Dissecting 5516 cases of sudden death, we found that there are four things in common.
The original distressing Jiushu 39 Health Network
In the group match of Asian Youth Badminton Championship on June 30th, 17-year-old Zhang Zhijie of China Badminton Team suddenly fainted and died after being sent to hospital for rescue.
According to the press conference of Indonesian Badminton Association on July 1st, the treatment and examination results of Air Force Central Hospital and Central General Hospital showed that Zhang Zhijie died of sudden cardiac arrest.
In the face of sudden bad news, many teammates of Zhang Zhijie expressed their condolences over his death. Some teammates said that "Zhang Zhijie was in good health at ordinary times and had never heard of any diseases".
The death of such a young and promising child is really sad, and his departure also reminds us that even people who seem to be healthy at ordinary times may die suddenly.
This has a great relationship with the reasons behind sudden cardiac arrest.
Cardiac arrest refers to the sudden stop of the heart, which leads to the interruption of blood circulation, and the organs of the body can not get enough oxygen and nutrition. If not rescued in time, the patient will soon die.
This is often the main cause of sudden cardiac death.
According to China Cardiovascular Disease Report, about 544,000 people die of sudden cardiac death (SCD) every year in China, which is equivalent to one person dying of cardiac arrest every minute.
Because of the rapid onset and unpredictable onset time of sudden cardiac death, sometimes people around you will be gone before they can react, so it is very important to understand its inducement, symptoms before coming and preventive measures.
Although sudden cardiac death is urgent, it is not completely untraceable. Today, Uncle Jiu came to explore the "trace" of sudden death.
During strenuous exercise, the myocardial oxygen demand increases, which will aggravate the heart load. If the cardiovascular function is inherently impaired, it is easy to cause oxygen imbalance, myocardial necrosis, and eventually lead to sudden cardiac death.
In addition, long-term or strenuous exercise may also lead to a lot of sweating, which in turn leads to electrolyte imbalance, especially the loss of potassium and sodium ions, resulting in hypokalemia.
Once patients with myocardial infarction are complicated with hypokalemia, it is easy to cause malignant arrhythmia, such as ventricular tachycardia or ventricular fibrillation, which leads to a sharp drop in blood supply and even cardiac arrest. Sudden cardiac death is easy to occur if the rescue is not timely.
Clinical data show that hypokalemia is the most common cause of sudden death in badminton or marathon.
A study of 5,516 cases of sudden death in chinese journal of critical care medicine in 2020 found that sudden cardiac death was the primary cause of sudden death, accounting for 57.76%.
The second place is emotional excitement, accounting for 25.66%.
When angry, the blood flow of the heart doubles than usual, the contractility of the heart is strengthened, the heartbeat is accelerated, and a large amount of blood rushes to the heart, which is easy to induce angina pectoris and myocardial infarction, and then lead to sudden death.
Modern people have a fast pace of work, great pressure in life, and often stay up late to be a demon, which is easy to make their bodies overworked.
At this time, the body will continue to be tense, the nervous system is also highly tense, and the sympathetic nerve has been stimulated, thus raising blood pressure and increasing the burden on the heart.
Overwork can also lead to an increase in heart rate and increase the oxygen consumption of the heart, which may lead to acute myocardial infarction in severe cases and then sudden cardiac death.
Sudden cardiac death is closely related to heart problems, so people with cardiovascular diseases are more likely to be targeted.
If suffering from coronary heart disease, it will cause myocardial infarction, leading to myocardial necrosis and cardiac dysfunction;
Cardiomyopathy makes the structure and function of myocardium abnormal, which increases the risk of arrhythmia and sudden cardiac arrest.
Severe arrhythmia, such as ventricular fibrillation and ventricular tachycardia, can make the heart lose its effective pumping function, lead to insufficient blood supply and eventually lead to sudden death.
Conditions such as congenital heart disease and myocarditis can also lead to similar heart events.
Therefore, people with basic diseases should especially take care of their hearts.
For young people, the main causes of exercise-induced sudden death are coronary heart disease and hypertrophic cardiomyopathy. In addition, excessive tension, excitement, fatigue and other factors will also increase the risk of sudden cardiac death in young people.
Middle-aged people, especially those aged between 30 and 63, are often at high risk of sudden cardiac death. Because of the pressure of work and life, staying up late and working overtime, irregular diet and other factors, they are more prone to coronary heart disease.
Older people are more susceptible to myocarditis, heart failure and other diseases, which will lead to the gradual decline of heart function, thus increasing the risk of sudden cardiac death.
Although sudden death is urgent and heavy, it often sends us a distress signal before it happens, which must not be ignored.
If you have severe, tight and crushing pain in your chest, you need to be vigilant when you feel like your chest has been squeezed repeatedly and you feel suffocated.
Chest pain is also a typical manifestation of coronary heart disease, which generally occurs behind the sternum. More attention should be paid to this situation.
Our emotions will also protect our bodies. If there is a sense of panic at this time, don’t ignore the "alarm" of your body. No matter what you are doing, stop and observe immediately.
In addition to chest pain, in the absence of injury or illness, shoulders, chin, throat, teeth appear pain, and sometimes feel depressed, this situation should also be vigilant.
If a patient with hypertension suddenly has severe headache or even vomiting, it is necessary to highly doubt whether a cerebrovascular accident has occurred, and beware of sudden death.
In addition to pain, if there are obvious cyanosis, purple lips and decreased blood oxygen, it is highly doubtful whether there is pulmonary embolism.
Acute pulmonary embolism, if not handled properly in time, will easily lead to pulmonary infarction, blood circulation disorder and sudden death.
