The atmosphere on our planet, the distance to the sun and many other incredible coincidences have led to the fact that life on Earth can exist as we know it. All this is perceived by us as a given, 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 unusable to sustain the life we ​​know. Maybe this will not 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 core of the planet will cool down

The earth is surrounded by a magnetic field called the magnetosphere, which protects us from the solar wind.
This field is created by the rotation of the planet, due to which the liquid iron-nickel shell (outer core) moves around the solid metal core (inner core), forming a giant magnetic generator.
The magnetosphere deflects energy particles emitted by the sun, changing their size and shape.
If the planet's core cools down, then we will lose our magnetosphere - as well as protection from the solar wind, because of which it will gradually spread the Earth's atmosphere throughout space.
Mars, which once had water and an atmosphere, suffered just such a fate several million years ago, and it turned into the dry and lifeless world as we know it now.

2) The Sun will expand

The sun, and especially our distance to it, is perhaps the most important factor that made life possible.
However, the Sun is a star. And the stars are dying.
Right now, the Sun is in the middle of its life, constantly converting hydrogen to helium through thermonuclear reactions.
But this cannot last forever. In a few billion years, the hydrogen in the Sun's core will run out, and it will begin to process helium.
Due to the fact that the processing of helium gives much more energy, the Sun will begin to expand, and, possibly, pull the Earth towards itself.
We will burn and evaporate.
Either that, or the expansion of the sun opposite, will push the Earth away, it will leave its orbit and will be doomed to wander through space like a wanderer planet - a dead piece of cold stone.

3) Earth will collide with a wanderer planet

There are many planets in space that move freely through it, and do not revolve around the star. Planets are often thrown out of their star systems during their formation.
Recent calculations show that the number of wandering planets in Milky way exceeds the number of stars by 100,000 times.
One of these planets can approach the Earth and dangerously destabilize its orbit.
Or a roaming planet could collide with Earth. And this has already happened - about 4.5 million years ago, a small planet collided with a larger one, which formed the Earth and the Moon as we know them.

4) Earth will collide with an asteroid

Hollywood is very fond of such scenarios.
Stones from space can be very destructive - one of them destroyed the dinosaurs. Although, of course, in order to completely destroy the planet, many more asteroids are needed.
But it can still happen. For example, over the hundreds of millions of years since the formation of the Earth, asteroids collided with it very often. The blows were so strong that the oceans boiled for years and the air temperature was over 500 degrees Celsius. Life on Earth was then unicellular, and was represented in the form of particularly heat-resistant microbes. Most of modern forms life would not have endured.

5) Earth may approach a wandering black hole

Black holes are perhaps the second most popular cause of death in Hollywood. It's easy to see why.
They are mysterious and frightening. Even their name sounds creepy.
We know little about black holes, but we do know that they are so massive that even light cannot escape beyond their event horizon.
Scientists also know that there are black holes that freely travel through space. So it is possible that one of them can visit the solar system.
If light cannot escape from the black hole, then the Earth certainly cannot. There are two theories of what happens to a planet after it crosses the point of no return of a sufficiently large black hole. A smaller one will simply stretch (as astrophysicists say, “spaghettize”) the planet.
Some physicists say that beyond the event horizon, atoms will stretch until they are completely destroyed.
Others - that we will find ourselves in another part of the universe, or even in another dimension.
But, even if the black hole does not pull the Earth into itself, then after passing close enough, it can cause earthquakes and other natural disasters or disrupt the orbit of the planet, so we will either leave solar system, or fall into the sun.

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

Gamma ray bursts (or simply gamma ray bursts) are some of the most powerful phenomena in the universe.
Many of them are the result of the collapse of the star at the time of its death. One short burst can contain more energy than the Sun can generate in its entire life.
Such a powerful flow of energy can deprive the Earth of the ozone layer, making us defenseless against dangerous ultraviolet radiation, and trigger the mechanism of a rapid global cooling.
A gamma-ray burst that hit the Earth 440 million years ago could be the cause of the first mass extinction.
But fortunately, David Thompson, deputy project manager for gamma-ray observation, said that gamma-ray bursts are actually not very dangerous.
He said that the chance of the Earth being caught in a gamma-ray burst stream is roughly equal to "the chance that I will meet a polar bear in my toilet."

7) the Universe will fall apart in its last "Big Rip"

This is something that can destroy the entire universe, not just the Earth.
The bottom line is this: An unknown force called dark energy is causing the universe to expand faster and faster.
If the expansion continues (which is very possible), in 22 billion years, interatomic bonds will weaken, and all matter in the universe will gradually dissipate in the form of energy.
But if we assume that the Great Rip still will not happen, then what can happen after a global catastrophe that humanity will not survive?
It is possible that some microbes will survive, from which life will then develop again.
But if the destruction is absolute, then, in extreme cases, we can hope that somewhere in the universe there is another intelligent life that can give us the last honors.

