If your close person is in the terminal stage of the disease, it is incredibly difficult to accept that he will soon be gone. Knowing what to expect can make things easier.

This article examines 11 signs that death is approaching and discusses ways to cope with the death of a loved one.

How to understand that he is dying

When a person is terminally ill, they may be in hospital or receiving palliative care. It is important for loved ones to know the signs of approaching death.

Human behavior before death

Eats less

As a person approaches death, he becomes less active. This means that it the body requires less energy than before. He practically stops eating or drinking as his appetite gradually decreases.

Those caring for a dying person should allow the person to eat only when he is hungry. Offer the patient ice (or fruit ice) to maintain hydration levels. A person may stop eating completely a few days before death. When this happens, you can try using a moisturizing balm on your lips to avoid drying out.

Sleeps more

During the 2 or 3 months before death, a person begins to spend more and more time sleeping. Lack of wakefulness is due to the fact that the metabolism becomes weaker. No metabolic energy

Anyone caring for a dying loved one should do everything they can to ensure that they sleep comfortably. When the patient has energy, you can try to encourage him to move or get out of bed and walk around to avoid bedsores.

Tired of people

The energy of the dying person fades away. He can't spend as much time with other people as he used to. Perhaps your company will also weigh on him.

Vital signs change

As a person approaches death, their vital signs may change as follows:

• Blood pressure decreases
• Breathing changes
• Heartbeat becomes irregular
• Pulse weak
• Urine may be brown or rusty in color

Toilet habits are changing

As a dying person eats and drinks less, their bowel movements may become smaller. This applies to both solid waste, and urine. When a person completely refuses food and water, he stops using the toilet.

These changes may be upsetting to loved ones, but they are to be expected. Perhaps the hospital will install a special catheter that will alleviate the situation.

Muscles lose their strength

In the days leading up to death, a person's muscles become weak. Muscle weakness means that an individual will not be able to perform even simple tasks that were previously available to him. For example, drinking from a cup, turning over in bed, and so on. If this happens to a dying person, loved ones should help them lift things or turn over in bed.

Body temperature decreases

When a person dies, his blood circulation deteriorates, so the blood concentrates in internal organs. This means that not enough blood will flow to the arms and legs.

Decreased blood circulation means that a dying person's skin will become cold to the touch. It may also appear pale or mottled with blue and purple spots. A person who is dying may not feel cold. But if this does happen, offer him a blanket or blanket.

Consciousness is confused

When a person dies, their brain is still very active. However sometimes those who are near death begin to become confused or express their thoughts incorrectly. This happens when a person loses control over what is happening around him.

Breathing changes

Dying people often have breathing problems. It may become more frequent or, conversely, deep and slow. The dying person may not have enough air, and the breathing itself often becomes irregular.

If the person caring for your loved one notices this, there is no need to worry. This is a normal part of the dying process, and usually does not cause pain to the dying person. In addition, if you have any concerns about this, you can always consult a doctor.

Painful sensations appear

It can be difficult to come to terms with the inevitable fact that a person's pain levels may increase as they approach death. Seeing a painful expression on a person's face or hearing the groans a patient makes is, of course, not easy. A person caring for a dying loved one should talk to their doctor about the use of pain medications. The doctor can try to make this process as comfortable as possible.

Hallucinations appear

It is quite common for dying people to experience visions or Although this may seem quite frightening, there is no need to worry. It is better not to try to change the patient’s opinion about visions, to convince him, as this will most likely only cause additional difficulties.

How to survive the last hours with a loved one?

With the onset of death, human organs stop working, and all processes in the body stop. All you can do in this situation is just be there. Show you care and try to do last hours making the dying person as comfortable as possible.

Continue to talk to the dying person until he passes, because often the dying person hears everything that is happening around him until the last minute.

Other signs of death

If the dying person is connected to a monitor heart rate, loved ones will be able to see when his heart stops beating, which will indicate death.

