well as unconditioned reflexes like sneezing. With oxygen starvation medulla, which is actually a continuation of the spinal cord, dies one of the last parts of the brain. However, although the vital centers may not be damaged, decortication will already have set in by then, making it impossible to return to normal life.

Other human organs, such as the heart, lungs, liver, and kidneys, can go much longer without oxygen. Therefore, one should not be surprised at the transplantation, for example, of kidneys taken from a patient with an already brain dead. Despite the death of the brain, the kidneys are still in working condition for some time. And the muscles and cells of the intestine live without oxygen for six hours.

Currently, methods have been developed that allow increasing the duration of clinical death up to two hours. This effect is achieved with the help of hypothermia, that is, artificial cooling of the body.

As a rule (unless, of course, the case takes place in a clinic under the supervision of doctors), it is quite difficult to determine exactly when the cardiac arrest occurred. According to current regulations, doctors are required to carry out resuscitation measures: heart massage, artificial respiration within 30 minutes from start. If during this time it was not possible to resuscitate the patient, then biological death is stated.

However, there are several signs of biological death that appear as early as 10–15 minutes after brain death. First, a symptom of Beloglazov appears (when pressing on eyeball the pupil becomes like a cat), and then the cornea of the eye dries up. If these symptoms are present, resuscitation is not carried out.

How many people safely survive clinical death

It may seem that most people who find themselves in a state of clinical death come out of it safely. However, this is not the case, only three to four percent of patients can be resuscitated, after which they return to normal life and do not suffer from any mental disorders or loss of body functions.

Another six to seven percent of patients, being resuscitated, nevertheless do not recover to the end, suffer various lesions brain. The vast majority of patients die.

This sad statistic is largely due to two reasons. The first of them - clinical death can occur not under the supervision of doctors, but, for example, in the country, from where the nearest hospital is at least half an hour away. In this case, the doctors will come when it will be impossible to save the person. Sometimes it is impossible to timely defibrillate when ventricular fibrillation occurs.

The second reason is the nature of body lesions in clinical death. When it comes to massive blood loss, resuscitation is almost always unsuccessful. The same applies to critical myocardial damage in a heart attack.

For example, if a person has a blockage in one of coronary arteries more than 40 percent of the myocardium is affected, a fatal outcome is inevitable, because the body does not live without the heart muscles, no matter what resuscitation measures are taken.

Thus, it is possible to increase the survival rate in case of clinical death mainly by equipping crowded places with defibrillators, as well as by organizing flying ambulance crews in hard-to-reach areas.

Clinical death for patients

If clinical death for doctors is emergency, in which it is urgent to resort to resuscitation, then for patients it often seems like a road to a bright world. Many near-death survivors have reported seeing light at the end of a tunnel, some meeting their long-dead relatives, others looking at the earth from a bird's eye view.

“I had a light (yes, I know how it sounds), and I seemed to see everything from the outside. It was bliss, or something. No pain for the first time in so much time. someone else's life and now I just slide back into my skin, my life - the only one that I feel comfortable in. It is a little tight, but it is a pleasant tightness, like a worn pair of jeans that you have been wearing for years, "says Lydia, one of the patients who underwent clinical death.

It is this feature of clinical death, its ability to evoke vivid images, that is still the subject of much controversy. With purely scientific point vision, what is happening is described quite simply: there is hypoxia of the brain, which leads to hallucinations in the actual absence of consciousness. What kind of images arise in a person in this state is a strictly individual question. The mechanism of occurrence of hallucinations has not yet been fully elucidated.

At one time, the endorphin theory was very popular. According to her, most of what people feel at near-death experiences can be attributed to the release of endorphins due to extreme exertion. Since endorphins are responsible for obtaining pleasure, and in particular even for orgasm, it is easy to guess that many people who survived clinical death considered ordinary life after it to be only a burdensome routine. However, in last years this theory was debunked because researchers found no evidence that endorphins are released during near-death experiences.