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

The interpretation of death

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

Leaving life to some extent proves that the fittest and fittest survive. Without it, biological progress would have been impossible, and man, perhaps, would never have appeared.

Despite the fact that this natural process has always interested people, it is difficult and difficult to talk about death. First of all, because it gets up psychological problem... Talking about it, we seem to be mentally approaching the end of our life, so we really 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, did not experience it, therefore we cannot say what a person feels when he dies.

Some compare death with ordinary falling asleep, while others argue that this is a kind of forgetting, when a person completely forgets about everything. But neither one nor the other is naturally wrong. These analogies cannot be called adequate. It can only be argued 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 continue forever, but they will never give a definitive answer about how people feel at this moment. It is simply impossible, no one has ever returned from the afterlife to tell us how and what is happening there.

What does a person feel when they die

Physical sensations, probably at this moment, depend on what led to death. Therefore, they may be painful or not, and some find 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 suggests that after the heart muscle stops, the brain lives for a few seconds, the person no longer feels anything, but is still conscious. Some believe that it is at this time that the summing up of life takes place.

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, it is also necessary to approach the classification from this point of view. Based on this, the following categories of death can be distinguished:

1. Natural.
2. Unnatural.

The natural can be attributed to the physiological death, which can occur due to:

• Aging of the body.
• Underdevelopment of the fetus. Therefore, he dies almost immediately after birth or even in the womb.

Unnatural death is subdivided into the following types:

• Death from illness (infection, cardiovascular disease).
• Sudden.
• Sudden.
• Death from external factors ( mechanical damage, respiratory failure, from exposure electric current or low temperatures, medical intervention).

This is roughly how you can characterize death from a biological point of view.

Socio-legal classification

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

• Violent (murder, suicide).
• Nonviolent (epidemics, industrial accidents, occupational diseases).

Violent death is always associated with external influences, while nonviolent death is due to senile flabbiness, disease or physical disabilities.

With any kind of death, damage or disease trigger pathological processes, which are directly the 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 the initial and reliable signs that indicate that the person has died. The first group includes:

• The body is motionless.
• Pale skin.
• Consciousness is absent.
• Breathing stopped, no pulse.
• There is no reaction to external stimuli.
• Pupils do not respond to light.
• The body becomes cold.

Signs that speak of 100% death:

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

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

Death stages

Leaving life can take different periods of time. This can last for minutes, and 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 respiration 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, the activity of the brain stops. This period lasts only a few minutes.
3. Agony. The body suddenly begins to struggle for survival. At this time, there are short stops in breathing, weakening of cardiac activity, as a result, all organ systems cannot carry out their work normally. Changes appearance human: eyes sink, the nose becomes sharp, the lower jaw begins to droop.
4. Clinical death... Breathing and blood circulation stops. 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 organism finally ceases to exist.

After death, many organs retain their vitality for several hours. This is very important, and it is during this period that they can be used for transplantation to 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 activity disappear.

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

Signs of clinical death

If you carefully observe a person, then it is quite easy to determine the onset of clinical death. She has the following signs:

1. There is no pulse.
2. Breathing stops.
3. The heart stops working.
4. Greatly dilated pupils.
5. Reflexes are absent.
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, it is necessary to feel the pulse and see the pupils. Clinical death differs from biological death in that the pupils retain the ability to respond to light.

The pulse can be felt on the carotid artery. This is usually done at the same time as the pupil test to speed up the diagnosis of near-death death.

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

How to recognize impending 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 certainty when a person will leave this world and how it will happen. However, most dying people experience similar symptoms when death approaches. How a person dies may not even be influenced by the reasons that provoked the onset of this process.

Before his death, certain psychological and physical changes occur in the body. Among the brightest and most common are the following:

1. Energy remains less and less, often drowsiness and weakness throughout the body.
2. The frequency and depth of breathing changes. The periods of stopping are followed by frequent and deep breaths.
3. Changes take place in the sense organs, a person can hear or see what the others do not hear.
4. Appetite becomes weak or almost disappears.
5. Changes in organ systems lead to the appearance of too dark urine and difficult stools.
6. Temperature jumps are observed. High can be abruptly replaced by low.
7. The person completely loses interest in the outside world.

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

Feelings of a person 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. For everyone, this happens in their own way, but in any case, at this moment there is an acute oxygen deficiency in the brain.

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

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

As the lungs fill up with water, a burning sensation and distension appears in the chest. Gradually, after a few minutes, calmness appears, which suggests that consciousness will soon leave a 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 under water, the chances of survival are diminishing by the minute.