Other signs of death include:

• No pulse
• Lack of breathing
• No muscle tension
• Fixed eyes
• Emptying the bowel or bladder
• Closing the eyelids

After confirming the death of a person, loved ones will be able to spend some time with someone who was dear to them. Once they say goodbye, the family usually contacts the funeral home. The funeral home will then take the person's body and prepare it for burial. When a person dies in a hospice or hospital, staff contact the funeral home on behalf of the family.

How to cope with the loss of a loved one?

Even when death was expected, it is extremely difficult to come to terms with it. It is important that people give themselves time and space to grieve. Don't give up on the support of friends and family either.

Since the appearance of man, he has always been tormented by questions of the mystery of birth and death. It is impossible to live forever, and, probably, it will not be long before scientists invent an elixir of immortality. Everyone is concerned about the question of how a person feels when he dies. What is happening at this moment? These questions have always worried people, and until now scientists have not found an answer to them.

Interpretation of death

Death is a natural process of ending our existence. Without it, it is impossible to imagine the evolution of life on earth. What happens when a person dies? This question has interested and will continue to interest humanity as long as it exists.

Passing away proves to some extent that it is survival of the fittest and the fittest. Wouldn't have been possible without him biological progress, and the person might never have appeared.

Despite the fact that this natural process has always interested people, talking about death is difficult and difficult. First of all because it gets up psychological problem. Talking about it, we seem to be mentally approaching the end of our life, which is why we don’t want to talk about death in any context.

On the other hand, it is difficult to talk about death, because we, the living, have not experienced it, so we cannot say what a person feels when he dies.

Some compare death to simply falling asleep, while others argue that it is a kind of forgetting, when a person completely forgets about everything. But neither one nor the other, of course, is right. These analogies cannot be called adequate. We can only say that death is the disappearance of our consciousness.

Many continue to believe that after his death a person simply passes into another world, where he does not exist at the level physical body, but at the level of the soul.

It is safe to say that research into death will always continue, but it will never provide a definitive answer about how people feel at this moment. This is simply impossible; no one has ever returned from the other world to tell us how and what is happening there.

How does a person feel when he dies?

Physical sensations probably at this moment depend on what led to death. Therefore, they can be painful or not, and some believe that they are quite pleasant.

Everyone has their own inner feelings in the face of death. Most people have some kind of fear sitting inside, they seem to resist and do not want to accept it, clinging to life with all their might.

Scientific evidence shows that after the heart muscle stops, the brain still lives for a few seconds, the person no longer feels anything, but is still conscious. Some believe that it is at this time that life’s results are summed up.

Unfortunately, no one can answer the question of how a person dies and what happens. All these sensations are most likely strictly individual.

Biological classification of death

Since the very concept of death is a biological term, classification must be approached from this point of view. Based on this, the following categories of death can be distinguished:

1. Natural.
2. Unnatural.

Natural death can be classified as physiological death, which can occur due to:

• Aging of the body.
• Fetal underdevelopment. Therefore, he dies almost immediately after birth or while still in the womb.

Unnatural death is divided into the following types:

• Death from disease (infections, cardiovascular diseases).
• Sudden.
• Sudden.
• Death by external factors(mechanical damage, breathing problems, exposure to electric current or low temperatures, medical intervention).

This is how we can roughly characterize death with biological point vision.

Socio-legal classification

If we talk about death from this perspective, then it can be:

• Violent (murder, suicide).
• Non-violent (epidemics, industrial accidents, occupational diseases).

Violent death is always associated with external influence, while non-violent death is caused by senile flabbiness, illness or physical disabilities.

In any type of death, injuries or illnesses trigger pathological processes, which are the direct cause of death.

Even if the cause of death is known, it is still impossible to say what a person sees when he dies. This question will remain unanswered.

Signs of death

It is possible to identify initial and reliable signs that indicate that a person has died. The first group includes:

• The body is motionless.
• Pale skin.
• There is no consciousness.
• Breathing stopped, no pulse.
• There is no reaction to external stimuli.
• The pupils do not react to light.
• The body becomes cold.

