In recent years, news about sudden death has been common on the Internet. Although going to bed early and getting up early, relaxing, nutritionally balanced, regular diet and proper exercise are the healthy lifestyles that most people know, but in today’s high-pressure society , many people have their own involuntary consequences, so while we regret the loss of young lives, we can’t help but worry about ourselves and the people around us.
I remember that the wife of an emergency room doctor once consulted me about high blood pressure. I was very confused at the time. Why did her husband come to consult me even though her husband was a doctor himself?
The wife said that she was worried because she had seen many reports of sudden deaths of young doctors, and her husband was busy working as an emergency physician, working day and night and under great pressure, and his blood pressure had not been well controlled.
These patients who are usually healthy or seemingly healthy die suddenly due to illness in an unexpectedly short period of time, which is called “sudden death”. Normally, the time from onset to death is no more than 6 hours.
What may cause sudden death?
According to statistics on autopsy results of past sudden death cases:
About 65%-70% of sudden deaths are caused by ischemic heart disease, which are mainly coronary heart disease, myocardial infarction, etc. that we are familiar with.
10% of sudden deaths are caused by other structural abnormalities of the heart, such as congenital heart disease, cardiomyopathy, etc.
There are also 5%-10% of patients who die from arrhythmia. These patients often have no cardiac structural problems, but suddenly develop severe arrhythmia, which is common in some genetically related heart diseases.
The above three situations can all be called sudden cardiac death. It can be said that sudden cardiac death is the main cause of sudden death.
In addition, 15%-25% of patients die suddenly due to diseases other than heart. There are many types of diseases, including cerebral hemorrhage, pulmonary embolism, poisoning, asphyxia, etc.
Sudden cardiac death is caused by the sudden stop of the heart. In this case, the disease often progresses more rapidly, and death often occurs within an hour of onset. Perhaps most people would think that such an unfortunate thing would never happen to them.
But in reality, is sudden cardiac death really a small probability event?
Sudden cardiac death is not a rare event
In China, epidemiological surveys have found that the annual incidence of sudden cardiac death is approximately 41.8 cases per 100,000 people.
What is the concept of this number? According to statistics from the National Health and Family Planning Commission, the mortality rate from malignant tumors in China in 2012 was 166.3 cases per 100,000 people, which means that for every four people who died of tumors, one died of sudden cardiac death.
It is estimated that 544,000 people die from sudden cardiac death in China every year. According to statistics from the National Health and Family Planning Commission, only 170,000 people died in motor vehicle traffic accidents in China in 2012.
Seeing this number, you will shudder, right?
With the development of self-media, sudden death used to be a personal tragedy lamented by relatives and friends, but now it has gradually begun to ferment in the public eye, making people panic.
Is sudden death really like the sword of Damocles hanging over people’s heads, which will fall at some point? In fact, doctors reviewed the past medical records of patients who died suddenly and the memories of their family members and found that more than 50% of patients who died suddenly had experienced “alarm symptoms” to varying degrees in the previous four weeks. However, often, these symptoms are not recognized and taken seriously by patients in time, and the opportunity for timely treatment is missed.
Please look out for these “alarm symptoms”
The most common alarm symptoms are chest pain and difficulty breathing (often described as chest tightness, shortness of breath, etc.).
The picture above well describes the characteristics of myocardial ischemic chest pain. An elderly man walked out of the restaurant after a meal, carrying heavy luggage in the cold wind, and developed chest pain when he walked up the steps. Chest pain caused by myocardial ischemia often occurs when the heartbeat speeds up and the heart load increases during exercise, fatigue, anger, cold, and a heavy meal, and it often occurs during exercise, not after exercise. Of course, in rare cases, chest pain may occur without the above triggers.
The red part in the picture is the location where pain often occurs, including the chest area (possible on both the left and right sides), upper abdomen, and back; the pain may also radiate to the left shoulder, left mandible, and left upper limb. Pain tends to be widespread rather than localized.
Everyone’s feelings and descriptions of the nature of pain are also very individual: Myocardial ischemic chest pain is commonly described as “the feeling of pressing a big stone”, “tearing”, and “unbearable”; there is also a very special kind, The incomprehensible feeling is called the “sense of death”. Many patients who have experienced angina pectoris or myocardial infarction will describe it as – “I can’t tell what kind of discomfort it is, but I just feel that I am going to die.” This This “dying feeling” often indicates the possibility of serious heart problems.
If the chest pain is described as “pinprick-like” or “feeling of boredom”, it is less likely to be chest pain caused by myocardial ischemia. There is no direct correlation between the severity of pain and whether it is ultimately diagnosed as myocardial ischemia. Some people will describe it as “unimaginable pain”, while others will only describe it as mild chest discomfort.
Chest pain may also be accompanied by other symptoms, such as pale complexion, clammy skin, sweating, a tightening sensation in the throat (as if someone is strangling the neck), nausea, and vomiting (females are more likely to experience nausea, vomiting, and breathing). Difficulty and other symptoms, and sweating is more common in men); these symptoms represent the activation of the sympathetic nervous system and also indicate the possibility of a more serious disease.
Transient myocardial ischemic chest pain often lasts for a few minutes (rather than a few seconds) and will relieve itself after resting. However, this does not mean that the disease will also disappear, especially if transient ischemic chest pain occurs repeatedly in a short period of time. You should be more careful about possible serious cardiovascular events in the near future and seek help from your doctor as soon as possible.
If you have persistent and severe chest pain, or are accompanied by the following conditions, including confusion (or) loss of consciousness, pale face, profuse sweating and cold limbs, hypotension (blood pressure <90/60mmHg), shortness of breath or difficulty breathing; please Don’t hesitate to go to the emergency room immediately.
Risk factors for cardiovascular and cerebrovascular diseases
I once treated a client who woke up from his sleep with sudden chest pain in the early morning. The pain lasted for 3-4 minutes and then relieved. He felt slight sweating and fatigue, and described that he felt like he wanted to ” It’s over” feeling. During the consultation, it was learned that this was the first time he had experienced such symptoms.
For such cases, I first assess the patient’s risk factors for cardiovascular and cerebrovascular diseases. Cardiovascular and cerebrovascular diseases are caused by multiple factors. There is no exact cause. Instead, every problem that may increase the risk of cardiovascular and cerebrovascular diseases is called a “risk factor.”
Some of these risk factors are non-modifiable, including:
● As age increases, the risk of cardiovascular and cerebrovascular diseases will gradually increase. For people over 80 years old, the incidence of cardiovascular diseases will exceed 20%;
● The risk is higher for men than for women;
● First-degree relatives (parents or siblings) suffer from cardiovascular and cerebrovascular diseases when men are <55 years old and women are <65 years old.
Some risk factors are related to our lifestyle habits, including: smoking (no matter how much), unhealthy eating habits, lack of exercise, obesity, stress and pressure, etc.
Some risk factors are related to chronic diseases, including: hypertension, diabetes, chronic kidney disease, dyslipidemia, proteinuria, metabolic syndrome, etc.
Please check yourself and count the above risk factors to see how many of them you have. The more risk factors you have, the higher the cumulative risk of cardiovascular and cerebrovascular diseases.
Doctors need to understand whether there are corresponding risk factors, assess potential cardiovascular and cerebrovascular risks, and then decide whether to conduct examinations or give drug treatment based on the patient’s specific situation.
Summarize
Therefore, when faced with various “sudden death” news in your circle of friends, please do not be afraid or panic. On the contrary, we should take a good look at our own health status, actively improve our lifestyle, closely observe our symptoms, and seek help from doctors in a timely manner, so as to be “cautious”.