An already lifeless body can still be taken out of the water and brought back to life, if not very much time has passed. The first step is to free the airways from water, and then fully carry out resuscitation measures.

Feelings at the moment of a heart attack

In some cases, it happens that a person suddenly fell and died. Most often, death from a heart attack does not occur suddenly, but the development of the disease occurs gradually. Myocardial infarction does not strike a person right away, for some time people may feel some discomfort in the chest, but try not to pay attention to it. This is the big mistake that ends in death.

If you are prone to heart attacks, then you should not expect everything to go away by itself. This hope can cost you your life. After cardiac arrest, it will take only a few seconds until the person loses consciousness. A few more minutes, and death is already taking our loved one away from us.

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

Some scientists associate the death at high temperatures 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 at this moment no measures are taken, then death will come.

Many such cases happen to people in alcoholic intoxication, who fall asleep in the winter right on the street and no longer wake up.

Emotional changes on the eve of death

Usually, before death, a person becomes completely indifferent to everything that happens around. He stops orienting himself in time and dates, becomes taciturn, but some, on the contrary, start constantly talking about the upcoming road.

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

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

Death is always difficult, each of us will step over this line between life and non-existence in due time. Unfortunately, it is impossible to predict when this will happen and under what circumstances how you will feel. Everyone has a purely individual feeling.

Fires - like any manifestation of unbridled elements - always bring destruction and death with them. But especially grave consequences are those of them that break out in public, residential buildings with a massive presence of people.

The death of people in fires is largely due to the lack of fire-fighting knowledge and skills among Russian citizens. People often do not know not only basic rules fire safety but even the phone number of the nearest fire department. Not to mention the actions at the initial moment of the development of the fire before the arrival of the fire brigade units, the methods of self-rescue in extreme situation... This is especially true for residential buildings, where the largest number of fires with the death of people occurs.
What is the cause of the death of people in the fire? What do you need to know about a fire to stay alive?

1. The fire is blinding, you cannot see in the fire.
If you have never experienced real fire factors, you will be in a state of complete shock.
To your horror, you learn that in a real fire you cannot see anything. The flame makes everything black. It carries no light. Nothing is visible, only heat and ash, terrible darkness. You absolutely cannot navigate, you cannot find the exit door you are familiar with. Total loss orientation due to panic. The fire is black as night, which will lead to inevitable death.

In order to avoid this, they are used in buildings:
- emergency lighting;
- light indicators "evacuation (emergency) exit";
- fire safety signs used on escape routes,
including glow-in-the-dark;
- electric lights.

2. Kills smoke and gas, not flames.
A modern apartment is literally stuffed with objects: and materials that, when burned in huge quantities, emit more than 70 types of toxic substances (carbon monoxide, carbon dioxide, diphosgene, phosgene, hydrogen cyanide, etc.). A few breaths in such an atmosphere - and a person can no longer be saved.

Basically, people do not die from fire or collapsed structures, but from smoke and lack of oxygen. Moreover, more than half of the victims of the smoke die at the site of the fire. 42% of the victims of the survivors receive severe poisoning, every third of them dies in the hospital without regaining consciousness. About 70% of all those killed in the fire die from exposure to smoke, and the speed of its spread is high: 2-3 minutes a corridor, 1-1.5 minutes a staircase of a ten-story building.

The most dangerous thing is if a fire breaks out in a residential building in the middle of the night. Do you think you will wake up and take action? but scary fact is that you will not wake up from the smell of smoke. From it you will only fall asleep even more soundly. You fall into deep sleep as if under anesthesia. You cannot move. Smoke kills your brain.

Ninety percent of the people that firefighters find in the smoke look like they were asleep.

If you are in a room filled with smoke, you not only cannot see anything, but you also cannot breathe. It is similar to drowning and head underwater. Are you scared. You forget everything that you thought you knew about the fire. You get lost, panic, behave unpredictably, because not psychologically ready for such an extreme situation.

To combat smoke, the following are used:
- smoke-free staircases (due to the pressurization of air or floor entrances through the outdoor air zone along balconies or loggias);
- removal of smoke from rooms, corridors through automatically opening smoke exhaust valves by turning on powerful exhaust fans;
- installation in corridors on staircases of self-closing doors with sealed porches preventing the spread of smoke;
- the device of the automatic fire alarm(smoke and heat detectors, manual fire alarm buttons, fire alarm bells, fire alarm stations);
- systems for warning people about fire and evacuation management;
- funds individual protection respiratory organs in case of fire;
- autonomous fire detectors operating from a battery for apartments in residential buildings;
- group and individual rescue kits, rope ladders.