Signs that indicate 100% death:

• The corpse is numb and cold, and cadaveric spots begin to appear.
• Late cadaveric manifestations: decomposition, mummification.

The first signs can be confused by an ignorant person with loss of consciousness, so only a doctor should pronounce death.

Stages of death

Death may take different periods time. This can last minutes, or in some cases hours or days. Dying is a dynamic process, in which death does not occur immediately, but gradually, if you do not mean instant death.

The following stages of dying can be distinguished:

1. Preagonal state. The processes of blood circulation and breathing are disrupted, this leads to the fact that the tissues begin to lack oxygen. This condition can last for several hours or several days.
2. Terminal pause. Breathing stops, the work of the heart muscle is disrupted, and brain activity stops. This period lasts only a few minutes.
3. Agony. The body suddenly begins to fight for survival. At this time, short pauses in breathing and weakening of cardiac activity occur, as a result of which all organ systems cannot function normally. Changes appearance person: the eyes become sunken, the nose becomes sharp, the lower jaw begins to sag.
4. Clinical death. Breathing and blood circulation stop. During this period, a person can still be revived if no more than 5-6 minutes have passed. It is after returning to life at this stage that many people talk about what happens when a person dies.
5. Biological death. The body finally ceases to exist.

After death, many organs remain viable for several hours. This is very important, and it is during this period that they can be used for transplantation into another person.

Clinical death

It can be called a transitional stage between the final death of the organism and life. The heart stops working, breathing stops, all signs of the body’s vital functions disappear.

Within 5-6 minutes the brain does not yet have time to start irreversible processes, so at this time there is every chance of bringing a person back to life. Adequate resuscitation actions will make the heart beat again and the organs function.

Signs of clinical death

If you carefully observe a person, you can easily determine the onset of clinical death. She has the following symptoms:

1. There is no pulse.
2. Breathing stops.
3. The heart stops working.
4. Severely dilated pupils.
5. There are no reflexes.
6. The person is unconscious.
7. The skin is pale.
8. The body is in an unnatural position.

To determine the onset of this moment, you need to feel the pulse and look at the pupils. Clinical death is different from biological topics that the pupils retain the ability to react to light.

The pulse can be felt in the carotid artery. This is usually done simultaneously with checking the pupils to speed up the diagnosis of clinical death.

If a person is not helped during this period, then biological death, and then it will be impossible to bring him back to life.

How to recognize approaching death

Many philosophers and doctors compare the process of birth and death with each other. They are always individual. It is impossible to predict with accuracy when a person will leave this world and how it will happen. However, most dying people experience similar symptoms as death approaches. How a person dies may not even be influenced by the reasons that triggered the onset of this process.

Just before death, certain psychological and physical changes. Among the most striking and frequently encountered are the following:

1. There is less and less energy left, and drowsiness and weakness throughout the body often occur.
2. The frequency and depth of breathing changes. Periods of stopping are replaced by frequent and deep breaths.
3. Changes occur in the senses, a person can hear or see something that others cannot hear.
4. Appetite becomes weak or practically disappears.
5. Changes in organ systems lead to urine that is too dark and stools that are difficult to pass.
6. There are temperature fluctuations. High can suddenly give way to low.
7. The person completely loses interest in the outside world.

When a person is seriously ill, other symptoms may occur before death.

A person's feelings at the moment of drowning

If you ask the question of how a person feels when he dies, the answer may depend on the cause and circumstances of death. This happens differently for everyone, but in any case, at this moment there is an acute lack of oxygen in the brain.

After the movement of blood is stopped, regardless of the method, after about 10 seconds the person loses consciousness, and a little later the death of the body occurs.

If the cause of death is drowning, then the moment a person finds himself under water, he begins to panic. Since it is impossible to do without breathing, after a while the drowning person has to take a breath, but instead of air, water enters the lungs.