There is also a religious point of view. As, however, in any cases that are inexplicable from the standpoint of modern science. Many people (there are scientists among them) tend to believe that after death a person goes to heaven or hell, and the hallucinations that survivors of near-death experience saw are only proof that hell or heaven exists, like the afterlife in general. It is extremely difficult to give any assessment to these views.

Nevertheless, not all people experienced heavenly bliss during clinical death.

“I suffered clinical death twice in less than one month. I didn’t see anything. When they returned, I realized that I was nowhere, in oblivion. I didn’t have anything there. I concluded that you get rid of everything there by completely losing yourself, probably , along with the soul. Now death does not really bother me, but I enjoy life, "accountant Andrey cites his experience.

In general, studies have shown that at the time of human death, the body loses little in weight (literally a few grams). Adherents of religions hastened to assure mankind that at this moment from human body the soul separates. However scientific approach states that the weight of the human body changes due to chemical processes occurring in the brain at the time of death.

Doctor's opinion

Current standards dictate resuscitation within 30 minutes of the last heartbeat. Resuscitation stops when the human brain dies, namely on registration on the EEG. I have personally resuscitated a patient once who went into cardiac arrest. In my opinion, the stories of people who have experienced clinical death are, in most cases, a myth or fiction. I have never heard such stories from our patients. medical institution. As well as there were no such stories from colleagues.

Moreover, people tend to call clinical death completely different conditions. It is possible that the people who allegedly had it did not actually die, they just had a syncopal state, that is, fainting.

The main cause that leads to clinical death (as well as, in fact, to death in general) remains cardiovascular diseases. Generally speaking, such statistics are not kept, but it must be clearly understood that clinical death occurs first, and then biological. Since the first place in mortality in Russia is occupied by diseases of the heart and blood vessels, it is logical to assume that they most often lead to clinical death.

Dmitry Yeletskov

anesthesiologist-resuscitator, Volgograd

One way or another, the phenomenon of near-death experiences deserves careful study. And it is quite difficult for scientists, because in addition to the fact that it is necessary to establish which chemical processes in the brain lead to the appearance of certain hallucinations, it is also necessary to distinguish truth from fiction.

We expose! Starting the heart with a defibrillator? October 8th, 2013

There was a post recently and its readers decently criticized it. And what do you say about it?

Myth: If the heart has stopped, it can be restarted with a defibrillator.

Scenes like this in Hollywood movies always end well. The hero lies on a hospital bed motionless, and only rhythmic sound signals inform that all is not lost. And then, suddenly, the signal gets stuck on one note, and an ominous straight line appears on the monitor.

The doctors burst in. One of them keeps yelling, “Defibrillator! We're losing him!" And here are a few discharges, dramatic music, without fail someone's cry “LIVE, DAMN YOU!”, and in a miraculous way the heart begins to beat. The hero is saved!

And everything would be fine, but ... the problem is that with the help of a defibrillator it is impossible to start a stopped heart. Alas.

In medicine, a straight line on a monitor is called asystole and means no heartbeat. The idea that these contractions can be restarted with an electric shock seems perfectly reasonable.

In order to understand why this is not so, we must first understand how the heartbeat occurs.

The heart usually receives 60-100 tons of “thumps” per minute from stimulating cells in the upper wall of the right atrium (sinoatrial node). These specialized cells create an electrical differential between the inside and outside of the cell membrane. At a certain moment, an impulse is sent down the heart muscle, causing it to contract. This electrical signal travels throughout the heart.

You are probably thinking that if the heart contracts from the impulses it has created, then why can't it be forced to contract with the help of outside influences? Let's figure it out.

The sinoatrial node creates an electrical differential using electrolytes such as potassium, sodium, and calcium. We will not quote a lecture for medical students, however, for some understanding of why shock therapy does not work, we briefly summarize what happens in our body.

The electrical charge of these electrolytes travels through the cell walls using channels named after the electrolytes themselves—sodium channels, calcium channels, and so on.

Before contraction, potassium is mostly inside the cells, while sodium and calcium are outside. Blood pressure (if you didn't have it, you would simply die) occurs when sodium enters the cells. This causes potassium to exit the cells, creating an electrical potential.

