Hello,
everyone. I am Dr. Wang Liang from the Department of Cardiology. Today we are going to talk about an alarming topic- “sudden death”. Sudden death occurs suddenly and often leads to death in a short time. Understanding the main causes and preventive measure of sudden death will help us better protect our heart health. Cardiac arrest occurs in up to 6 million people worldwide each year, with a survival rate of less than 10%. It is characterized by suddenness, rapidity and unpredictability. Among them, cardiac sudden death accounts for about 80% of all sudden deaths, while non-cardiac sudden death accounts for about 20% of all sudden deaths.
What is sudden death? Sudden death refers to the sudden loss of vital signs due to cardiac or non-cardiac causes in a short period of time under normal health conditions. Sudden death usually occurs within one hour after the onset of symptoms and is common in patients with cardiovascular disease, especially in people over 40 years of age. It includes sudden cardiac death and non-sudden cardiac death, of which sudden cardiac death is the most common, accounting for about 80%.
Let’s first introduce what are the sudden cardiac death?
Coronary artery disease mainly includes coronary heart disease, acute myocardial infarction, coronary artery spasm, congenital coronary artery dysplasia and so on, of which coronary heart disease is the most common. Comparing the heart to the change of the house, coronary artery disease is the problem of the water pipe in the house, which sometimes needs to be dredged.
2 is cardiomyopathy. Hypertrophic cardiomyopathy is the most common cause of sudden death in cardiomyopathy. Hypertrophic cardiomyopathy (HCM) is a complex inherited cardiomyopathy characterized by left ventricular wall thickening with multiple clinical and genetic manifestations. Studies have shown that patients with hypertrophic cardiomyopathy have a history of ventricular tachycardia, severe left ventricular wall hypertrophy (≥ 30 mm), history of unexplained syncope, family history of sudden death, and exercise-related hypotension. If athletes or heavy sports enthusiasts also suffer from thick cardiomyopathy, they are prone to sudden death.
3 is structural heart disease. In particular, patients with congenital heart disease in the terminal stage and complex congenital heart disease without timely surgical correction are more prone to sudden death. There are also heart valve diseases, such as severe aortic stenosis. If the heart is compared to a house, structural heart disease is a problem with the doors, windows and walls of the house, which sometimes needs to be repaired in time.
4. Sudden death can be induced by abnormal electrophysiological activity, primary abnormal electrocardiogram or abnormal ion channels, such as sinus node lesions, abnormal cardiac conduction system, short Q-T interval syndrome, long Q-T interval syndrome, etc. Once cardiac electrophysiological abnormalities occur, it may induce cardiac pacing conduction disorders, which can lead to complete atrioventricular block, or ventricular tachycardia, ventricular fibrillation and other malignant arrhythmias, eventually leading to sudden death. If the heart is compared to a house, abnormal electrophysiological activity means that the circuit of the house is out of order and sometimes needs to be repaired.
Other causes of sudden death include acute pericardial tamponade, aortic dissection, intracardiac thrombus shedding, electrolyte disorders, sleep apnea and so on.
Sudden
cardiac death is usually caused by arrhythmias, especially ventricular fibrillation, which causes rapid and disorderly ventricular contraction, so that the heart can not pump effectively, blood pressure drops, and important organs have no blood supply. The main causes of sudden death include overeating, psychological stress, forced defecation, exercise or overwork, staying up late for a long time, hypoxemia and electrolyte disorders. Among them, sudden death caused by psychological stress, such as rage, accounts for the majority, so anger really kills people.
Next, we will introduce other causes of non-cardiac sudden death. Sudden noncardiac death may also be caused by sudden respiratory, cerebrovascular, or other conditions, such as: Pulmonary embolism: a large blood vessel becomes blocked by a thrombus, resulting in acute respiratory failure and sudden death. Stroke: Severe stroke may result in loss of brainstem function, triggering acute failure of vital signs. Severe allergic reaction or drug overdose: Acute anaphylactic shock or drug toxicity that may result in respiratory arrest.
Although sudden death is difficult to predict, the risk of sudden death can be significantly reduced through systematic physical examination and good lifestyle. I suggest:
One is self-prevention. Have a physical examination at least once a year, especially electrocardiogram and cardiac imaging, to detect cardiac abnormalities early. At the same time, we should develop a healthy lifestyle, such as reasonable diet, regular exercise, smoking cessation and alcohol restriction. Actively control underlying disease, such as hypertension, diabetes, hyperlipidemia, etc., to prevent progression to severe coronary heart disease, cerebral infarction, etc. It is necessary to know the family medical history, especially whether there has been sudden death in the family.
Second, drug prevention. Drug treatment is indispensable for special high-risk groups who have been screened. Drugs commonly used to prevent sudden death include beta-blockers, amiodarone, angiotensin-converting enzyme inhibitors, and aldosterone receptor antagonists. These drugs must be evaluated by a cardiologist and can only be used if necessary, otherwise they will lead to serious consequences.
Third, surgical prevention. This is mainly aimed at people with definite lesions and predictable risk of sudden death. It mainly includes ① Interventional therapy of coronary artery stenosis: For severe stenosis with hemodynamic significance, early restoration of blood supply and completion of revascularization are of great significance to prevent the recurrence of cardiac arrest and improve the prognosis. ② Radiofrequency ablation: It is mainly aimed at patients with arrhythmia indications such as ventricular tachycardia, and is not the first choice for other patients with high risk of sudden death. ③ Cardiac synchronization therapy: It is mainly used for patients with end-stage heart disease, heart failure and low risk of malignant arrhythmia.
Although
sudden death occurs suddenly, many signs of heart disease can be detected in advance. Pay attention to heart health, develop good living habits, and stay away from the risk of sudden death. I hope today’s content is helpful to you!
Coronary heart disease Sudden death Sudden cardiac death
