Srčani zastoj

Srčani zastoj
lat.
Institio cordis
EKG koji prikazuje ventrikularnu fibrilaciju
Specijalnostkardiologija, Urgentna medicina
Klasifikacija i eksterni resursi
ICD-10I46
ICD-9427.5

Srčani zastoj[1] ili klinička smrt (lat. Institio cordis) je nagli prestanak normalne cirkulacije krvi usled nemogućnosti srca da se pravilno kontrakuje tokom sistole.[2]

Srčani zastoj se razlikuje od srčanog udara, gde je prisutan poremećaj dotoka krvi u srčani mišić, iako srčani udar može biti uzrok srčanog zastoja.

Zaustavljena cirkulacija sprečava dostavljanje kiseonika u tkiva organizma. Cerebralna hipoksija, ili nedostatak kiseonika u mozgu, izaziva gubitak svesti i prestanak disanja, ponekad uz preostalo agonalno disanje. Povreda moždanih tkiva je verovatna u slučajevima zastoja srca dužim od 5 minuta,[3] iako neke nove procedure mogu da produže ovo vreme (indukovana hipotermija).[4][5] Da bis se poboljšale šanse za preživljavanje i oporavak neuroloških funkcija od najvećeg značaja je brza intervencija.[6]

Srčani zastoj je urgentno stanje kod kojeg je izvestan postotak pacijenata moguće povratiti u normalno stanje, ako je medicinska intervencija brza. Kada srčani zastoj dovede do smrti, ova pojava se naziva iznenadna srčana smrt.[2] Primarni oblik prve pomoći kod ovog stanja je mehanička stimulacija srca i disanja koja održava cirkulaciju do trenutka kada bude dostupna potpunija medicinska pomoć. Ona će zavisiti od vrste poremećaja, stanja srčanog ritma, i najčešće se sastoji od srčane defibrilacije ili primene medikamenata.

Vrste

Ventrikularna fibrilacija je poremećaj u kontrakciji srčanog mišića. Rad srčanih mišićnih ćelija je nekoordinisan, stoga srce ne potiskuje krv.

Ventrikularna tahikardija je pojava gde srce kuca prebrzo, nedovoljno se puni, i stoga ne pumpa krv.

Elektromehanička disocijacija srca je stanje gde su električni impulsi u srcu pravilni, ali oni ne izazivaju mehaničke kontrakcije.

Asistola je potpuni prestanak električnih i mehaničkih dejstava u srcu.

Uzroci

Sve bolesti koje dovode do smrtnog ishoda dovode osobu u stanje srčanog zastoja. Stoga su mogući uzroci ovog stanja brojni. Mnogi od njih posredno uzrokuju zastoj rada srca (recimo: gušenje koje dovodi do hipoksije, koja izaziva srčani zastoj). Ponekad nije moguće sprečiti ovaj uzrok što dovodi do smrti.

Među odraslima, glavni uzrok srčanog zastoja je ishemijska bolest srca.[7] Pri autopsiji 30% smrtnih slučajeva uzrokovanih zastojem srca pokazuje simptome nedavnog srčanog infarkta. Druga srčana oboljenja koja mogu dovesti do srčanog zastoja su: strukturalne anomalije, aritmije i kardiomiopatije. Uzroci nevezani za srčani mišić su: infekcije, trovanja lekovima, traume, rak i drugi.

Lista uzroka

Reference

  1. ↑ Srčani zastoj (Cardiac arrest)
  2. ↑ 2,0 2,1 Harrison's Principles of Internal Medicine Arhivirano 2012-08-04 na Wayback Machine-u 16th Edition, The McGraw-Hill Companies, ISBN 0-07-140235-7
  3. ↑ Safar P (1986). „Cerebral resuscitation after cardiac arrest: a review”. Circulation (Lippincott Williams & Wilkins) 74: IV138–153. Pristupljeno 2007-01-05. 
  4. ↑ Holzer M, Behringer W (2005). „Therapeutic hypothermia after cardiac arrest”. Current Opinion in Anaestesiology (Lippincott Williams & Wilkins) 18: 163–168. Pristupljeno 2007-01-03. 
  5. ↑ Safar P et al. (1996). „Improved cerebral resuscitation from cardiac arrest in dogs with mild hypothermia plus blood flow promotion”. Stroke (Lippincott Williams & Wilkins) 27: 105–113. Pristupljeno 2007-01-07. 
  6. ↑ Irwin and Rippe's Intensive Care Medicine Arhivirano 2005-11-07 na Wayback Machine-u by Irwin and Rippe, Fifth Edition (2003), Lippincott Williams & Wilkins, ISBN 0-7817-3548-3
  7. ↑ Cardiac Resuscitation Arhivirano 2008-12-06 na Wayback Machine-u Mickey S. Eisenberg, M.D., Ph. D., and Terry J. Mengert, M.D. New England Journal of Medicine, Volume 344:1304-1313, April 26, 2001

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