Author of this article:
Zhejiang Hospital Wu Jing
Zhejiang Provincial People's Hospital Yang Taoyu
Zhejiang Run Run Run Shaw Hospital Li Wenfang
Winter is the high incidence of cardiovascular and cerebrovascular disease season, in the process of controlling the disease in normal times, some special times that are prone to sudden emergencies should also focus on prevention and stabilize the winter.
Sudden chest pain while playing mahjong
Myocardial infarction and malignant arrhythmias
【Outpatient Observations】
In the past month, the heart center of The Sandun Branch of Zhejiang Hospital has received nearly 30 cases of myocardial infarction patients, including young patients in their 30s and patients in their 90s, including a male patient in his 50s, who suddenly had chest pain when playing mahjong at home, malignant arrhythmias after myocardial infarction, repeated ventricular fibrillation after being sent to the emergency room, multiple electrical defibrillations, and finally successfully rescued.
【Expert Interpretation】
Du Changqing, chief physician of the Department of Cardiology of Zhejiang Hospital: Winter often eats greasy, coupled with the sedentary playing of mahjong, the amount of exercise is reduced, the amount of water is reduced, and the oxygen content in the confined space will also decrease, so that the blood lipids will increase, the blood viscosity will also increase, the blood is concentrated, and the platelets are easier to accumulate under low temperature conditions, which ultimately promotes the formation of blood clots.
Especially when playing mahjong, if there is a sustained chest discomfort for more than a few minutes, can not bear, hold back, to explain the situation to the people around as soon as possible, go to the hospital in time, to avoid missing their own treatment time.
In winter, the temperature is low, the human body is stimulated by the cold to cause vasoconstriction, blood pressure shows a significant upward trend, and the heart load is aggravated.
At the same time, the body's sympathetic nervous system excitability is increased, catecholamine secretion increases, resulting in increased heart rate, vasoconstriction, increased cardiac oxygen consumption, and catecholamines themselves may also induce the occurrence of coronary spasm, resulting in myocardial ischemia and hypoxia.
Sudden chest tightness in the middle of the night
Don't miss the golden time for heart attack treatment
Ms. Gao is in good health, the usual physical examination indicators are normal, there is no hypertension, diabetes and other underlying diseases, in the early morning of January 11, she suddenly felt a tight chest and rushed to the hospital. Due to the timely delivery of the doctor and the timely opening of the blood vessels, the patient quickly recovered his health and returned to normal life.
Du Changqing, chief physician of the Department of Cardiovascular Medicine of Zhejiang Hospital: The patient's situation is very typical, because he feels that he is usually in good health, and sudden chest tightness often does not get enough attention, fortunately, the patient and his family insist on sending it to the hospital in time, and opened the occlusive blood vessel within 120 minutes of the golden time of myocardial infarction treatment, which won valuable time for her health.
Elderly patients, regardless of whether there are cardiovascular and cerebrovascular problems, if there is chest pain, chest tightness, especially at night, must seek medical treatment in time.
Entering the winter, chest pain and other discomfort occur at night, and patients do not want to go out because it is too cold outside and delay again and again, in fact, many dangerous heart infarction, cerebral infarction and other conditions occur at night.
Chest discomfort lasts for more than a few minutes, it is recommended to call 120 to the hospital chest pain center for treatment. Acute myocardial infarction often requires the opening of occluded blood vessels within the golden treatment time, which requires doctors and patients to trust each other.
Dizzy and restless after meals
People with high blood pressure also have postprandial hypotension
The 86-year-old Mr. Luo has a history of hypertension for more than 20 years, and in recent years, Mr. Luo often has symptoms of dizziness, and it is particularly obvious after breakfast, and even has panic, sweating, and unsteadiness in standing when it is serious. Combined with the dizziness symptoms and blood pressure changes that occur after meals, Mr. Luo Lao was diagnosed with: postprandial hypotension.
Sun Dongsheng, chief physician of the Cadre Department of Zhejiang Provincial People's Hospital: Postprandial hypotension is a special condition of hypotension, and the systolic blood pressure drops by more than 20 mm Hg compared with before the meal within two hours after the meal, and there are symptoms of discomfort.
Do I still need to take antihypertensive drugs when hypotension occurs after a meal?
Postprandial hypotension is an abnormality in which "there is a problem with the regulation of blood pressure in the human body". Under normal circumstances, in order to better digest food after eating, the digestive system will allocate more blood to the digestive tract, and the blood in other systems and organs will be relatively reduced, resulting in a downward trend in blood pressure.
The ability of the elderly to regulate blood pressure is weakened, and the autonomic regulatory function may fail, so the ability to maintain blood pressure after a meal decreases, resulting in the occurrence of hypotension. Especially in patients with hypertension, diabetes, and various autonomic dysfunctions.
It is recommended that elderly friends with such conditions lie down for half an hour after each meal, adjust the diet structure, reduce carbohydrates, appropriately increase fatty foods, and seek professional help in regular hospitals to let doctors adjust antihypertensive drugs.
When you go to the toilet and get up too quickly
Be wary of myocardial infarction and syncope
Many emergency departments are sent unexpectedly because of the toilet, especially some cardiovascular and cerebrovascular patients, after the defecation gets up too quickly, there will be syncope, it is easy to fall, some patients because of forced defecation or even myocardial infarction. With the increase of age, the number of underlying diseases increases, and toilet accidents will also increase relatively, which needs to be paid attention to.
Chen Liying, chief physician of the Department of General Medicine of Run Run Shaw Hospital, affiliated to Zhejiang University School of Medicine: The prevalence of constipation in the elderly is high, and when they defecate forcefully, they have more or less experienced blood surges and red ears.
Excessive force can lead to a rapid increase in intra-abdominal pressure, an increase in cardiac return blood, an increase in blood pressure, and an increase in myocardial oxygen consumption. For patients with heart disease, it is easy to cause myocardial ischemia, angina or severe arrhythmias, and even sudden death.
It is recommended that patients with heart disease do not force their bowel movements, and if necessary, they can reserve corresponding laxative drugs under the guidance of a doctor; put a small stool under their feet to facilitate defecation.
After going to the toilet and getting up too quickly, some people will feel dizzy, their eyes will be black, and they may even faint. This phenomenon is called orthostatic hypotension. There is a foundation of arteriosclerosis, the cardiovascular regulation ability is weakened, the blood pressure suddenly drops when the position is changed, and the dizziness and blackening of the eyes may fall and faint.
It is recommended to wake up in the morning and sit for a while before getting out of bed to go to the toilet; slowly get up after going to the toilet.
This article was first published on 2022-01-21 Health Times "Dangerous Moments for Cardiovascular Patients"
Editor of this article: Yao Xinran Wang Zhen Review Director: Yang Xiaoming