When this potential becomes high enough, calcium channels open. When the calcium channels are open, sodium and calcium break through into the cells, creating a certain charge. When a charge is generated, the heart sends out an impulse called depolarization.

Move the slider and change the transparency of the heart.

Where is this impulse directed by the sinoatrial node? It immediately passes into the atrium. Then in another cell node, called the atrioventricular node, a pulse is formed. All this allows the lower part of the heart to receive blood from upper division. The atrioventricular node transmits the impulse down to the bundle of His, and further along two paths, called the right and left legs.

It is this electrical conductivity that doctors are looking for, peering into the monitor. Simply put, this impulse causes a contraction, which creates a pulse. However, sometimes the presence of an impulse does not mean anything. It happens that normal electrical conductivity is reflected on the monitor, but there is no pulse. This phenomenon is called pulseless electrical activity(PEA). This is one of the reasons why doctors still have to check the pulse and blood pressure, even if the person is connected to a heart monitor.

If someone goes into cardiac arrest and has no pulse, an electric shock may be needed, depending on how the electrical conduction system works. During cardiac arrest, there may be several options for electrical rhythms. Let's dwell on the most common ones and figure out why the electric shock still sometimes works.

The most common heart rhythm during cardiac arrest is called ventricular fibrillation (arrhythmic contraction of the muscle fibers of the atrium). When the sinoatrial node is not producing an impulse, many other cells in the heart try to do so. As a result, numerous areas of the heart shake it simultaneously from different directions. Instead of measured blows, we are seeing a heart attack.

With this rhythm, the heart cannot pump blood through itself. The only way to force all these various areas hearts again work in unison - an electric shock more powerful than the ones they create.

When you pass this charge of electricity through these cells, it activates all the electrolytes from the cells at the same time. Hope (and it really is just hope) only that normal functioning cardiac electrolytes, passing through cell membranes in an organized manner, will be renewed.

In a state of asystole, a person does not have such an electrical differential that can be shown by a heart monitor. In reality, there are simply no electrolytes inside the cell that can create an impulse. In such a situation, the discharge will not help. Thus, if asystole (the complete absence of ventricular contractions) occurs before you can apply a defibrillator, all you can do is burn the heart high temperature from the rank.

It is a myth that you can beat asystole with a defibrillator. For this, the heart must produce a certain electrical impulse.

Or even such revelations: did you know, but the vaz is a mystery - What do you think The original article is on the website InfoGlaz.rf Link to the article from which this copy is made -

There are a large number of factors in our troubled world that can lead to the death of a person. A huge number of people leave our lives every day. Causes of death may be natural (old age, incurable disease) or violent (accident, fire, drowning, war, etc.). However, today there is one cause of death that claims a large number of lives every year. Although death can be prevented in this case, it is heart failure, which often comes on suddenly, even in quite healthy people. We are taught how to provide first aid, however, as practice shows, faced with such a situation, not everyone can immediately perform necessary measures for the salvation of man. In order to do everything right, you need to know what you are facing in this case.

How to determine that the heart has stopped. Symptoms of cardiac arrest.

There are several main signs by which cardiac arrest can be identified.

No pulse in large arteries. In order to determine the pulse, it is necessary to apply the average and forefinger on the carotid artery and, if the pulse is not detected, resuscitation should begin immediately.
Lack of breath. Breathing can be determined using a mirror, which must be brought to the nose, as well as visually - by respiratory movements chest.
Dilated pupils that do not respond to light. It is necessary to shine a flashlight into the eyes and, if there is no reaction (the pupils do not narrow), this will indicate the cessation of the functioning of the myocardium.
Blue or gray complexion. If the natural pinkish color of the skin is replaced - this is important feature, which indicates a violation of blood circulation.
Loss of consciousness that occurs for 10-20 seconds. Loss of consciousness is associated with ventricular fibrillation or asystole. They are determined by a pat on the face or with the help of sound effects (loud claps, screaming).

How to save a person. How much time is there. First aid and medical care for cardiac arrest.