3. The heat from the fire can cause instant death. The heat is terrible. He kills. Fever alone is fatal within seconds. It is very difficult to describe in words. At 65 ° C, your body stops functioning, your lungs literally evaporate, and a person loses consciousness.

In the room, a fire lasting just over one minute creates a temperature in the smoke layer of 370 ° C. If the head is unprotected, then instant death occurs. Above, the temperature and smoke concentration is even higher. When everything that can burn in the room burns, the heat will reach its climax. The smoke itself is ready to explode, it seems that the whole structure will fly into the air. In such heat, there is no chance of surviving.

4. The fire does not leave time for reflection. You need to have time to break out of the fire.
Most people think they have time left in a fire. But this is not so, there is no time in case of fire.

The fire starts in the trash can. It goes unnoticed. A minute later, the sofa lights up and smoke begins to fill the room. The temperature is rising. After two minutes, the person may lose consciousness.

In three minutes, the whole room is on fire. No one can stay alive anymore. In four minutes, the corridors will become impassable. It takes only 5 minutes for a fire inside the house to cause the death of all its inhabitants. So, from 3 to 5 minutes and the end of it all! It turns out that in a fire, time can be your worst enemy.

How long does it take to stay alive in a kitchen fire? Most people think they have 10 minutes. But in fact, after 30 seconds, the fire will become uncontrollable. You need to have time to jump out, without stopping and not thinking about things, close the door behind you (but not with the lock) and inform the fire department.

In order to have time to evacuate, there is an unshakable rule: in children's institutions, children of younger groups, preschool age are not dressed, but wrapped in a blanket and taken out of the danger zone. School students are brought out under the guidance of teachers or educators who are personally responsible for the group of children with whom they studied. In hotels for quick evacuation, it is forbidden to pack suitcases, etc.
5. In the event of a fire, panic may occur.

People get lost in panic and behave unpredictably. Sometimes, when panic occurs, more people die than from the dangerous factors of a fire. It is quite obvious that a person who is psychologically prepared and trained in such an extreme situation would behave differently.

6. The death of people in fires is largely due to the lack of elementary fire-fighting knowledge and skills of self-defense among the population.
Statistics show that most people do not think about fires, do not care about the safety of their homes, and neglect their own safety and the health of their loved ones. This is evidenced by the absence of a fire extinguisher, which would allow to extinguish a fire that has begun on a TV, electrical appliance, fat, oil in the kitchen for elderly people and schoolchildren without any problems. Almost a few citizens have provided their apartments with commercially available autonomous fire detectors operating from conventional battery... They are installed in the hallway, in the kitchen, in the room, and when smoke appears, they make a sharp sound, loud enough to attract attention, wake up sleeping people. Unfortunately, in society there is a clear underestimation of the values ​​of the reality of the threat of fire, its dangerous factors.

Evidence of this is our attitude to balconies and loggias of residential buildings. Most of them are glazed, the hatches of the emergency stairs of the balconies are tightly closed, the openings for the passage through the loggias are laid, furniture is installed in the walls. All this will not allow you to independently evacuate to a non-burning floor, to stand behind a wall of a balcony or loggia in case of a fire in an apartment, if you could not leave it in time or because the main evacuation staircase was blocked by smoke. In this case, the chances of surviving until the arrival of the fire brigade will be small, especially for those who today do not think about it, do not have personal respiratory protection, or rope ladder, a rescue kit for evacuation through balconies, loggias, windows, an electric lamp, and also ignores the conduct of firefighting drills at home, as citizens of developed foreign countries do.

FGKU "9th detachment of the FPS in the Altai Territory"

Sudden death occurs as a result of a fast latent or clinically expressed painful state. As medical practice shows, sudden death in adults often occurs due to acute coronary insufficiency, congenital or acquired cardiac and vascular pathologies. Find out what symptoms may indirectly indicate a hidden threat.

What is sudden death

According to international medical recommendations, the death of a person is considered sudden within 6 hours after the first symptoms of a pathological condition appear. Instant death, or sudden death in English, occurs without knowingly known reason... In addition, there are no morphological signs on the basis of which an autopsy can be used to make an appropriate diagnosis of the patient's sudden death.

Nevertheless, in the course of a postmortem examination of a person by a pathologist, comparing all the available data, he can make a logical conclusion about the instant or violent death of a person. In most cases, such changes in organs speak in favor of instant death, in which the continuation of life for the shortest period of time is impossible.

Causes of sudden death

Statistics show that the main cause of most deaths is heart disease: ischemic pathology, the onset of ventricular fibrillation. At the same time, answering what causes instant death, experts often call chronic ailments, which for a long time proceed in a latent form, after which they suddenly become aggravated and lead to an unexpected death of a person. One of these deadly dangerous diseases is cancer.

