Sudden death due to 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 suddenness factor 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 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 they occur.

The greatest risk of sudden coronary death can be traced in people aged 45-70 who have some form of disturbance in the vessels, heart muscle, and its 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, gender differences are smoothed out, and the ratio of men and women with this pathology becomes 2:1.

Most patients with sudden cardiac arrest finds themselves 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 a life 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 a bus. It is necessary to at least try to conduct a basic one - an indirect heart massage and artificial respiration, after calling the doctors for help. Cases of indifference are not uncommon, unfortunately, therefore, the percentage of unfavorable outcomes due to late 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 materials 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 cause of cardiac arrest can be an acutely developed one, in which proper hemodynamics is impossible, the organs suffer from hypoxia, and the heart itself cannot withstand the load and.

The causes of sudden cardiac death are:

• Cardiac ischemia;
• 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;
• with hypertension, vice,;
• Metabolic diseases (amyloidosis, hemochromatosis);
• Congenital and acquired;
• Injuries and tumors of the heart;
• Physical overload;
• Arrhythmias.

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

Minor, 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. Risk also smokers, 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, therefore death from a heart attack is possible in physically healthy athletes during training, matches, and competitions.

diagram: distribution of causes of SCD at a young age

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

1. Patients undergoing resuscitation for cardiac arrest or;
2. Patients with chronic insufficiency and ischemia of the heart;
3. Persons with electrical ;
4. Those diagnosed with significant cardiac hypertrophy.

Depending on how quickly death occurred, instant cardiac death and fast 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 Patients noted one to two weeks before the attack, deterioration in health in the form of:

• More frequent pain attacks in the region of the heart;
• Rising ;
• A noticeable decrease in efficiency, feelings of fatigue and fatigue;
• More frequent episodes of arrhythmias and interruptions in the activity of the heart.

Before cardiovascular death, pain in the region of the heart sharply increases, many patients have time to complain about it and experience strong fear, as happens with myocardial infarction. Psychomotor agitation is possible, the patient grabs the region of the heart, breathes noisily and often, catches air with his mouth, sweating and reddening of the face are possible.

Nine out of ten cases of sudden coronary death occur outside the home, often against the background of a strong emotional experience, 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, dizziness begins, 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, and the pulse on large vessels is also not determined. In a matter of minutes, clinical death occurs with all the signs characteristic of it. 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 stops.

The brain is most sensitive to 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, and the sooner 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, unbearable exercise stress. 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, a rapid increase in the liver and jugular veins, pulmonary edema is possible, which accompanies shortness of breath up to 40 respiratory movements per minute, severe anxiety and convulsions.

If the patient already suffered from chronic organ failure, but edema, cyanosis of the skin, an enlarged liver, and expanded borders of the heart during percussion can indicate the cardiac genesis of death. Often, when the ambulance team arrives, the patient's relatives themselves indicate the presence of a previous chronic illness, they can provide doctors' records and extracts from hospitals, 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. The autopsy did 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 coronarogenic nature of the pathology.

After the arrival of the ambulance and before the start of resuscitation, the patient's condition is diagnosed, which by this time is already unconscious. Breathing is absent or too rare, convulsive, it is impossible to feel the pulse, heart sounds are not detected during auscultation, 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, erratic waves of contractions appear on the ECG, the heart rate is above two hundred per minute, soon these waves are replaced by a straight line, indicating cardiac arrest.

With ventricular flutter, the ECG record resembles a sinusoid, gradually giving way to erratic fibrillation waves and an isoline. Asystole characterizes cardiac arrest, so the cardiogram will only show 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 a toxicological study for some drugs that can cause arrhythmia. 24-hour ECG monitoring, ultrasound examination of the heart, electrophysiological examination, and stress tests will definitely be carried out.

Treatment of 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. Urgent care should be started as early as possible and include cardiopulmonary resuscitation and immediate transport of the patient to a 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 owns her techniques - artificial respiration and chest compressions.