As the lungs fill with water, a feeling of burning and fullness appears in the chest. Gradually, after a few minutes, calm appears, which indicates that consciousness will soon leave the person, and this will lead to death.

The lifespan of a person in water will also depend on its temperature. The colder it is, the faster the body becomes hypothermic. Even if a person is afloat and not underwater, the chances of survival decrease every minute.

An already lifeless body can still be taken out of the water and brought back to life if not much time has passed. The first thing you need to do is release respiratory tract from water, and then carry out full resuscitation measures.

Feelings during a heart attack

In some cases, it happens that a person suddenly falls and dies. Most often, death from a heart attack does not occur suddenly, but the development of the disease occurs gradually. Myocardial infarction does not affect a person immediately; for some time, people may feel some discomfort in the chest, but try not to pay attention to it. This is what big mistake which ends in death.

If you're prone to heart attacks, don't expect things to go away on their own. Such hope may cost you your life. After cardiac arrest, only a few seconds will pass until the person loses consciousness. A few more minutes, and death is already taking away our loved one.

If the patient is in the hospital, then he has a chance to get out if doctors detect cardiac arrest in time and carry out resuscitation measures.

Body temperature and death

Many people are interested in the question of at what temperature a person dies. Most people remember from biology lessons in school that for humans a body temperature above 42 degrees is considered fatal.

Some scientists attribute fatalities to high temperature with the properties of water, the molecules of which change their structure. But these are only guesses and assumptions that science has yet to deal with.

If we consider the question of at what temperature a person dies, when hypothermia of the body begins, then we can say that already when the body cools down to 30 degrees, a person loses consciousness. If no measures are taken at this moment, death will occur.

Many such cases occur with people intoxicated who fall asleep in winter time right on the street and never wake up again.

Emotional changes on the eve of death

Usually, before death, a person becomes completely indifferent to everything that happens around him. He ceases to be oriented in time and dates, becomes silent, but some, on the contrary, begin to constantly talk about the road ahead.

A loved one who is dying may begin to tell you that they talked to or saw deceased relatives. Another extreme manifestation at this time is a state of psychosis. It’s always hard for loved ones to bear all this, so you can consult a doctor and get advice about taking medicines to alleviate the condition of the dying.

If a person falls into a state of stupor or often sleeps for a long time, do not try to stir him up or wake him up, just be there, hold his hand, talk. Many people, even in a coma, can hear everything perfectly.

Death is always difficult; each of us will cross this line between life and non-existence in due time. When this happens and under what circumstances, how you will feel, unfortunately, is impossible to predict. This is a purely individual feeling for everyone.

Why did the woman die from alcoholism? How do men die from alcoholism? What are the main reasons similar deaths? It's worth knowing the answers to all these questions. Alcohol is a highly toxic substance; with its constant use, irreversible changes occur in the body, which has a detrimental effect on the human condition as a whole. Gradual poisoning of the body provokes the development of diseases, which can often result in death. Death after drinking alcohol-containing drinks is a consequence of the gradual toxic effect of alcohol on the body or is associated with its ability to quickly worsen a person’s health in chronic diseases and various hidden pathologies.

Main causes of death from alcohol dependence

Important! Death from alcohol is one of the leading causes of sudden death for many apparently healthy men, obvious signs no intoxication is visible.

How can you die from alcoholism? Lethal outcome from alcohol abuse can be various reasons. In acute pancreatitis, a person's heart may suddenly stop. The cause of death will also be a blood clot that breaks off and blocks the blood supply while drinking alcohol. Often the cause of death is the use of lethal dose alcohol - in in this case death usually observed the next day.

Diseases

By statistical information According to the World Health Organization, every year people die from alcoholism and diseases caused by alcoholic beverages worldwide. internal organs about 4% of the population, now approximately 2.5 million people. Such cases include:

• At least 1/5 of the deaths from alcohol are due to various cancers that were provoked by alcohol;
• About 16% of people who drink die from liver disease, most of them die from cirrhosis;
• Approximately 14% of deaths are due to cardiovascular diseases caused by alcohol;
• 18% of deaths are related to others chronic diseases and pathologies that are aggravated due to alcohol poisoning.