In most cases, oncology develops asymptomatically and makes itself felt when the patient is often already considered hopeless. Thus, malignant liver damage is the main cause of unexpected deaths in China. Another insidious disease that can lead to sudden death is AIDS, which claims millions of lives in Africa every year. In addition, it is worth mentioning separately about Mexico. This is the only country in which cirrhosis of the liver is the main cause of high mortality.

In young age

Today, young men and women are exposed to the negative influences of modern lifestyles every day. From TV screens, covers of fashion magazines, the cult of a slender (often dystrophic) body, accessibility and licentiousness are imposed on young people. Therefore, it is quite understandable that the mortality rate of persons who are just starting their life path, will grow over time. The main causes of instant death among boys and girls under 25 years old are considered to be:

• alcohol;
• smoking;
• promiscuous sex;
• drug addiction;
• improper nutrition;
• psychological susceptibility;
• hereditary diseases;
• severe congenital pathologies.

In a dream

Unexpected death in this condition occurs due to the loss of special cells responsible for the contractility of the lungs. So, scientists from the United States were able to prove that people die in their sleep in most cases due to central sleep apnea. In this case, a person may even wake up, but still leave this mortal world due to oxygen starvation caused by a stroke or cardiac arrest. As a rule, elderly people are susceptible to this syndrome. There are no specific treatments for central sleep apnea.

Sudden infant death

This syndrome was first described in the early 60s of the last century, although cases of instant death of babies were recorded earlier, but they were not subjected to such a thorough analysis. Small children have very high adaptive abilities and incredible resistance to a variety of negative factors, because death infant considered to be an exceptional situation. Nevertheless, there are a number of external and internal reasons that can lead to sudden infant death:

• elongation Q-T interval;
• apnea (the phenomenon of periodic breathing);
• deficiency of serotonin receptors;
• overheat.

Risk factors

Due to the fact that the main cardiogenic cause of instant death is ischemic disease, it is quite logical to assume that the syndromes accompanying this heart pathology can be fully attributed to conditions that can increase the likelihood of sudden death. With all this, it has been scientifically proven that this connection is mediated through the underlying disease. Clinical risk factors for the development of clinical death among patients with ischemic syndrome are:

• acute myocardial infarction;
• postinfarction macrofocal sclerosis;
• unstable angina;
• violation of the heart rhythm due to ischemic changes (rigid, sinus);
• asystole of the ventricles;
• myocardial damage;
• episodes of loss of consciousness;
• damage to the coronary (cardiac) arteries;
• diabetes;
• an electrolyte imbalance (eg, hyperkalemia);
• arterial hypertension;
• smoking.

How sudden death comes

This syndrome develops in a matter of minutes (less often hours) without any warning in the midst of complete well-being. In most cases, instant death affects young men between the ages of 35 and 43. In this case, often during the pathological examination of the deceased, vascular causes of the onset of sudden death are found. So, studying the more frequent cases of instant death, experts came to the conclusion that the main provoking factor for the onset of this syndrome is a violation of the coronary blood flow.

With heart failure

In 85% of cases, an instant death is recorded in persons with structural anomalies of the organ pumping blood into the vessels. At the same time, sudden cardiac death looks like a lightning-fast clinical variant of ischemic disease. Medical practice shows that a quarter of people who die instantly, before the onset of primary symptoms, bradycardia and episodes of asystole are observed. Death from cardiac arrest occurs due to the launch of the following pathogenetic mechanisms:

• Decrease in fractional ejection of the left ventricle by 25-30%. This syndrome greatly increases the risk of sudden coronary death.
• Ectopic focus of automatism in the ventricle (more than 10 ventricular extrasystoles per hour or unstable ventricular tachycardia), arising as a result of ventricular arrhythmias. The latter mostly develop against the background of acute transient myocardial ischemia. The ectopic focus of automatism is usually classified as a risk factor for sudden arrhythmic death.
• The process of spasm of the blood vessels of the heart, which leads to ischemia and contributes to the deterioration of the restoration of blood flow to the damaged areas.

It is worth noting that tachyarrhythmia is a particularly significant electrophysiological mechanism due to which sudden coronary death occurs in a person with heart failure. At the same time, timely treatment of this condition using a defibrillator with a modified pulse configuration significantly reduces the number of deaths among patients who have undergone sudden cardiac arrest.

From a heart attack

Blood flows to the heart through the coronary arteries. If their lumen closes, the formation of primary foci of necrosis, ischemia in the heart occurs. Acute manifestation of cardiac pathology begins with damage to the vascular wall with further thrombosis and arterial spasm. As a result, the load on the heart increases, the myocardium begins to experience oxygen starvation, which affects its electrical activity.

