The Hunt for Red October (novel)/Headscratchers

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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 broke his neck.
    • It was a broken neck - this is made clear in the novel.
  • Specifically: he slams Putin against the edge of the table at the juncture of the spine and skull, and presses down on his chest, making a clean break of the spinal cord between the second and third vertebrae. This cuts the brain stem off from Putin's lungs, so his diaphragm stops working. Although his heart keeps beating for about two minutes, Putin suffocates to death.

So does Putin exist in the Ryanverse?

Does Vladimir Putin exist in the Ryanverse or did his expy get killed by Ramius?