This article is from WeChat public account: husk (ID: Guokr42) , author: Generation day medicine, Li Xiaokui, from FIG title: visual China
This morning, artist Gao Yixiang suddenly fainted while recording a sports variety show. After the rescue, the hospital announced the sudden cardiac death of Gao Yixiang.
Gao Yixiang, an artist born as a model, has always appeared in the public view with a healthy, strong and energetic image. But perhaps it was the exercise of intense fatigue that caused sudden cardiac death to take away his young life.
Sudden Death
Sudden death refers to an accidental death within 1 hour after a person who seems healthy appears uncomfortable without trauma. Most of these sudden deaths are sudden cardiac deaths experienced by Gao Yixiang, that is, sudden deaths due to heart problems.
Sudden death, we have heard about it in the news more or less, but it is not a distant rare case. According to data from the National Cardiovascular Center, the incidence of sudden cardiac death in China is about 41.8 cases per 100,000 people, that is to say, nearly 1500 people suffer from sudden cardiac death every day.
Figure 丨 pixabay
Young people and sudden cardiac death
When it comes to heart problems, it seems to be a disease exclusively for the elderly, but it is not. In the London area of the United Kingdom, the sudden cardiac death rate under the age of 35 is 4.5 cases per 100,000 people, which is still a number that cannot be ignored.
Sudden cardiac death occurs in young people. Most often occur during exercise. The most common cause is hypertrophic cardiomyopathy, followed by abnormal coronary artery origin. Other diseases include dilated cardiomyopathy, pre-excitation syndrome, idiopathic progressive cardiac conduction disorder, long QT syndrome and short QT syndrome, Brugada syndrome (a hereditary arrhythmia syndrome) .
Some athletes with sudden cardiac death in recent years 丨 Wikipedia
There are also drugs that affect the heart’s conduction function and increase the risk of sudden cardiac death in young people.
Screening before strenuous exercise
Being young and healthy doesn’t mean you’re safe from strenuous exercise. You know, about half of those with sudden cardiac death haven’t seen any heart disease before. If you must participate in strenuous exercise, you can find the hidden dangers in advance through the following three types of screening. If there is an abnormality, be sure to consult your doctor if you can exercise and if further examination is necessary.
Personal medical history:
1. Chest pain or chest discomfort during exercise;
2. Syncope or near syncope without explanation for other reasons;
3. Excessive dyspnea or fatigue during exercise;
4. Heart murmur has been found;
5. Increased blood pressure.
Family history:
1. A relative died suddenly of heart disease before 50 years of age;
2. Close relatives are disabled due to heart disease before age 50;
3. Relatives have the following heart diseases: hypertrophic or dilated cardiomyopathy, long QT syndrome or other ion channel diseases, Marfan syndrome, severe arrhythmia.
Medical examination:
1. Auscultation for cardiac murmur;
2. Auscultation for femoral arterial sounds suggesting aortic constriction;
3. Observe the presence of Marfan syndrome;
4. Measure brachial artery blood pressure in the sitting position.
One more important thing. For people who have been healthy before, if they experience chest pain and discomfort during exercise, or palpitations, dyspnea, fatigue, blurred vision, dizziness and other symptoms that do not match the intensity of the exercise, be sure to stop and rest immediately, If you can’t alleviate it, seek medical treatment in time.
What to do at high risk for sudden death
People who are young or old, who have already had heart-related disease, or who have experienced severe arrhythmia, are at a higher risk of sudden cardiac death. For these people, anti-arrhythmic drugs can be taken under the guidance of a doctor, or catheter ablation can be performed. Radiofrequency current can be used to cause abnormal myocardial necrosis and prevent sudden cardiac death.
If you have ever had more severe heart disease, such as ventricular fibrillation, severe ventricular tachycardia, and poor heart function, the risk of sudden cardiac death is very high. In this case, consider implantable cardioverter defibrillator (ICD) , which is a pacemaker-like device , The main part is close to the size of a matchbox and is placed under the skin of the chest. When the defibrillator senses the arrhythmia, the lead that enters the heart through the blood vessel will be paced or shocked to restore the heart rhythm to normal.
Figure 丨 msdmanuals.com
What can I do for others?
The sudden onset of cardiogenic death is very rapid, and it can happen anytime, anywhere. Once it occurs, the rescue time is calculated in seconds.
About 60% of sudden cardiac deaths occur outside the hospital. Out-of-hospital emergency is an important way to recover sudden cardiac death. If you find that someone suddenly falls to the ground, does not respond to palpation calls, and does not breathe, you should suspect the risk of sudden cardiac death. Outside the hospital, the most effective treatment is CPR immediately, and defibrillation if necessary.
External defibrillation exercises for puppet teaching aids pixabay
However, public awareness of CPR is scarce, and few people use automatic external defibrillators in public places. If out-of-hospital emergency training for cardiac arrest can be popularized, we will also have more chips on our way to race against the death sprint.
References:
[1] Mahmood S, Lim L, Akram Y, Alford-Morales S, Sherin K; ACPM Prevention Practice Committee. Screening for sudden cardiac death before participation in high school and collegiate sports: American College of Preventive Medicine position statement on preventive practice. Am J Prev Med. 2013; 45 (1): 130-133.
[2] Piccini JP Sr, Allen LA, Kudenchuk PJ, Page RL, Patel MR, Turakhia MP; American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing. Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death: AScience Advisory From the American Heart Association. Circulation. 2016; 133 (17): 1715-27.
[3] Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekvål TM, Spaulding C, Van Veldhuisen DJ; ESC Scientific Document Group. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC) . Eur Heart J. 2015; 36 (41): 2793-2867.
[4] “China Cardiovascular Report 2018”, National Cardiovascular Center
[5] Huawei, Ding Ligang. Prevention and prospect of sudden cardiac death [J]. Chinese Journal of Circulation, 2014, 29 (12): 961-963.
This article is from the WeChat public account: husk (ID: Guokr42) , author: Generation day medicine, Li Xiaokui