As a result of a sudden coronary spasm, ventricular fibrillation occurs, a few seconds after this, the complete cessation of blood circulation in the brain occurs. At the next stage, the patient experiences respiratory arrest, atony, and the absence of corneal and pupillary reflexes. After 4 minutes from the onset of ventricular fibrillation and complete cessation of blood circulation in the body, irreversible changes occur in the brain cells. In general, death from a heart attack can occur in 3-5 minutes.

From a blood clot

In the venous bed, these pathological formations arise due to the uncoordinated work of the coagulation and anticoagulant systems. So, the beginning of the appearance of a clot is caused by damage to the vascular wall and its inflammation against the background of thrombophlebitis. Perceiving the appropriate chemical signal, the coagulation system is activated. As a result, fibrin threads are formed near the pathological site, in which blood cells become entangled, creating all the conditions for the detachment of a thrombus.

In the arteries, the formation of clots occurs due to the narrowing of the vascular lumen. So, cholesterol plaques block the path of free blood flow, as a result of which a lump of platelets and fibrin filaments is formed. It is important to note that in medicine, floating and parietal blood clots are distinguished. Compared to the first type, the latter has a small chance of breaking off and causing a blockage (embolism) of the vessel. In most cases, the causes of sudden cardiac arrest from a blood clot are due to the movement of a floating clot.

One of the serious consequences of the separation of such a clot is the blockage of the pulmonary artery, which is expressed in a strong cough, cyanosis of the skin. Often there is a violation of breathing with subsequent cessation of cardiac activity. An equally serious consequence of the separation of a blood clot is a violation of cerebral circulation against the background of embolism of the great vessels of the head.

Sudden death diagnostics

A timely physical examination is the key to the success of further activities for cardiopulmonary resuscitation (CPR). The diagnosis of instant death is based on the symptoms characteristic of the natural death of the patient. So, the absence of consciousness is determined if no external stimuli cause reactions from the reanimated person.

Diagnosis of breathing disorders is noted when in 10-20 s. observation fails to catch the coordinated movements of the sternum, the noise of the air exhaled by the patient. At the same time, agonal breaths do not provide adequate ventilation of the lungs and cannot be interpreted as spontaneous breathing. During ECG monitoring, pathological changes characteristic of clinical death are detected:

• fibrillation or flutter of the ventricles;
• asystole of the heart;
• electromechanical dissociation.

Clinical manifestations

In 25% of cases, sudden death occurs instantly without any precursors. Some patients, a week before clinical death, complain of various prodromal manifestations: increased sternum pain, general weakness, shortness of breath. It is important to note that today there are already methods for the prevention of a heart attack, based on the early diagnosis of the preventive symptomology of this condition. Immediately before the onset of sudden death, half of the patients have an anginal attack. The clinical signs of the patient's imminent death include:

• loss of consciousness;
• lack of pulse in the carotid arteries;
• dilated pupils;
• lack of breathing or the appearance of agonal breaths;
• discoloration of the skin from normal to gray with a bluish tinge.

Medical care for sudden death

Typically, most cases of unexpected cardiac arrest occur outside the hospital walls. For this reason, it is extremely important to master the technique of rendering emergency care with a sudden onset of clinical death. This is especially true of the subjects of society, which, by virtue of their job responsibilities contact with a large number of people. Remember, well-performed resuscitation actions right in the first minutes after the onset of symptoms of cardiac arrest will help buy time before the arrival of medical workers.

Urgent care

The main problem that occurs in unconscious persons is the obstruction of the airways with the root of the tongue and the epiglottis due to muscle atony. I must say that this condition develops in any position of the body, and when the head is tilted forward, it develops in 100% of cases. Therefore, the first thing to do is to ensure proper airway patency. For this purpose it is necessary to use P. Safar's triple technique, consisting of the following sequential actions:

1. Throwing back the head;
2. Moving the lower jaw forward;
3. Opening the mouth.

After the patency of the airways is ensured, you should switch to artificial ventilation (ALV). When providing first aid, this measure is carried out by mouth-to-mouth method. So, one hand is located on the victim's forehead, while the other squeezes his nose. Then the resuscitator fixes his own lips around the mouth of the person being revived and blows in air, while controlling the excursion of the patient's chest. With its visible lifting, you need to release the victim's mouth, giving him a chance to make a passive exhalation.

At the next stage, artificial support of blood circulation is carried out, for which an algorithm for performing an indirect heart massage, or chest compression, is used. For this purpose, it is necessary to properly lay the resuscitated person on a flat surface. Next, you should determine the points of compression: by palpation of the xiphoid process and deviating from it by 2 transverse fingers up.