If you are close to someone who has had this disease, the main thing on your part is not to hesitate. You have only 7 minutes so that the cardiac arrest goes away for the victim without serious consequences. If it is possible to return a person within 7-10 minutes, then the patient is likely to have mental and neurological disorders. Belated help will lead to a deep disability of the victim, who will remain incapacitated for life.

The main task in providing assistance is to restore breathing, heart rate and launching the circulatory system, since oxygen enters the cells and tissues with blood, without which the existence of vital organs, especially the brain, is impossible.

Before assisting, it is necessary to make sure that the person is unconscious. Slow down the victim, try to call out to him loudly. If all else fails, it is worth providing first aid, which includes several basic steps.

The first step is to lay the patient on a hard surface and tilt his head back.
After that, clear the airways from foreign bodies and slime.
The next step is mechanical ventilation (mouth to mouth or nose)
Indirect (external) cardiac massage. Before proceeding to this stage, it is necessary to perform a “precordial blow” - you should beat with your fist in middle part sternum. The main thing is that the blow should not be directly in the region of the heart, as this can aggravate the situation of the victim. Precordial stroke helps to immediately resuscitate the patient or increases the effect of cardiac massage. After preparatory procedure if the patient could not be resuscitated, proceed to external massage.

Every two or three minutes, it is necessary to check the condition of the victim - pulse, breathing, pupils. As soon as breathing appears, you can stop resuscitation, but if only a pulse appears, you need to continue artificial ventilation lungs. Heart massage should be done until the skin color begins to acquire a normal, natural color. If the patient cannot be brought back to life, then assistance can be stopped only when a doctor arrives, who can give permission to stop resuscitation.

It is important to remember that these activities are only the initial stage of assistance to the victim, which must be done before the doctors arrive.

Ambulance doctors use special methods to further maintain the life of the victim. The main task of physicians is restoring the patient's breathing. For this use mask ventilation. If a this method does not help or it is impossible to use it, then they resort to tracheal incubation - this way is the most effective in providing patency respiratory tract. However, only a specialist can install the tube into the trachea.

To start the heart, doctors use a defibrillator - a device that affects electric shock to the heart muscle.

Doctors also come to the aid of special medical preparations. The main ones are:

Atropine- used for asystole.
epinephrine(adrenaline) - necessary to strengthen and increase the heart rate.
Bicarbonate of soda- it is often used in prolonged cardiac arrest, especially in cases where cardiac arrest was caused by acidosis or hyperkalemia.
Lidocaine , amiodarone and bretylium tosylate- are antiarrhythmic drugs.
Magnesium sulfate helps stabilize heart cells and stimulates their excitation
Calcium used for hyperkalemia.

Causes of cardiac arrest

There are several main causes of cardiac arrest

The first place is ventricular fibrillation. In 70-90% of cases it is given reason is a consequence of cardiac arrest. Muscle fibers, of which the walls of the ventricles are composed, begin to shrink randomly, which leads to interruptions in the supply of blood to organs and tissues.

Second place - ventricular asystole- complete cessation of electrical activity of the myocardium, which accounts for 5-10% of cases.

Other reasons include:

ventricular paroxysmal tachycardia with the absence of a pulse in large vessels;
electromechanical dissociation- electrical activity in the form of rhythmic QRS complexes without corresponding contractions of the ventricles;

There is also genetic predisposition- This Romano-Ward syndrome, which is associated with the inheritance of ventricular fibrillation.

In addition, quite healthy person possible cardiac arrest, the cause of which may be the following factors:

Hypothermia (body temperature drops below 28 degrees)
electrical injury
Medicines: cardiac glycosides, adrenergic blockers, analgesics, and anesthetics
Drowning
Lack of oxygen, such as by suffocation
Coronary artery disease . People with coronary artery disease who abuse alcohol are very much at risk, since cardiac arrest in this case occurs in almost 30% of cases.
Atherosclerosis
Arterial hypertension and left ventricular hypertrophy
Anaphylactic and hemorrhagic shock
Smoking
Age

In the presence of one or more factors, you should be more attentive to your health. It is advisable to regularly undergo examinations with a cardiologist. To control the work of the heart, it is possible to use the Cardiovisor device, with which you will always be aware of the state of your main organ. Regular performance monitoring of cardio-vascular system will allow you to live a fulfilling life.

