Source: Health Times
Health Times reporter Chu Chao
Not long ago, 36 year old IT engineer Zhang Bin sudden death The news of was forwarded frequently in the WeChat friends circle, and many netizens were shocked after the disclosure of their work unit's clocking records - nine of the 10 days' clocking records were in the early morning, and there was an interval of 21 hours between two clocking in one day! The day before his sudden death, he said to his mother, "I'm too tired. On April 13, a night shift taxi driver in Jinzhou, Liaoning, died suddenly at the age of 28
Recently, the news of sudden death of young adults has been reported repeatedly. People can't help thinking about why sudden cardiac death happens so many times when they are shocked and regretful? Why are all the sudden deaths young men? Does sudden cardiac death really "favor" these young "pillars"? Is overwork the direct cause of sudden cardiac death? What bad living habits are likely to increase the risk of sudden cardiac death? With these questions in mind, the reporter gave an exclusive interview to Professor Zhang Haicheng, chief physician of Cardiovascular Medicine Department of Peking University People's Hospital.
The proportion of young adults with sudden cardiac death is not large
Is Sudden Cardiac Death Really Frequent in Young People? Professor Zhang said that at present, sudden cardiac death is still mainly among the elderly, and the incidence gradually increases with age. Data shows that the sudden cardiac death rate of young adults before the age of 45 is low, and it has almost risen in a straight line since the age of 45, especially in the age of 55-64. The sudden cardiac death rate of people over 65 years old has further increased. According to statistics, the sudden cardiac death rate over 65 years old can reach about 200 people/100000, and it will double again over 70 years old.
As for a series of regrettable sudden death events recently, Professor Zhang said: "Although the sudden death rate of young people is not high, from the perspective of people's usual thinking, the younger the sudden death is, the more likely it is to cause shock and vigilance. In addition, the frequent reports on it will inevitably lead people to the misunderstanding that sudden cardiac death occurs frequently in young and middle-aged people."
Sudden cardiac death is probably caused by coronary heart disease cause
Whether it's a 36 year old IT man or a 28 year old night taxi, overwork seems to be the culprit leading to sudden death. But is overwork really the main cause of sudden death? "In fact, it's not always true. External causes work through internal causes, and overwork is only an external cause, not an internal cause." Professor Zhang explained that there must be problems in his body that lead to sudden death. Epidemiological survey found that about three-quarters of sudden death is caused by heart, for example, young people's sudden death is mostly caused by severe diseases myocarditis , Heredity Arrhythmia 、 Cardiomyopathy The middle-aged and elderly are mainly coronary heart disease, and sudden death caused by coronary heart disease accounts for about 80% of all sudden deaths.
In addition to heart disease, what other bad habits are likely to lead to sudden cardiac death? In this regard, Professor Zhang said that, except for taking cocaine, other bad habits have no obvious impact on sudden death.
When it comes to drinking, Professor Zhang gives a typical example. Many people usually have the habit of drinking too much, which over time leads to heart enlargement, heart failure and arrhythmia. Hospital admission was diagnosed as Alcoholic cardiomyopathy , ask them to stop drinking and stay in bed. After half a year of recuperation, the heart function will gradually recover and the size of the heart will gradually return to the normal range.
"Although bad habits are not the direct cause of sudden death, their potential dangers should not be underestimated." Professor Zhang said that many white-collar workers sit in front of computers for hours, almost motionless except for eating and going to the toilet. This is easy to form on the leg blood vessels thrombus If you get up suddenly, the thrombus may fall off, and the thrombus will travel to the heart, which is very easy to cause pulmonary embolism Sudden death.
The main culprits of sudden cardiac death are different in gender
Several cases reported and forwarded frequently on the Internet show that sudden death is male. Is it true that sudden cardiac death is more common among men? Professor Zhang said: "There are different types. Different types of heart diseases have different gender priorities. For example, sudden death caused by coronary heart disease is more common in men, and sudden death caused by long QT syndrome is more common in women."
There are three types of long QT syndrome (this disease is prone to sudden loss of consciousness and sudden death due to the abnormality of cardiac potassium channel). The more common type is that sudden death occurs more frequently during exercise (especially swimming), the second type occurs more frequently after being frightened by sound stimulation (such as telephone bell, alarm clock, etc.), and the third type is often manifested as sudden death at night.
Professor Zhang also introduced that sudden death caused by Brugada syndrome (Brugada syndrome is a familial primary cardiac disease caused by abnormal gene encoding ion channels) is frequent in Southeast Asia, and the number of sudden deaths has exceeded car accidents, becoming the first culprit of young people's deaths in Asia. In particular, Brugada syndrome also has gender selection, which is characterized by multiple males and family clustering. Sudden death often occurs at night.
"A terrible thing happened once: there were four brothers in a family. One night, the second brother died suddenly in sleep. Three days later, on the night of his burial, the eldest brother died suddenly again. Within a few months, the fourth and third brother died of sudden death, leaving only one girl in the family. The five brothers and sisters were all 20 to 45 years old." For the bizarre death of the four brothers, Professor Zhang explained that they suffered from Brugada syndrome, which had no signs before the onset of the disease. Some people checked the ECG and found that it was abnormal. Some people could only show abnormalities in the case of drug provocation tests, and some patients had drunk have a fever After sauna and exercise, abnormal ECG will appear.
Popularize "the first life-saving skill", and fight with the god of death every second
Professor Zhang also called on: "The public should learn some common sense of first aid and cardiopulmonary resuscitation technology, so that they can save their families and friends at the critical moment. If people around them fall down due to cardiac arrest and just wait for the arrival of the ambulance, it is likely to be very unlucky." He also gave an example of a 27 year old female white-collar worker who fell to the ground due to sudden cardiac arrest when working, Fortunately, the People's Hospital of Peking University had previously trained all the staff in the unit in cardiopulmonary resuscitation technology. The colleagues in the office immediately gave them chest compressions and contacted "120". The chest compressions did not stop when they arrived at the ambulance. After that, the patient went to the emergency room for medication and defibrillation treatment. A few days later, he walked out of the hospital and recovered very well in all aspects.
"Cardiopulmonary resuscitation (CPR), the" first life-saving technique ", should be popularized. In Europe and the United States, it is a compulsory course for middle schools. Statistics show that CPR has been popularized in the United States, making about 200000 people can save lives every year. However, our country still needs to make efforts in this regard, because it is unlikely that the ambulance can arrive at the scene within 'diamond 4 minutes', and the traffic congestion in some big cities is serious. " At the same time, Professor Zhang stressed that cardiac arrest for 4-6 minutes would lead to irreversible damage and even brain death. If external chest compression is carried out in time from the onset of cardiac arrest, the survival rate of patients can be greatly improved, and the earlier the start, the greater the hope. The success rate will be reduced by 10% for each minute of delay in rescue.
Interviewee: Zhang Haicheng
Chief physician of Cardiovascular Department of Peking University People's Hospital, graduated from the medical department of Beijing Medical University (now Peking University Medical Department). His main research interests are arrhythmia, electrocardiogram, cardiac electrophysiology and pacing, and he is good at cardiovascular diseases, especially various arrhythmias hypertension Diagnosis and treatment.
