We are in the outpatient clinic, and we often encounter some people with fake "myocardial ischemia".
They are often told that there is "myocardial ischemia" with coronary heart disease, and even some people have been "myocardial ischemia" for many years, and coronary heart disease for many years. Taking medicine for a long time, and experiencing mental pressure for a long time, the child himself suddenly suffered a myocardial infarction one day.
Among these so-called "myocardial ischemia" coronary heart disease patients, many of them are false "myocardial ischemia", among these people, there are often young women, there are menopausal women, and some old women say that their myocardial ischemia ischemia is 50 years; most of them are false "myocardial ischemia".
Today, Dr. Cardiovascular Wang will share with you what is uncertain, fake "myocardial ischemia", if it is a fake "myocardial ischemia", you must go to a professional cardiovascular hospital to re-evaluate it. Don't take medicine and worry about it.
First, the myocardial ischemia is judged solely by electrocardiogram
The most common false "myocardial ischemia" we encounter in the clinic is to judge myocardial ischemia coronary heart disease simply by electrocardiogram.
Including some young people, young women, often say that they have coronary heart disease myocardial ischemia. Ask them how they judged they had coronary heart disease myocardial ischemia.
They would all reply: I did an electrocardiogram, and the myocardial ischemia written on the electrocardiogram.
Later, he was told that it was myocardial ischemia coronary heart disease.
There are also some people who finish the ELECTROCardiogram, and the ECG reads: ST segment change, T wave change, T wave inversion and so on. It is also later told that it is myocardial ischemic coronary heart disease.
In fact, we have always stressed that a person cannot be judged to have myocardial ischemia or coronary heart disease simply based on the change of the ST segment of an electrocardiogram, the change of T waves, and the inversion of T waves. EcG can not appear on the ecglyphogram: myocardial ischemia, these four words!
Anyone who does not combine the specific situation of the patient, just looking at an electrocardiogram, it is not rigorous, or even wrong.
1, some people's electrocardiogram, born is the so-called ST segment depression, or T wave caused, so can not say that seeing the ECG ST or T is a little depressed and inverted, it is said that it is myocardial ischemic coronary heart disease. That is, this part of the people, from the age of 20, to the age of 40, 60 years old, the electrocardiogram is like this. Therefore, you can't see that the ELECTROCARDI has this kind of performance, and you can say myocardial ischemia coronary heart disease without asking for other information.
2. The writing of the ELECTROCARDI report can generally only be objectively described, and the name of a disease cannot be written directly; the diagnosis of the disease is that the doctor can give a diagnosis after combining the specific conditions of the patient and making a comprehensive judgment, so it cannot be said that after reading the ECG, it is directly written "myocardial ischemia" Four words.
3. The electrocardiogram can indeed help us determine whether a person has myocardial ischemia, but it must be combined with the patient's symptoms and some other information, and finally it can be judged, rather than simply looking at the electrocardiogram.
More importantly, judging whether there is myocardial ischemia through the electrocardiogram is to be dynamically observed, that is to say, the patient's electrocardiogram under normal conditions is not the same as the electrocardiogram under uncomfortable conditions, which is called dynamic change. In this way, we can help diagnose myocardial ischemia coronary heart disease.
Second, simply judge myocardial ischemia by discomfort
There are also some people who have not even done an electrocardiogram, but have some uncomfortable manifestations, and they are told that it is myocardial ischemia.
For example, the most common chest pain, chest pain is only a manifestation, behind the hidden many kinds of diseases, such as angina, aortic dissection, pulmonary embolism, pneumothorax, esophageal diseases, lung diseases, tumors, costochondritis, chest tightness disease, herpes zoster, autonomic nerve dysfunction and other diseases. Therefore, it cannot be said that chest pain is myocardial ischemia.
For example, if someone holds his breath in his chest, he is told that it is myocardial ischemia, and there are many possibilities for chest tightness, such as myocardial ischemia, there may be heart failure, there may be lung disease, there may be pleural disease, there may be anemia and so on.
Therefore, it is not possible to judge whether it is myocardial ischemia based solely on symptoms.
Third, how to accurately judge myocardial ischemia by cardiovascular doctors
1. Age of myocardial ischemia
Although the age of onset of coronary heart disease is younger, the proportion of coronary heart disease in the elderly is relatively large.
If we can all live to a sufficient age, then everyone may have coronary heart disease, because coronary heart disease itself is a manifestation of arterial vascular aging, as we increase age, our arteries will harden, and even atherosclerosis will appear, eventually leading to coronary heart disease.
Therefore, the older you are, the more likely you are to have myocardial ischemia in coronary heart disease.
2. Gender characteristics of myocardial ischemia
In premenopausal women, the risk of developing myocardial ischemia and coronary heart disease is very low, so young women must be cautious in diagnosing coronary heart disease myocardial ischemia.
What 20-year-old girl has myocardial ischemia, what 66-year-old woman has 40 years of myocardial ischemia, and so on are almost all pseudomyocardial ischemia.
The risk of myocardial ischemia in young men is more than 6 times greater than that of young women; but when women pass menopause and lose the protection of estrogen, the risk of cardiovascular disease increases, almost the same as that of men. Therefore, after menopause, the risk of developing myocardial ischemic coronary heart disease will increase significantly.
3. Who is more likely to have myocardial ischemia
People with a family history of cardiovascular disease, people with high blood pressure, diabetes, hyperlipidemia and other three highs, long-term obesity, smoking and drinking, eating and drinking, not exercising, staying up late, stressing, unhealthy diet and other factors, the more likely they are to develop coronary heart disease.
This is also a factor in our judgment of whether a person has coronary heart disease.
4. What are the symptoms of myocardial ischemia?
There is a more accurate way to judge myocardial ischemia, that is, symptoms, typical angina can judge myocardial ischemia. But it must be an experienced doctor who judges according to your symptoms comprehensively, not that a chest pain is coronary heart disease myocardial ischemia.
If it is said that myocardial ischemia is judged by symptoms, then the more scientific, that is, we use clinically is a test method that our hospital will use, exercise test.
Simply put, but if there is chest pain, chest tightness and other similar situations in our activities, exercise, labor, etc., then each time last for a few minutes, after rest can be relieved, at this time can be preliminarily judged to be myocardial ischemia, but also have to combine the patient's high-risk factors, family history, electrocardiogram, etc., and finally if necessary, through coronary angiography or myocardial nuclide and other examinations to judge.
5. What tests can be done to judge myocardial ischemia
The symptoms are only the patient's feelings, even experienced doctors, can not be 100% confirmed, can only say highly suspicious.
To further diagnose the presence or absence of myocardial ischemia:
Coronary CTA or coronary angiography, which can see whether the cardiovascular system has stenosis, and how much stenosis, can confirm the diagnosis of coronary heart disease. However, it is not possible to accurately determine whether there is myocardial ischemia.
Exercise test, that is, running with an electrocardiogram on the treadmill, at this time the ECG changes and the patient's angina symptoms, it is possible to determine whether there is myocardial ischemia.
Another test that does not require exercise is myocardial nuclide, which can help us determine whether there is myocardial ischemia.
In short, anyone who has only done an electrocardiogram to be told of myocardial ischemia, or just a little symptom to be told of myocardial ischemia friends, it is best to find a professional cardiovascular doctor to re-evaluate.
Because once diagnosed with coronary heart disease myocardial ischemia, it is a lifelong thing, once this hat is not easy to take off, not only need to take medicine for a long time or even for life, but even endure a lot of pressure for a long time, and even long-term anxiety!