On the premise of no lack of sleep, strenuous exercise or illness, there is an unrelenting sense of fatigue for days, weeks or even months.
And accompanied by insomnia, anxiety, waking up at night and other symptoms, it is necessary to consider whether there is a heart problem.
Before sudden cardiac death, many patients will have a lot of cold sweat, which is one of the typical manifestations of myocardial infarction.
If you don’t have a history of heart disease, but suddenly you have sweating, palpitation, chest pain and other symptoms, you must not be careless, and you must see a doctor in time.
First of all, take responsibility for your health.
Maintain healthy living habits, feel your physical condition with your heart, and be alert to every alarm signal.
When you feel chest tightness, chest pain, dizziness and unknown pain, it is the body that reminds you that it is time to rest. Don’t sacrifice your life in pursuit of temporary efficiency.
Sedentary people should also pay attention to standing up and walking every hour or two, which can effectively promote blood flow in the legs and avoid pulmonary embolism.
Second, pay attention to your emotions.
If you know that you are angry, angry, grumpy and emotional, you should control it properly and find the right way to relieve your emotions.
Take things slowly, sometimes it will be faster.
If you find that you have signs of sudden death, don’t panic, rest quietly first, lie down when you are comfortable, and sit when you are comfortable, but don’t move unless necessary.
If there is oxygen inhalation equipment nearby, you should take oxygen as soon as possible with the help of your family or people around you.
At the same time, take the first-aid medicine that you carry with you immediately, such as chewing nitroglycerin and putting it under your tongue.
Patients with angina pectoris can usually relieve their pain in about two minutes. If the effect is not good, they can take a piece of nitroglycerin under their tongue 10 minutes later and call 120 emergency number quickly.
Finally, if you have spare capacity, you may be able to do your part by learning some first-aid skills when people around you suddenly fall to the ground and have signs of sudden death.
A report published in Military Medical Research shows that after cardiac arrest, the recovery rate of heartbeat can reach 41.7% if the rescue time is within 0~5 minutes; However, if the rescue time is within 5~10 minutes, the recovery rate of heartbeat is only 14.3%.
Therefore, in the first aid of sudden death, there has always been a saying of "golden four minutes". If we can grasp these few minutes, it is likely to save a life.
First aid can be done according to the following methods:
First of all, don’t carry or shake the patient, let him lie on his back on the ground, then pat the patient on the shoulder and call ta loudly.
Then observe the patient’s breathing: whether there is wheezing or abnormal breathing in the chest or abdomen (no more than ten seconds).
At the same time, touch the carotid artery for pulsation (non-medical personnel do not need to judge). At the same time, call for help loudly, and designate the personnel present to dial 120 emergency number. When there are no personnel present, call them quickly and keep effective communication with the medical staff in the emergency center.
If the patient is unconscious and his breathing and pulse disappear, chest compressions and artificial respiration should be performed immediately.
Pressing method: straighten your arms, one palm is close to the patient’s chest wall, the other palm is placed on the back of this hand, your fingers are crossed and held up, and the roots of your palms are forced.
Pressing position: the midpoint of the connecting line between the two nipples.
The compression amplitude and frequency are: the sternum sinks 5 ~ 6 cm (adult), and the chest fully rebounds after each compression, and the hands do not leave the chest wall, and the frequency is 100 ~ 120 times/minute.
按压时间与放松时间各占一半,放松时掌根部不要离开胸壁,以免按压点移位。
必要时进行人工呼吸:清理气道异物,仰头提颏法开放气道,一手捏鼻,嘴巴张大包紧患者嘴唇进行缓慢持续1秒钟吹气,吹气时余光观察患者胸廓是否微微起伏,放松捏鼻再次进行吹气。
按压和通气比例为30∶2,按压30次,人工呼吸2次,按压和人工呼吸5个循环后重新评估患者的意识、呼吸和脉搏。
*注意在开放气道的同时应用手指挖出病人口中异物或呕吐物,如有假牙者应取出假牙。
最后,如果旁边有自动体外除颤器(AED)就最好了。
设计AED的初衷就是让任何一个人都能毫无门槛地操作。因为情况紧迫,没有给人看说明书的时间,所以打开电源开关后,AED都是有语音提示的。
最后的最后,虽然九叔写文辛苦,但真心希望大家在生活中不会遇到上面的情况。
参考资料:
[1]赵智梅,陈晓松,杨仪君,杜鹏举,周攀豪. 我国5516例尸解猝死病例流行特征分析[J]. 中国急救医学, 2020, 40(2): 158-16
[2]王乾,赵丽. 心脏性猝死的研究进展[J]. 中华急诊医学杂志,2021,30(11):1407-1409.
[3] Health first aid science teaches you to learn to use the life-saving artifact AED. Xinhuanet.2023-04-20.
[4]Gu XM, Yao SB, He ZJ, et al. Meta-analysis of the success rate of heartbeat recovery in patients with prehospital cardiac arrest in the past 40 years in China.Mil Med Res. 2020; 7(1):34.
[5] All sudden deaths are planned for a long time! We must pay attention to the six signals sent by the body. Wuxi CDC .2022-08-02.
[6] Guo Yu teenager Zhang Zhijie passed away after fainting. Emergency expert: Three life-saving links were missed at the scene. Upstream news .2024-07-01.
[7] After dissecting more than 5,000 cases of sudden death, doctors found that people who died suddenly had these rules! . Health Times. 2020-08-06.
[8] How to give first aid to patients with sudden cardiac death? Keep these four steps in mind. Healthy China. 2023-10-09.
Original title: "Dissecting 5516 cases of sudden death, discovering the law of sudden death: people who are prone to sudden death have four things in common"
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