Cardiac arrest

Introduction Cardiac arrest refers to the sudden termination of cardiac ejection function, the aortic pulsation and heart sound disappear, and important organs (such as the brain) are severely ischemia and hypoxia, leading to the termination of life. This unexpected sudden death is medically known as sudden death. The most common cause of cardiac arrest is ventricular fibrillation. If the patient is called without a response, the pressure is on the squat and the underarm is unresponsive, and the patient is determined to be in a coma. Then pay attention to observe the patient's chest and abdomen with or without undulating breathing. If there is no pulsation of the carotid artery and femoral artery, the heart can not hear the heartbeat, it can be determined that the patient has a cardiac arrest.

Cause

The common causes of cardiac arrest in the 2005 American Heart Association Cardiopulmonary Resuscitation and Cardiovascular Emergency Guidelines are summarized as follows: 1 hypoxia. 2 hypokalemia / hyperkalemia and other electrolyte abnormalities. 3 low temperature / body temperature is too high. 4 low blood volume. 5 hypoglycemia / high blood sugar. 6 drugs. 7 heart pack stuffing. 8 pulmonary embolism. 9 coronary vascular embolization. 10 pneumothorax, asthma.

an examination

Related inspection

ECG dynamic electrocardiogram (Holter monitoring)

ECG performance

1. Ventricular fibrillation or flutter, accounting for about 91%.

2. Electrocardiographic separation, wide and deformed, low amplitude QRS, frequency 20 to 30 beats / min, does not produce mechanical contraction of the heart muscle.

3. The ventricle is still, showing a straight line without electric waves, or only seeing the atrial wave. Ventricular fibrillation remained unresolved for more than 4 minutes, almost all of which turned to ventricular quiescence.

Differential diagnosis

Ventricular fibrillation (referred to as ventricular fibrillation): is one of the common factors that cause cardiac arrest and sudden death. The ventricle delivers continuous, rapid, and even excitement more than 240 times per minute, called ventricular flutter. If the excitement of ventricular release is rapid and irregular, it is called ventricular fibrillation (ventricular fibrillation). The frequency of ventricular fibrillation can be between 250 and 600 beats per minute.

Heart sound and pulse disappear: it is a manifestation of ventricular fibrillation: the pulse can not be touched, the heart sound disappears, the blood pressure (systolic blood pressure) is often below 60 mm Hg or the signs of deterioration of blood circulation are not detected.

Heart Beat Jump: A sudden heartbeat in addition to a regular heartbeat is called premature beat (premature beat). It can be asymptomatic in premature beats, or it can have a heart palpitations or a heartbeat pause. Frequent premature beats reduce the amount of cardiac output, which may cause fatigue, dizziness and chest tightness when the blood supply to the brain is insufficient, and may increase the original angina or heart failure. When you measure the pulse by hand, you can find pulse instability, early jump or "leak jump". Premature beats can occur occasionally or frequently. Premature beats can occur in patients of any age.

Cardiac arrest: refers to the fact that the myocardium still has bioelectrical activity, but no effective mechanical function, intermittently appearing a slow but very weak and incomplete "shrinkage" condition, and there are intermittently wide, deformed, low amplitude QRS on the electrocardiogram. Wave group, the frequency is more than 20 to 30 times per minute. At this time, the myocardium has no contraction and blood discharge function, and the heart sound is not heard when the heart is auscultated, and the peripheral arteries are not beaten.

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