The Hunt for Red October (novel)/Headscratchers

How did Ramius kill Putin?
We see him slam the Putin's head against the table and do something to him slightly off-screen that looks like it could be CPR chest compressions if he wasn't murdering him, then we get a shot of his wide-eyed, stricken (yet still alive) face, which makes it look like he can't breathe. So how did he die? This one has always had me slightly puzzled.
 * I always thought Ramius.
 * It was a broken neck - this is made clear in the novel.
 * Specifically:

So does Putin exist in the Ryanverse?
Does Vladimir Putin exist in the Ryanverse or did his expy get killed by Ramius?
 * Given that in real life Vladimir Putin is an amateur weightlifter who has black belts in both judo and karate, as well as martial arts competition experience, the Putin in the novel is clearly some other guy. If that had been Vladimir, Ramius would be the guy with his head put through the table.