Video: performing basic cardiopulmonary resuscitation

Ambulance team after diagnosis clinical death begins indirect heart massage and artificial ventilation of the lungs with an Ambu bag, provides 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, an ECG is taken to clarify the causes of death, the type of arrhythmia and the nature of the heart's activity in this moment. If ventricular fibrillation is detected, then the most best method it will stop, and if the necessary device is not at hand, then the specialist makes a blow to the precordial region and continues resuscitation.

defibrillation

If a cardiac arrest is detected, there is no pulse, there is a straight line on the cardiogram, then during general resuscitation, the patient is injected with any accessible way epinephrine and atropine at intervals of 3-5 minutes, antiarrhythmic drugs, pacing is established, after 15 minutes sodium bicarbonate is added intravenously.

After placing the patient in the hospital, the struggle for his life continues. It is necessary to stabilize the condition and begin treatment of 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, and normalize electrolyte disturbances. For this purpose, beta-blockers, cardiac glycosides, antiarrhythmic drugs, antihypertensives or cardiotonic drugs, infusion therapy are prescribed:

• Lidocaine for ventricular fibrillation;
• Bradycardia is stopped by atropine or izadrin;
• Hypotension serves as a reason for intravenous administration of dopamine;
• Fresh frozen plasma, heparin, aspirin are indicated for DIC;
• Piracetam is administered to improve brain function;
• With hypokalemia - potassium chloride, polarizing mixtures.

Treatment in the post-resuscitation period lasts about a week. At this time, electrolyte disturbances, DIC, neurological disorders are likely, so the patient is placed in the intensive care unit for observation.

Surgery may consist in radiofrequency ablation of the myocardium - with tachyarrhythmias, the efficiency reaches 90% or more. 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, they are plastic.

Unfortunately, it is not always possible to provide resuscitation within the first few minutes, but if it was possible to bring the patient back to life, then the prognosis is relatively good. According to research data, 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 for a long time after coronary death.

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

A cardioverter-defibrillator may be implanted to prevent a heart attack, and is especially effective for serious arrhythmias. AT right moment the device generates the impulse necessary for the heart and does not allow it to stop.

Require medical support. Beta-blockers, calcium channel blockers, products containing omega-3 are prescribed fatty acid. Surgical prophylaxis consists of operations aimed at eliminating arrhythmias - ablation, endocardial resection, cryodestruction.

Non-specific measures for the prevention of 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

Sudden death occurs as a result of a fast-paced latent or clinically pronounced disease 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 sudden death of a person is considered within 6 hours after the onset of the first symptoms of a pathological condition. Instant death, or in translation into English sudden death, occurs without a known cause. In addition, there are no morphological signs based on which, at autopsy, an appropriate diagnosis can be made about the sudden death of the patient.

Nevertheless, in the course of a post-mortem examination of a person, a pathologist, having compared all the available data, can make a logical conclusion about the instantaneous or violent death of a person. In most cases, in favor of instantaneous death, such changes in organs speak in which the continuation of life for the shortest period of time is impossible.

Causes of sudden death

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

In most cases, oncology develops asymptomatically and makes itself felt when the patient is often already considered hopeless. Thus, malignant liver disease 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 every year in Africa. 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 the population.

In young age

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

• alcohol;
• smoking;
• promiscuity;
• drug addiction
• malnutrition;
• psychological susceptibility;
• hereditary diseases;
• severe congenital pathologies.

In a dream

Unexpected death in this state occurs due to the loss of special cells responsible for the contractility of the lungs. So, scientists from the USA managed to prove that people die in their sleep in most cases due to central sleep apnea. At the same time, a person can even wake up, but still leave this mortal world due to oxygen starvation caused by a stroke or cardiac arrest. As a rule, this syndrome affects people of advanced age. There is no specific treatment for central sleep apnea.

Sudden infant death

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

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

Risk factors

Due to the fact that ischemic disease is the main cardiogenic cause of instant death, it is quite logical to assume that the syndromes associated with this pathology of the heart 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;
• post-infarction macrofocal sclerosis;
• unstable angina;
• heart rhythm disturbance due to ischemic changes (rigid, sinus);
• ventricular asystole;
• myocardial damage;
• episodes of loss of consciousness;
• damage to the coronary (cardiac) arteries;
• diabetes;
• electrolyte imbalance (eg, hyperkalemia);
• arterial hypertension;
• smoking.