Consequences of cardiac arrest

To my deepest regret only 30% of people survive after cardiac arrest, and worst of all, to a normal life, without serious harm to health, only 3.5% returned. Basically, this is due to the fact that timely assistance was not provided.

The consequences of cardiac arrest very much depend on how quickly they began to provide assistance to the victim. The later the patient was brought back to life, the more likely serious complications. Lack of oxygen supply to vital organs for a long time leads to ischemia(oxygen starvation). Most common in cardiac arrest survivors ischemic damage brain, liver and kidneys, which greatly influence the subsequent life of a person.

Due to vigorous cardiac massage, rib fractures and pneumothorax are possible.

Cardiac arrest in children

Cardiac arrest in children- this is a rather rare phenomenon, which, unfortunately, occurs more and more every year. The causes of this pathology in children are different and very often come to light only after autopsy. Most often, this is a genetic predisposition, which is associated with abnormal functioning of the cardiovascular system. How to predict and prevent danger? Often in children, cardiac arrest is heralded by bradycardia. Often respiratory failure or shock can lead to cardiac arrest. Also, the factors of this pathology in children include ischemic heart disease.

If, nevertheless, the child had a cardiac arrest, timely right help, the correct resuscitation measures on the part of doctors, since it is they who will affect the further health of the child. Such measures include properly done artificial lung ventilation, oxygenation (oxygen enrichment of tissues and organs), temperature control, blood pressure, and blood glucose levels.
With an external heart massage, it must be remembered that the ribs of children are not so strong and, most importantly, do not overdo it with pressure on them. Depending on the age of the child, they press with two or three fingers, and for the newborn indirect massage hearts do thumbs while wrapping your arms around your baby's chest. Only thanks to the right approach of doctors, the survival and normal health of the child in the future is possible.
None of us is completely protected from this terrible phenomenon. However, we can protect ourselves and minimize the likelihood of myocardial arrest. By using the service,

Your heart will never give you unpleasant surprises. After all, regular monitoring of the work of the heart is important step towards health!

Rostislav Zhadeiko, especially for the project .

To the list of publications

Cardiac arrest is a complete cessation of ventricular contractions or a severe loss of pumping function. At the same time, electrical potentials disappear in myocardial cells, the pathways for conducting impulses are blocked, and all types of metabolism are quickly disrupted. The affected heart is unable to push blood into the vessels. Stopping blood circulation poses a threat to human life.

According to WHO statistics, 200,000 people around the world stop their hearts every week. Of these, about 90% die at home or at work before medical care. This points to lack of awareness of the population on the importance of education on measures emergency care.

The total number of deaths from sudden cardiac arrest is greater than from cancer, fires, traffic accidents, AIDS. The problem concerns not only the elderly, but also people of working age, children. Some of these cases can be prevented. Sudden cardiac arrest does not necessarily occur as a consequence serious illness. Such a defeat is possible against the background of full health, in a dream.

The main types of cessation of cardiac activity and the mechanisms of their development

The causes of cardiac arrest according to the mechanism of development are hidden in a sharp violation of its functional abilities, especially excitability, automatism and conduction. Types of cardiac arrest depend on them. Cardiac activity can stop in two ways:

asystole (in 5% of patients);
fibrillation (in 90% of cases).

Asystole is a complete cessation of ventricular contraction in the diastolic phase (during relaxation), rarely in systole. The “order” to stop can come to the heart from other organs reflexively, for example, during operations on gallbladder, stomach, intestines.

With reflex asystole, the myocardium is not damaged, has a fairly good tone

In this case, the role of the wandering and trigeminal nerves.

Another option is asystole against the background:

general oxygen deficiency (hypoxia);
high content carbon dioxide in the blood;
shifts in acid-base balance towards acidosis;
altered electrolyte balance (increase in extracellular potassium, decrease in calcium).