The hand must be positioned on the border of the middle and lower part of the sternum so that the fingers are parallel to the ribs. Jerks are performed with the limbs straightened at the elbows. Compression of the chest is performed at a frequency of 100 clicks per minute with a break for artificial ventilation. The depth of the tremors is about 4-5 cm. Measures to restore cardiac activity should be discontinued if:

1. Pulse appeared in the main arteries.
2. The actions taken do not have the desired effect within 30 minutes. In this case, the following conditions are an exception, requiring prolongation of resuscitation:

• hypothermia;
• drowning;
• drug overdose;
• electrical injury.

Resuscitation measures

Today, the concept of CPR is based on strict rules ensuring the complete safety of the activities for human life. In addition, an algorithm for the actions of a resuscitator in case of sudden cardiac arrest or a sharp loss of respiratory function in an injured person is presented and scientifically substantiated. With the development of these conditions the main role time plays: only a few minutes separate a person from death. The algorithm for cardiopulmonary resuscitation involves the following actions:

1. Determination of the victim's condition, on the basis of which the range of measures necessary for revitalization is selected;
2. Early onset of CPR, involving the performance of two manipulations: chest compressions and mechanical ventilation.
3. If the second stage is ineffective, they switch to defibrillation. The procedure involves the action on the heart muscle with an electrical impulse. In this case, the discharges direct current should be applied only if the electrodes are correctly positioned and they are in good contact with the victim's skin.
4. At this stage, as a rule, the victim is provided with specialized medical care, including the following early treatment measures:

• artificial ventilation of the lungs with tracheal intubation;
• medication support, involving the use of:
• catecholamines (Adrenaline, Atropine);
• antidiuretic hormones (vasopressin);
• antiarrhythmic drugs (Cordaron, Lidocaine);
• fibrinolytic agents (streptokinase).
• intravenous drip of electrolyte or buffer solutions (for example, sodium bicarbonate is injected with acidosis)

Video

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

Sudden cardiac death (SCD) is one of the most severe cardiac pathologies that usually develops in the presence of witnesses, occurs instantly or in a short period of time and has as the main cause of 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, instant death occurs within a few minutes. A slower development of pathology is also possible, when arrhythmias, heart pains and other complaints appear, and the patient dies in the first six hours after their onset.

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

The majority of patients with sudden cardiac arrest occurs at home, a fifth of cases occur on the street or in public transport. Both there and 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 lives can depend on the actions of others, so you can't just walk past a person who suddenly fell on the street or passed out on the bus. It is necessary at least to try to carry out the basic - indirect heart massage and artificial respiration, having previously called for the help of doctors. Cases of indifference are not rare, unfortunately, therefore, the percentage of unfavorable outcomes due to late started resuscitation takes place.

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 vessels. The lion's share of sudden deaths is caused when fatty arteries form in the coronary arteries that impede blood flow. The patient may not be aware of their presence, they may not present complaints as such, then they say that a completely healthy person suddenly died of a heart attack.

Another reason for cardiac arrest can be acutely developed, in which correct hemodynamics is impossible, 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 with and without atherosclerosis;
• with hypertension, defect,;
• Metabolic diseases (amyloidosis, hemochromatosis);
• Congenital and acquired;
• Injuries and tumors of the heart;
• Physical overload;
• Arrhythmias.

The risk factors are highlighted when the probability of acute coronary death becomes higher. The main such factors include ventricular tachycardia, a previous episode of cardiac arrest, cases of loss of consciousness, transferred, a decrease in the left ventricle to 40% or less.

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

diagram: distribution of causes of SCD at a young age

For closer observation and targeted examination identified groups of people with a high risk of SCD. Among them:

1. Patients who have undergone resuscitation for cardiac arrest or;
2. Patients with chronic heart failure and ischemia;
3. Individuals 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 for no apparent reason. Other patients noted for one to two weeks before the attack worsening of health in the form of:

• More frequent pain attacks in the heart area;
• Build-up;
• A noticeable decrease in performance, feelings of fatigue and fatigue;
• More frequent episodes of arrhythmias and interruptions in the activity of the heart.

Before cardiovascular death, pain in the heart area sharply increases, many patients have time to complain about it and experience severe fear, as happens with myocardial infarction. Perhaps psychomotor agitation, the patient grasps the region of the heart, breathes noisily and often, catches air with his mouth, sweating and redness of the face are possible.

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

With ventricular fibrillation and cardiac arrest against the background of an attack, severe weakness appears, the head begins to spin, the patient loses consciousness and falls, breathing becomes noisy, convulsions are possible due to deep hypoxia of the brain tissue.