The harmful effects of alcohol are observed when taking ethanol in any volume, and regular alcohol intoxication causes diseases of many internal organs, of which the greatest danger is:

• Heart diseases – myocardial dystrophy, arrhythmia;
• Nervous system – polyneuropathy, myopathy, hepatic encephalopathy, epileptiform seizures;
• Diseases digestive tract– pancreatitis, gastric ulcer, esophageal reflux, liver failure;
• Genitourinary system – acute urinary retention, nephritis, sexual disorders;
• Pneumonia;
• Bone fractures.

Alcohol consumption leads to disturbances in purine and carbohydrate metabolism, contributes to the exacerbation of gout, diabetes, and destroys the immune system.

Accidents

According to WHO statistics, about 30% of drunken deaths occur due to an accident. Here are just some examples of how people die from alcohol:

• Falling under various vehicles(cars, trams, trains, etc.);
• Fall from a height;
• Hypothermia or overheating;
• Gassing;
• Improper handling of all kinds of household appliances;
• Death in fires;
• Drowning.

When the dose of alcohol was large enough, intoxication had set in a long time ago, the person no longer felt a change in the conditions around him - temperature, altitude, obstacles. Reflexes are dulled and in this state any absurd accident can happen. Suicides among alcoholics occur a little less frequently. Psychoses caused by alcohol abuse can provoke alcoholics to many actions, including suicide.

Medicines

Alcohol and medicines very often they do not combine with each other. Alcoholic drinks (including beer) can make medications either simply ineffective or change their effect in the most unpredictable way. For fatal poisoning in this case, it is enough to mix alcohol with drugs:

• Sleeping pills – may cause drowsiness, coma or death;
• Cardiovascular– seriously increases the risk of developing vascular insufficiency;
• Antipyretic– provokes ulcerative lesions of the gastrointestinal tract;
• Diuretic – stimulates the development of pancreatitis and heart failure;
• Analgesics – increases tachycardia;
• Antibiotics – enhances the destructive effect of toxins on the body.

Eliminate use alcoholic drinks when undergoing any treatment with medications, it can often be vital. However, every year a certain number of people for some reason forget about this simple rule.

Surrogates

A high price, a beautiful bottle and label are not always signs of truly high-quality alcohol. Even reputable stores can sell products based on methyl alcohol(methanol), and it is much more dangerous than ordinary ethanol. These are just some of the harmful features of its effect on the human body:

• Methanol severely affects vision, including blindness;
• Methyl alcohol causes severe poisoning of the body;
• Methanol leads to intoxication many times faster, and causes much more damage to health.

Methyl alcohol as a lethal substitute for ethyl alcohol is used in industry, in food production it is prohibited because human body extremely harmful. But even such qualities do not stop some alcoholics from drinking questionable drinks.

Important! Due to the fact that methanol-based alcohol is visually indistinguishable from high-quality alcohol, dangerous drinks are successfully sold, but for the most part this is observed on the market in the low-price segment.

The weakening of the immune system, which is inherent in all alcoholics, leads to their increased susceptibility to various infections. With alcoholism, a person often dies extremely ill, experiencing unimaginable pain. And for which of the above-mentioned reasons this happens - with the worsening of alcoholism it becomes less important, because the person eventually almost completely loses touch with reality. Therefore, it is necessary to solve problems with alcohol as soon as they appear, so as not to lead to irreversible consequences.

How to avoid dying from alcohol poisoning?