How sudden death occurs

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

With heart failure

Instant in 85% of cases fatal outcome is registered in persons with structural abnormalities of the organ that pumps blood into the vessels. At the same time, sudden cardiac death looks like a lightning-fast clinical variant of coronary 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:

• Reducing the fractional ejection of the left ventricle by 25-30%. This syndrome greatly increases the risk of sudden coronary death.
• An ectopic focus of automatism in the ventricle (more than 10 ventricular extrasystoles per hour or unstable ventricular tachycardia), which occurs 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 qualified as a risk factor for sudden arrhythmic death.
• The process of spasm of the vessels of the heart, which leads to ischemia and contributes to the deterioration of the restoration of blood flow to damaged areas.

It should be noted that tachyarrhythmia is a particularly significant electrophysiological mechanism that causes sudden coronary death 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

The blood supply to the heart is carried out through the coronary arteries. If their lumen is closed, 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 spasm of the arteries. 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, after a few seconds there is a complete cessation of blood circulation in the brain. At the next stage, the patient has 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 anticoagulation systems. So, the onset 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 strands are formed near the pathological area, in which blood cells become entangled, creating all the conditions for the separation of a blood clot.

In the arteries, the formation of clots occurs due to the narrowing of the vascular lumen. So, cholesterol plaques block the free flow of blood, 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 thrombi are distinguished. Compared with the first type, the latter has little chance of breaking off and causing blockage (embolism) of the vessel. In most cases, the causes of sudden cardiac arrest from a thrombus are due to the movement of a floating thrombus.

One of the severe consequences of the separation of such a clot is 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 thrombus is a violation of cerebral circulation against the background of embolism of the main vessels of the head.

Diagnosis of sudden death

A timely physical examination is the key to the success of further cardiopulmonary resuscitation (CPR) activities. Diagnosis of instant death is based on symptoms characteristic of the natural death of the patient. Thus, the absence of consciousness is determined if no external stimuli cause reactions on the part of the resuscitated person.

Diagnosis of respiratory disorders is noted when for 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 proper ventilation of the lungs and cannot be interpreted as spontaneous breathing. During ECG monitoring, pathological changes characteristic of clinical death are detected:

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

Clinical manifestations

In 25% of cases, a sudden death occurs instantly without any precursors. Some patients a week before clinical death complain of various prodromal manifestations: increased pain in the sternum, 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 warning symptomatology of this condition. Immediately before the onset of sudden death, half of the patients have an anginal attack. The clinical signs of imminent death of the patient include:

• loss of consciousness;
• absence of a pulse in the carotid arteries;
• pupil dilation;
• lack of breathing or the appearance of agonal breaths;
• change in skin color from normal to gray with a bluish tint.

Medical care for sudden death

As a rule, most cases of unexpected cardiac arrest occur outside the hospital walls. For this reason, it is extremely important to master the technique of emergency care in case of sudden onset of clinical death. This is especially true for the subjects of society, which, by virtue of their official duties contact with large quantity of people. Remember, competently carried out resuscitation actions directly 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 by the root of the tongue and the epiglottis due to muscle atony. It must be said that given state 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, you need to use the triple technique of P. Safar, consisting of the following sequential actions:

1. tilting the head;
2. Pushing the lower jaw forward;
3. Mouth opening.

Once airway patency is secured, proceed to artificial ventilation lungs (IVL). When providing first aid, this measure is carried out by the mouth-to-mouth method. So, one hand is located on the forehead of the victim, while the other pinches his nose. Then the resuscitator fixes his own lips around the mouth of the resuscitated person and blows in air, while controlling the excursion of the patient's chest. With its visible rise, you need to release the victim's mouth, giving him a chance to make a passive exhalation.

At the next stage, artificial circulatory support is carried out, to ensure which an algorithm for conducting an indirect heart massage, or chest compression, is used. For this purpose, it is necessary to correctly lay the resuscitated person on a flat surface. Next, the compression points should be determined: by palpation of the xiphoid process and retreat from it by 2 transverse fingers up.