On examination, pallor of the skin is noted, the pupils dilate and stop responding to light, it is impossible to listen to heart sounds due to their absence, the pulse on 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, therefore, 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 does not work, 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 earlier the chest compressions are provided, the higher the chances of survival and recovery.

Sudden death due to concomitant atherosclerosis of the arteries, then it is more often diagnosed in the elderly.

Among young such attacks can occur against the background of a spasm of unchanged vessels, which is facilitated by the use of certain drugs (cocaine), hypothermia, and unbearable 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 cervical veins, possible pulmonary edema, which accompanies 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, expanded borders of the heart with percussion can indicate the cardiac genesis of death. Often, the patient's relatives, when the ambulance team arrives, themselves indicate the presence of a previous chronic illness, can provide doctors' records and hospital discharges, then the diagnostic issue is somewhat simplified.

Diagnostics of the sudden death syndrome

Unfortunately, cases of postmortem diagnosis of sudden death are not uncommon. Patients die suddenly, and doctors can only confirm the fact of a fatal outcome. An autopsy does not find any pronounced changes in the heart that could cause death. The unexpectedness of what happened and the absence of traumatic injuries speak in favor of the coronary character of the pathology.

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

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

An important instrumental method for diagnosing SCD is ECG. With ventricular fibrillation on the ECG, irregular waves of contractions occur, the heart rate is higher than two hundred per minute, and soon these waves are replaced by a straight line, which indicates cardiac arrest.

With ventricular flutter, the ECG recording resembles a sinusoid, gradually alternating with erratic 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, the patient will have to undergo numerous laboratory examinations, starting with routine urine and blood tests and ending with toxicological studies for some drugs that can cause arrhythmias. Daily monitoring of the ECG, ultrasound examination of the heart, electrophysiological examination, stress tests will certainly be carried out.

Treatment for sudden cardiac death

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

At the prehospital stage, the possibilities of resuscitation are limited, usually it is carried out by emergency specialists who find the patient in the most different conditions- on the street, at home, in the workplace. It is 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

The ambulance team, after diagnosing clinical death, begins indirect heart massage 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 inject drugs into the trachea during its intubation, and the intracardiac method is used most rarely - if 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 at the moment. If ventricular fibrillation is detected, then the most the best method it will be stopped, and if the necessary device is not at hand, then the specialist strikes the precordial region and continues resuscitation measures.

defibrillation

If a cardiac arrest is detected, there is no pulse, on the cardiogram there is a straight line, then during general resuscitation actions, the patient is administered any in an accessible way adrenaline and atropine at intervals of 3-5 minutes, antiarrhythmic drugs, cardiac stimulation is being established, after 15 minutes sodium bicarbonate is added intravenously.

After the patient is admitted to the hospital, the struggle for his life continues. It is necessary to stabilize the condition and start treating the pathology that caused the attack. You may need a surgical operation, the indications for which are determined by doctors in the hospital based on the results of examinations.

Conservative treatment includes the introduction of drugs to maintain pressure, heart function, normalization of electrolyte metabolism disorders. For this purpose, beta-blockers, cardiac glycosides, antiarrhythmic drugs, antihypertensive drugs or cardiotonic drugs, infusion therapy are prescribed:

• Lidocaine for ventricular fibrillation;
• Bradycardia is treated with atropine or izadrin;
• Hypotension prompts intravenous dopamine;
• Fresh frozen plasma, heparin, aspirin are indicated for disseminated intravascular coagulation;
• Piracetam is administered to improve brain function;
• In hypokalemia - potassium chloride, polarizing mixtures.

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

Surgery may consist in radiofrequency ablation of the myocardium - with tachyarrhythmias, the efficiency reaches 90% and higher. With a tendency to atrial fibrillation, a cardioverter defibrillator is implanted. Diagnosed atherosclerosis of the arteries of the heart as a cause of sudden death requires carrying out; in case of heart valve defects, their plastic is performed.

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 persons who have suffered sudden cardiac death do not have significant and life-threatening changes, therefore, maintenance therapy in accordance with the underlying pathology allows you to live after coronary death for a long time.

Prevention of sudden coronary death is needed for people with chronic diseases of cardio-vascular system who can cause an attack, as well as those who have already experienced it and have been successfully resuscitated.

A cardioverter defibrillator can be implanted to prevent a heart attack, which is especially effective for severe arrhythmias. IN the right moment the device generates the necessary impulse for the heart and does not allow it to stop.

Requires medical support. Beta blockers, calcium channel blockers, omega-3s are prescribed fatty acid... Surgical prophylaxis 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 - healthy image life, physical activity, rejection of bad habits, proper nutrition.

Video: Presentation on Sudden Cardiac Death

Video: lecture on prevention of sudden cardiac death