How to avoid dying from alcohol poisoning? Feeling unwell in the morning after drinking too much alcohol is an indicator of the onset of addiction to alcohol. Depending on the symptoms, the subsequent reaction of the body can be different, including death. Vomiting blood may well be a sign of a stomach ulcer, and a sign of a heart attack is pain in the heart. At severe pain you should not try to cope with it by willpower and various folk remedies. Fainting, increased temperature or blood pressure, worsening headache– all these symptoms should cause a person to immediately seek professional help medical care. You cannot do nothing if there is a strong heartbeat, dizziness, confusion, or painful repeated vomiting.

These symptoms may not be signs of intoxication, but may be an acute reaction of the body to any disease. With renal colic, pain can be relieved only by intravenous administration of painkillers; other methods will not help, especially if it is bilateral pain, acute urinary retention, or repeated vomiting. Warming procedures such as warm baths and warm compresses at the site of pain will also have no effect. In case of acute urinary retention, all attempts to help the patient on their own will only lead to increased suffering. To provide first aid, it is necessary to perform catheterization of the bladder. If you have symptoms of heart failure or hepatic coma, you should immediately call an ambulance.

You shouldn’t joke with your health in the situation of alcohol poisoning and at the first signs of intoxication you need to start acting, and not wait until everything “goes away on its own.” An alcoholic may not feel the worsening of his condition, which is why alcohol poisoning so often occurs with fatal among alcohol dependent people. The probability of death from alcoholism can be called the first and one of the main reasons to give up drinking right now and start living healthy image life.

The atmosphere on our planet, the distance to the sun and many others incredible coincidences led to the fact that life as we know it can exist on Earth. We take all this for granted, and we, rushing to work or relaxing at a table in a cafe, do not find anything surprising in our existence. But all good things come to an end. One day the Earth will become unsuitable for supporting life as we know it. Maybe this won't happen for millions of years. But astrophysics tells us that a catastrophe can happen at any moment. And scientists have found many reasons why the Earth can become lifeless.

1) The planet's core will cool down

2) The Sun will expand

3) The Earth will collide with a wanderer planet

4) The Earth will collide with an asteroid

5) The Earth may come close to a wandering black hole

6) The Earth will be destroyed by a burst of gamma radiation

7) The Universe will fall apart in its final “Big Rip”

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

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

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

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

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

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

Causes of sudden cardiac death

the main cause of SCD is atherosclerosis

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

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

The causes of sudden cardiac death are:

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

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

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

Diagram: distribution of causes of SCD at a young age

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

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

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

Signs of sudden cardiac death

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

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

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

Nine out of ten cases of sudden coronary death occur outside the home, often in the context of severe emotional experience, physical overload, but it happens that the patient dies from acute coronary pathology in his sleep.

When ventricular fibrillation and cardiac arrest occur during an attack, severe weakness appears, dizziness begins, the patient loses consciousness and falls, breathing becomes noisy, and convulsions are possible due to deep hypoxia of the brain tissue.

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

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

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

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

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

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

Diagnosis of sudden death syndrome

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

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

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

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

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

With successful resuscitation at the prehospital stage, already in a hospital setting the patient will undergo numerous laboratory examinations, starting with routine urine and blood tests and ending with a toxicological study for certain drugs that can cause arrhythmia. Daily ECG monitoring, ultrasound examination of the heart, electrophysiological study, and stress tests will be required.

Treatment of sudden cardiac death

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

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

Video: Performing basic cardiopulmonary resuscitation

After diagnosing clinical death, the ambulance team begins chest compressions and artificial ventilation of the lungs with an Ambu bag, providing access to a vein into which medications can be injected. In some cases, intratracheal or intracardiac administration of drugs is practiced. It is advisable to administer drugs into the trachea during intubation, and the intracardiac method is used most rarely - when it is impossible to use others.

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

defibrillation

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

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

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

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

Treatment in the post-resuscitation period lasts about a week. At this time, electrolyte disturbances, disseminated intravascular coagulation syndrome, neurological disorders, so the patient is admitted to the intensive care unit for observation.

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

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

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

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

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

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

Video: Presentation on Sudden Cardiac Death

Video: lecture on the prevention of sudden cardiac death