These processes, taken together, negatively affect the properties of the myocardium. The process of depolarization, which is the basis of myocardial contractility, becomes impossible, even if conduction is not impaired. Myocardial cells lose active myosin, which is necessary for obtaining energy in the form of ATP.

With asystole in the systole phase, hypercalcemia is observed.

fibrillation of the heart- this is a broken connection between cardiomyocytes in coordinated actions to ensure a general contraction of the myocardium. Instead of synchronous work that causes systolic contraction and diastole, there are many disparate areas that contract on their own.

The frequency of contractions reaches 600 per minute and above

In this case, the ejection of blood from the ventricles suffers.

Energy costs are much higher than normal, and there is no effective reduction.

If fibrillation captures only the atria, then individual impulses reach the ventricles and blood circulation is maintained at a sufficient level. Attacks of short-term fibrillation can end on their own. But such tension of the ventricles cannot provide hemodynamics for a long time, they are exhausted energy reserves and cardiac arrest occurs.

Other mechanisms of cardiac arrest

Some scientists insist on isolating electromechanical dissociation as a separate form of cessation of cardiac contractions. In other words, myocardial contractility is preserved, but not sufficient to ensure the pushing of blood into the vessels.

At the same time, there is no pulse and blood pressure, but the following are recorded on the ECG:

correct contractions with low voltage;
idioventricular rhythm (from the ventricles);
loss of activity of the sinus and atrioventricular nodes.

The condition is caused by inefficient electrical activity of the heart.

In addition to hypoxia, impaired electrolyte composition and acidosis, hypovolemia (a decrease in total blood volume) is important in pathogenesis. Therefore, more often such signs are observed with hypovolemic shock, massive blood loss.

Since the 70s of the last century, the term "Syndrome of obstructive sleep apnea". Clinically, it was manifested by a short-term cessation of breathing and cardiac activity at night. To date, a great deal of experience has been accumulated in the diagnosis this disease. According to the Research Institute of Cardiology, nocturnal bradycardia was found in 68% of patients with respiratory arrest. At the same time, according to a blood test, pronounced oxygen starvation was observed.

The device allows you to record the respiratory rate and heart rate

The picture of heart damage was expressed:

in 49% - sinoatrial blockade and stop of the pacemaker;
19% - blockade with atrial fibrillation;
5% - a combination different forms bradyarrhythmias.

The duration of cardiac arrest was recorded for more than 3 seconds (other authors indicate 13 seconds).

During the waking period, none of the patients experienced fainting or any other symptoms.

Researchers believe that the main mechanism of asystole in these cases is a pronounced reflex effect from the respiratory organs, coming through the vagus nerve.

Causes of cardiac arrest

Among the causes can be distinguished directly cardiac (cardiac) and external (extracardial).

The main cardinal factors are:

ischemia and inflammation of the myocardium;
acute obstruction pulmonary vessels due to thrombosis or embolism;
cardiomyopathy;
high blood pressure;
atherosclerotic cardiosclerosis;
disturbances of a rhythm and conductivity at defects;
development of cardiac tamponade in hydropericardium.

Extracardiac factors include:

oxygen deficiency (hypoxia) caused by anemia, asphyxia (suffocation, drowning);
pneumothorax (the appearance of air between the layers of the pleura, unilateral compression of the lung);
loss of a significant amount of fluid (hypovolemia) with trauma, shock, incessant vomiting and diarrhea;
metabolic changes with a deviation towards acidosis;
hypothermia of the body (hypothermia) below 28 degrees;
acute hypercalcemia;
severe allergic reactions.

Pneumothorax of the right lung sharply displaces the heart to the left, with a high risk of asystole

Indirect factors that affect the stability of the body's defenses are important:

excessive physical overload of the heart;
elderly age;
smoking and alcoholism;
genetic predisposition to rhythm disturbances, changes in electrolyte composition;
suffered electrical injury.

A combination of factors greatly increases the risk of cardiac arrest. For example, alcohol intake by patients with myocardial infarction causes asystole in almost 1/3 of patients.