The hand must be placed on the border of the middle and lower part of the sternum so that the fingers are parallel to the ribs. Pushes are performed with limbs straightened at the elbows. Chest compression is performed at a frequency of 100 compressions per minute with a break for mechanical ventilation. The depth of the shocks is about 4-5 cm. Measures to restore cardiac activity should be stopped if:

1. There was a pulse in the main arteries.
2. The actions taken do not have the desired effect within 30 minutes. In this case, the following conditions that require prolongation of resuscitation are an exception:

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

Resuscitation measures

To date, the concept of CPR is based on strict rules that ensure the complete safety of ongoing 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 leading role time plays: only a few minutes separate a person from death. The algorithm for conducting cardiopulmonary resuscitation involves the following actions:

1. Determining the condition of the victim, on the basis of which the range of measures necessary for revitalization is selected;
2. Early initiation of CPR, which involves performing two manipulations: chest compressions and mechanical ventilation.
3. If the second stage is ineffective, they proceed to defibrillation. The procedure involves the impact on the heart muscle with an electrical impulse. At the same time, the ranks direct current should only be applied if the electrodes are correctly positioned and good contact with the skin of the victim.
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;
• medical support, involving the use of:
• catecholamines (adrenaline, atropine);
• antidiuretic hormones (Vasopressin);
• antiarrhythmic drugs (Cordarone, Lidocaine);
• fibrinolytic agents (streptokinase).
• intravenous drip of electrolyte or buffer solutions (for example, sodium bicarbonate is administered for acidosis)

Video

According to medical statistics, 90 percent of sudden deaths in people 25 to 45 years of age are from pulmonary embolism associated with varicose veins.

- In our country, every second woman and every fifth man suffer from varicose veins, so pulmonary thromboembolism is more dangerous for women. According to scientific data, in the United States 250-300 thousand people die from this diagnosis a year, in Europe - 150 thousand people, in Russia - much more, the figures I have given can be safely multiplied by two. Although the statistics may say otherwise, because often sudden deaths from pulmonary embolism in our country are attributed to a heart attack or other heart diseases, says Yuri Khafizov.

To avoid such dangerous disease- varicose veins, you need to watch your legs. The first signs of varicose veins, the doctor called causeless swelling of the legs, often only one of them, spider veins, nodules on the veins of the legs.

- If you notice such changes in yourself, I advise you to see a therapist or phlebologist. By the way, there is no shortage of these narrow specialists in Chelny,” Yury Salmanovich told us.

In addition, you need to deal with the prevention of this disease, do special exercises, wear compression underwear.

- These exercises are completely easy, they can be done at any opportunity - sitting at work, standing at a bus stop (see diagram). And modern compression underwear - stockings, stockings, tights - looks quite attractive, sometimes even more beautiful than usual, says the doctor.

But there are other risks of sudden death from pulmonary thromboembolism. Among them are long flights on airplanes, trips to the mountains, non-compliance with the water regime, pregnancy. To protect yourself, Yuri Khafizov advises wearing compression underwear on airplanes, drinking at least 1.5-2 liters of water a day, not forgetting about the drinking regime in the mountains, and pregnant women should also wear special underwear.

Not the last role is played by heredity.

- A young girl came to my appointment recently, she is a little over 20 years old. She reported that the father was buried in the family when he was 30 years old, the brother, who turned 27. They suffered from varicose veins and died suddenly from thromboembolism. In the patient, we found the initial stage of varicose veins, which we managed to take under control, now the risk of developing the same scenario of the disease is significantly reduced in her, - says Yuri Salmanovich.

There are other, less common diagnoses that provoke sudden death from thrombosis - these are obesity, atrial fibrillation, hypertension.

According to the doctor, varicose veins and thromboembolism are mankind's price for walking upright. And most of all, the disease affects those who, due to their professional activities, are forced to stand a lot - surgeons, hairdressers, sellers.

Cause of death (causa mortis)

1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what "Cause of death" is in other dictionaries:

Cause of death- illness or event that caused death. The cause of death is established in accordance with the International Statistical Classification of Diseases, Injuries and Causes of Death ... Source: DECISION of the Government of Moscow dated 06/28/2005 N 482 PP ON THE CONCEPT ... ... Official terminology

- (causa mortis) a pathological condition that directly led to the onset of death (for example, asphyxia, shock, embolism) ... Big Medical Dictionary

INTERMEDIATE CAUSE OF DEATH- INTERMEDIATE CAUSE OF DEATH, previous cause of death, disease, pathological. a condition that caused the immediate cause of death and was the result of the initial cause of death. P. p. s. listed on the medical death certificate.

