Asystole

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Classification according to ICD-10
I46.- Cardiac arrest
ICD-10 online (WHO version 2019)
EKG recording of an asystole

Asystole (from a- "without" and systole "heart contraction") is a medical term . It is understood to mean a standstill in the electrical and mechanical action of the heart , which, if left untreated, leads to death within a few minutes.

Asystole can be recognized by a flat line in the ECG . Other symptoms such as lack of mechanical heart action in the echocardiography and lack of pulse in the person affected also occur with every asystole, but can also have other causes.

causes

In most cases, asystole is preceded by ventricular fibrillation , which can be triggered by a heart attack , for example. Such a secondary asystole is not a cause but an effect of a problem.

An electrical accident can also be triggering.

So-called primary asystole is only present in around 20 percent of cases . It is usually based on a standstill of the sinus node and the underlying subordinate excitation centers of the heart.

A total AV block without electrical and mechanical chamber action is rare and usually only temporarily (temporarily) detectable. You can recognize it in the ECG by the fact that the QRS complex is missing and only atrial waves (P waves) are present. The atria are still contracting, but the ventricles are no longer. This type of arrhythmia can therefore also be classified as asystole.

therapy

Until further therapy by the emergency doctor and rescue service , resuscitation measures ( chest compressions and ventilation ) must be carried out by the first aider . The use of a pacemaker may also be necessary.

Asystole can not be treated by defibrillation - contrary to what is sometimes disseminated medially by doctor's series - since irregular heart activity must be present for it to function, which in the ideal case can be rectified again. Drug therapy is carried out with adrenaline .

Individual evidence

  1. ^ Federal Medical Association (ed.): Resuscitation - Recommendations for resuscitation . Deutscher Ärzte-Verlag, 2011, ISBN 978-3-7691-0620-6 .
  2. ↑ Entry on asystole in Flexikon , a wiki from DocCheck , accessed on November 25, 2015.
  3. ↑ Thomas Schneider, Benno Wolcke, Roman Böhmer: Pocket Atlas Emergency & Rescue Medicine : Compendium for the emergency doctor . Springer-Verlag, 2013, ISBN 978-3-662-10216-9 ( limited preview in Google book search).
  4. ^ T. Ziegenfuß: Emergency Medicine. (= Springer textbook). 5th edition. Springer-Verlag, 2011, ISBN 978-3-642-21126-3 .

Web links

Commons : Asystole  - collection of images, videos and audio files