The negative impact of drugs

Drugs that cause cardiac arrest are used for treatment. In rare cases, intentional overdose has been fatal. This should be proven to the judicial authorities. When prescribing drugs, the doctor focuses on the age, weight of the patient, diagnosis, warns about possible reaction and the need to re-treat a doctor or call an ambulance.

The phenomena of overdose occur when:

non-compliance with the regimen (taking pills and alcohol);
intentionally increasing the dose (“I forgot to drink in the morning, so I’ll take two at once”);
combined with folk ways treatment (St.
carrying out general anesthesia against the backdrop of continuous medication.

The use of St.

Most common causes cardiac arrest serves reception:

sleeping pills from the group of barbiturates;
narcotic drugs for pain relief;
groups of β-blockers for hypertension;
medicines from the group of phenothiazines prescribed by a psychiatrist as a sedative;
tablets or drops of cardiac glycosides, which are used to treat arrhythmias and decompensated heart failure.

It is estimated that 2% of asystole cases are associated with medicines.

Determine which drugs have the most optimal readings and have the least properties for accumulation, addiction, only a specialist can. Do not do this on the advice of friends or on your own.

Diagnostic signs of cardiac arrest

Cardiac arrest syndrome includes early signs state of clinical death. Since this phase is considered reversible during effective resuscitation, every adult should know the symptoms, since a few seconds are allowed for reflection:

total loss consciousness - the victim does not respond to a shout, braking. It is believed that the brain dies 7 minutes after cardiac arrest. This is an average figure, but the time can vary from two to eleven minutes. The brain is the first to suffer from oxygen deficiency, the cessation of metabolism causes cell death. Therefore, there is no time to argue how long the brain of the victim will live. The sooner resuscitation is started, the greater the chance of survival.
The inability to determine the pulsation on carotid artery- this symptom in the diagnosis depends on practical experience surrounding. In its absence, you can try to listen to heartbeats by putting your ear to the naked chest.
Impaired breathing - accompanied by rare noisy breaths and intervals of up to two minutes.
"Before our eyes" there is an increase in the change in skin color from pallor to blue.
The pupils dilate after 2 minutes of cessation of blood flow, there is no reaction to light (narrowing from a bright beam).
The manifestation of convulsions in individual muscle groups.

If the scene arrives " Ambulance”, then asystole can be confirmed by an electrocardiogram.

What are the consequences of cardiac arrest?

The consequences of circulatory arrest depend on the speed and correctness of emergency care. Prolonged oxygen deficiency of organs causes:

irreversible foci of ischemia in the brain;
affects the kidneys and liver;
with vigorous massage in the elderly, children, fractures of the ribs, sternum, development of pneumothorax are possible.

Mass of the head and spinal cord Together it makes up only about 3% of the total body weight. And for their full functioning, up to 15% of the total cardiac output. Good compensatory capabilities make it possible to preserve functions nerve centers with a decrease in the level of blood circulation to 25% of the norm. However, even indirect massage allows you to maintain only 5% of normal level blood flow.

Consequences on the part of the brain can be:

partial or complete memory impairment (the patient forgets about the injury itself, but remembers what happened before it);
blindness accompanies irreversible changes in the visual nuclei, vision is rarely restored;
paroxysmal cramps in the arms and legs, chewing movements;
different types hallucinations (auditory, visual).

Statistics show an actual recovery in 1/3 of the cases, but full recovery functions of the brain and other organs occurs only in 3.5% of cases of successful resuscitation

This is due to the delay in assistance in a state of clinical death.

Prevention

Cardiac arrest can be prevented by following the principles healthy lifestyle life, avoiding factors that affect blood circulation.

Balanced diet, quitting smoking, alcohol, daily walks for people with heart disease are no less significant than taking pills.

Control for drug therapy needs to be remembered possible overdose, deceleration of the pulse. It is necessary to learn how to determine and count the pulse, depending on this, coordinate the dose of drugs with the doctor.

Unfortunately, the time to provide medical care in case of cardiac arrest is so limited that it is not yet possible to achieve full-fledged resuscitation in the community.