Ten-year-old marathon runners need to be careful when they run ＂horses＂ because of cardiac arrest!
"Stand up straight and stride." Under the guidance of medical staff, Xiao Chen, a running friend, is conducting exercise treadmill experiments in Beijing Hejia Hospital. In the Beijing Half Marathon in April this year, Xiao Chen had a cardiac arrest. Fortunately, he was discovered by the volunteers of Hejia AED, and was successfully rescued through cardiopulmonary resuscitation and AED (External Automatic Defibrillation Transporter) electric defibrillation. After months of recovery, doctors need to re-evaluate his heart function.
The start of the 2019 Beijing Marathon is just around the corner, and even senior runners may "stumble" and face the great risk of sudden cardiac death.
Cardiology experts remind that six types of patients, such as those who have a history of myocardial infarction, those who have been diagnosed with heart diseases and have undergone surgery, and those who have a history of unexplained syncope, are generally not suitable for marathon. If you want your heart to be safe in high-intensity events, you need scientific cognition and pre-competition heart evaluation.
Senior runner’s cardiac arrest AED successfully rescued
"I was more excited when I finally sprinted. I shouted and rushed over. After a few steps, my feet were soft and I suddenly lost consciousness." Xiao Chen, a runner who suffered an accident in this year’s semi-Marseille in Beijing, said that he has ten years of long-distance running experience and participated in eight or nine marathons, which is a senior runner. I didn’t expect that this time he became the object of "first aid".
At that time, it was Yuan Tong, an emergency nurse in Beijing Hejia Hospital, one of the medical security units of Beijing Half Horse Race, who was present to defibrillate Chen Jinxing AED. She said that the timely discovery of the support staff and the skilled use of AED pulled Xiao Chen back from the death line, otherwise once the cardiac arrest was not treated for 4 to 6 minutes, the brain would be irreversibly damaged, and even if the heartbeat was restored, it might become a vegetative state.
Wang Dezhao, chief physician of the Department of Cardiology, Beijing Hejia Hospital, said that cardiovascular system accidents that often lead to cardiac arrest and sudden death in marathons are usually sudden acute myocardial infarction or malignant arrhythmia. Although the probability of occurrence is low, once it appears, it is the most dangerous. It is the most effective way to rescue patients with cardiac arrest and sudden death by using artificial chest compressions and AED defibrillation in the early stage. Beijing United Family Hospital is the official and exclusive designated medical service provider for Beijing Marathon. All AED volunteers have passed the cardiopulmonary resuscitation training organized by the American Heart Association (AHA) and obtained the certificates of Basic Life Support (BLS) and Advanced Life Support (ACLS), so they have the ability to find and rescue runners with cardiac arrest in the first time.
Six groups of people should have a heart evaluation before the game.
How to run a horse safely? Wang Dezhao said that runners must first have a clear understanding of their physical condition, and the following groups of people are not suitable for participating in such high-risk events.
First, patients who had a history of myocardial infarction in the past, especially 6 months after myocardial infarction; Followed by patients who have been diagnosed with angina pectoris, or have undergone coronary stenting, coronary artery bypass grafting and installed pacemakers; Third, it is a patient who has a history of unexplained syncope or has done electrical cardioversion; The fourth is patients with severe arrhythmia or taking antiarrhythmic drugs; In addition, patients with a history of congenital heart disease, cardiomyopathy or cardiovascular malformation, and patients with special ECG manifestations, such as Brugada syndrome, long QT syndrome and preexcitation syndrome (all three groups have special ECG manifestations), are not suitable for high-risk events similar to marathon.
In addition to people who are not suitable for horse racing, there are six groups of people who can participate in the marathon, but they need to be evaluated before the race. The first category is people with risk factors of coronary heart disease, including smoking, hypertension, diabetes, hyperlipidemia, family history of premature coronary heart disease (male < 55 years old, female < 65 years old), heavy drinking, sedentary, obesity, staying up late and working under great pressure; The second category is people with family history of sudden cardiac death; The third category is people who have had severe diarrhea or used diuretics recently, and it is very likely that there are abnormal levels of potassium, magnesium and calcium ions; The fourth category is people who have arrhythmia without drug treatment, including sinus arrhythmia, various premature beats, sinus bradycardia, etc. The fifth category is people who have had discomfort in the area below the jaw and above the umbilicus related to activities, or have palpitations and shortness of breath; The sixth category is people who are anxious, hypochondriac and have had a history of panic attacks. Most of these people do not have the typical symptoms of organic heart disease, but they belong to high-risk groups. If there is no heart assessment, there may be unexpected situations in extreme sports such as marathon.
Three types of heart assessment help runners stay away from accidents
Wang Dezhao introduced that marathon is an extreme sport with certain potential risks. However, as long as the heart function is scientifically evaluated before the game and the physical condition is known in advance, accidents such as cardiac arrest can be avoided to the maximum extent.
"If the heart is compared to a house, then it has three systems, including waterway system, circuit system and structural system." According to Wang Dezhao, heart evaluation is also divided into three categories according to three systems: the first category is the evaluation of the "waterway system" of the heart, and the "waterway system" refers to the blood vessels of the heart itself — — Coronary artery. If the runner has chest tightness, shortness of breath, chest pain, pressure, burning pain, pain in the left upper limb or left shoulder and back, which suggests that angina pectoris is possible, it should be evaluated by exercise treadmill test to observe whether the runner will have myocardial ischemia when he reaches the limit heart rate, which is also a simple and effective means to screen coronary heart disease. If the exercise treadmill test is abnormal, further coronary CTA or coronary angiography is needed.
The second kind of evaluation depends on the "circuit system" of the heart, that is, the evaluation of cardiac electrical activity. If the runner has palpitation, irregular heartbeat, too slow or too fast heartbeat, it suggests that the cardiac electrical activity is abnormal, and it is necessary to do ECG monitoring for 24 hours, 7 days, 1 month or even longer. By monitoring the ECG changes at the onset of symptoms, the disease can be diagnosed and whether it is suitable for the competition can be evaluated.
The third category is the evaluation of heart structure. If the runner has heart murmur, myocarditis, cardiomyopathy, congenital heart disease, etc., it is necessary to evaluate the morphological structure of the heart by heart color Doppler ultrasound. If you have serious structural heart disease, especially hypertrophic obstructive cardiomyopathy or aortic stenosis, you are not suitable for marathon.
How to predict and save yourself when you suddenly feel unwell in the game? Wang Dezhao said that first of all, runners should stop exercising, rest in a comfortable and relaxed posture, and seek help from medical staff; If the heartbeat suddenly accelerates, fast and even, it may be supraventricular tachycardia. You can hold your breath and cough hard, which may stop the tachycardia. If the pain in the chest or other suspicious parts (back, upper limbs, pharynx, etc.) persists, the attack of acute myocardial infarction cannot be ruled out. It is best to lie on your back, relax as much as possible, take a deep breath slowly and wait for rescue. (Reporter Chen Si)