INITIAL CAUSE OF DEATH- ORIGINAL CAUSE OF DEATH, illness or injury, and the circumstances of an accident or violent death that cause a pathological sequence. processes leading directly to death. Usually selected for statistical ... ... Demographic Encyclopedic Dictionary

MAIN (MAIN) CAUSE OF DEATH- MAIN (MAIN) CAUSE OF DEATH, see Primary cause of death ... Demographic Encyclopedic Dictionary

THE ONLY CAUSE OF DEATH- THE SINGLE CAUSE OF DEATH, an indicator adopted in the international. practice of statistics. processing materials on the causes of death; selects only one cause of death. Such a statistical method based on the principle of selecting one diagnosis, ... ... Demographic Encyclopedic Dictionary

IMMEDIATE CAUSE OF DEATH- IMMEDIATE CAUSE OF DEATH, illness, injury or their complications, to rye were the final manifestation in the pathological chain. conditions leading to death. It is part of a complete diagnosis of the cause of death. N. p. s. should not be identified with signs ... ... Demographic Encyclopedic Dictionary

Rules in the first part of the manga Rules in the second part of the manga Rules in the anime ... Wikipedia

Some of the death gods Death gods (死神) are fictional supernatural beings described in manga, anime and movies "... Wikipedia

Cover of the first manga volume ... Wikipedia

Main article: Death Note computer games. Contents 1 Description 1.1 Appearance... Wikipedia

Books

• Cause of death, Andrei Leshchinsky. The cover does not deceive: the woman is alive, the bull's skull is real, pierced by a spear some thousands of years ago in the vicinity mediterranean sea. And everything that this bodily metaphor hints at in the novel ...

The death of Lenin - from what Vladimir Ilyich actually died. Cause of death

Throughout 1923, newspapers reported on Lenin's state of health, creating a new myth about a leader who staunchly fights illness: he reads newspapers, is interested in politics, hunts. It is known that Lenin survived a number of strokes: the first turned the 52-year-old Ilyich into an invalid, the third killed him.

In the last months of his life, Lenin hardly spoke, could not read, and his "hunt" looked like walking in a wheelchair. Almost immediately after his death, Lenin's body was opened to determine the cause of death. After a thorough examination of the brain, it was established that he had a hemorrhage. The workers were told: "the dear leader died because he did not spare his strength and did not know rest in work."

During the days of mourning, the press in every possible way emphasized the sacrifice of Lenin, the "great sufferer." This was another component of the myth: Lenin, indeed, worked hard, but he was also quite attentive to himself and his health, did not smoke, and, as they say, did not abuse.

Almost immediately after Lenin's death, a version appeared that the leader was poisoned on the orders of Stalin, especially since no tests were made that would have detected traces of poison in the body. It was assumed that syphilis could become another cause of death - the drugs at that time were primitive, and sometimes dangerous, and venereal diseases in some cases, indeed, they can provoke a stroke, but the symptoms of the leader, as well as a post-mortem autopsy, refuted these speculations. Detailed Report The first public bulletin, which was made public immediately after the autopsy, contained only summary causes of death. But already on January 25, “official autopsy results” appeared with numerous details.

In addition to a detailed description of the brain, the results of the study of the skin were given, up to the indication of each scar and damage, the heart was described and its Exact size, condition of the stomach, kidneys and other organs. The British journalist, head of the Moscow branch of the New York Times, Walter Duranty, was surprised that such detail did not make a depressing impression on the Russians, on the contrary, “the deceased leader was the object of such intense interest that the public wanted to know everything about him.”

However, there is evidence that the report aroused “shocked bewilderment” among the non-party Moscow intelligentsia, and they saw in it a purely materialistic approach to human nature characteristic of the Bolsheviks. Such detailed anatomy and emphasis, shifted to the inevitability of death, could have another reason - the doctors, who "failed" to save the patient, were simply trying to protect themselves.