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<  脇付 | メイン |  医者独特のことば「腔」(くう) >
 書誌情報『スポーツで心臓が止まる時』海老根東雄 著、 悠飛社、2004年、1600円(税別)

 「健康のためなら死んでも良い」なんてブラックジョークがありますが、本当に、健康のために良いと思っていた運動中に急死する人がいます。(ジョギングを世界中に広めたフィックスは、そのジョギング中に急死しました)
 有名なところでは、1986年バレーの日立対ダイエーの試合中に倒れて急死したハイマン、2003年夏コンフェデレーション杯準決勝中に急死したカメルーン代表のフォエ、2002年スカッシュ中に急死した高円宮……
 ハイマンはマルファン症候群(大動脈瘤ができやすい)でした。フォエも体格からその疑いがあるそうです。高円宮は心室細動でしたが、その原因については本書には書いてありませんでした。虚血性心疾患でも起されたのでしょうか。

 著者は東京都監察医務院にある突然死のデータ(1987年〜99年)29,699例のカルテを全部ひっくり返し、その中の0.5%の141例「運動中の急死例」を見つけます。死亡原因は冠動脈疾患78例・心機能不全15例・解離性大動脈瘤12例など多くが心血管疾患でした。他に急性心筋炎なども突然死の原因として考えられるでしょう。
 ならば運動中の突然死を防ぐためには「病気があるかどうか検診を厳しくしたらよい」でしょうか。もちろん明らかな病気の人は運動禁止でしょうが、実は話はそれほど簡単ではありません。厳しいスポーツで鍛えると、心臓は「スポーツ心」と呼ばれる状態になります。このスポーツ心は、スポーツの種類などによって肥大型と拡張型に分けられます。そして肥大型スポーツ心は肥大型心筋症・大動脈弁狭窄症・高血圧心疾患と、拡張型スポーツ心は拡張型心筋症・僧帽弁閉鎖不全症・大動脈弁閉鎖不全症とよく似ているのです。もしかしたら過度の運動は心臓には不健康、と言って良いのかもしれません。
 さらに原因不明の急死もあります。「心震盪」と呼ばれる状態で、ボールが胸に当たった程度でも心停止をきたしてしまうことがあるのです。これは事前のチェックが不可能です。不整脈源性右室異形成症(ARVD)やブルガダ症候群も突然の心室細動を起す原因として注目されています。

 では目の前で急性心停止が起きたらどうするか。医療関係者なら即答ですね。「蘇生のABC」です。本書にはそのことも(基礎的なことではありますが)書いてあります。ただ面白いことに、柔道の活法も載っています。異物を気道から除去するためにハイムリッヒ法が行われますが、活法の中にはハイムリッヒ法よりも気道内圧を上げることができる方法があるのだそうです。本書には解説と図がありますので、興味のある方はご覧ください。よく時代劇で失神している人に「ふん」と言いながら活を入れますが、それが医療に応用できるとは知りませんでした。

 オマケです。近年「救急蘇生法で、短時間だったら必ずしも人工呼吸は必要ない(心臓マッサージだけでもいける)」と言われるようになっていますが、これは広く知られているでしょうか。
http://www.naruoseikei.com/hakuzan/18/18.html
http://www.sakakibara-hp.com/AED/AED.htm
 ただ、早合点して最初から闇雲に胸を押すのはやめて欲しいとは思います。脈が触れないことを確かめて欲しいし、そもそも空気の通り道がちゃんと開いていなかったらいくら効果的に心臓マッサージをやっても無駄ですから。それと、これも誤解が多いのですが、AEDは「とまった心臓をまた動かすようにする器械」ではありません。「電気ショックを与えたらまた動くようになる状態の心臓に電気ショックを適切に与える器械」です。医療関係者でもそのことがわかっていない人が時々いるのは困ったものです。


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[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from twitter followers 2012.02.07 09:51
Blogs ou should be reading
[...]Here is a Great Blog You Might Find Interesting that we Encourage You[...]… [続きを読む]
posted from twitter followers 2012.02.07 18:40
Superb website
[...]always a big fan of linking to bloggers that I love but don’t get a lot of link love from[...]…... [続きを読む]
posted from Scrapebox Auto Approved 2012.02.07 23:18
Links
[...]Sites of interest we have a link to[...]… [続きを読む]
posted from Free walmart gift card 2012.02.08 00:19
Related…
[...]just beneath, are numerous totally not related sites to ours, however, they are surely worth go... [続きを読む]
posted from super exclusive scrapebox list 2012.02.10 22:21
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from Diablo 3 free key 2012.02.11 16:24
Recent Blogroll Additions…
[...]usually posts some very interesting stuff like this. If you’re new to this site[...]… [続きを読む]
posted from iphone app developer 2012.02.12 15:54
Online Article…
[...]The information mentioned in the article are some of the best available [...]... [続きを読む]
posted from Learn How To Bboy 2012.02.12 22:19

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