During the Spring Festival, the emergency departments of many hospitals rescued cardiovascular emergencies. In addition to myocardial infarction, there is also a cardiovascular emergency with chest pain as the main manifestation, aortic dissection aneurysm. This disease was relatively rare before, but in recent years, with the increase in patients with hypertension, the incidence has also increased.
They are all cardiovascular emergencies, and they are all manifested by chest pain, but the diseases are different and the treatment is also very different.
It is very important not to listen to the rumors, the so-called "chest pain attack, chewing aspirin can save lives" false rumors!
There are always people on the Internet who say that they should chew aspirin when chest pain attacks. Recently, some people have also said that to prepare aspirin, chest pain attack, if it is chest pain caused by myocardial infarction, eat aspirin before going to the hospital, chew 300mg, can greatly alleviate symptoms, but also can ensure a follow-up survival rate.
Is that right?
Seems right, because here it says myocardial infarction. If it is chest pain caused by myocardial infarction, if the patient has not taken aspirin before, it is necessary to chew aspirin 300 mg.
However, it is not feasible in practice.
Because before the onset of chest pain outside the hospital and going to the hospital, the patient, family members, or friends, cannot be sure that the patient's chest pain is myocardial infarction. If you can't be sure if it's a myocardial infarction, you can't take the drug. And if patients who have been taking aspirin for a long time in the past, there is no need to chew aspirin anymore. In addition, even if aspirin is chewed for acute myocardial infarction, it is impossible to "greatly alleviate symptoms", let alone "can ensure subsequent survival rate". Because myocardial infarction requires comprehensive treatment, the most important thing is to open the coronary arteries as soon as possible to restore blood supply, and aspirin is only one aspect of antiplatelet therapy.
Therefore, when myocardial infarction has not yet been diagnosed, it is necessary not to take this loading dose of aspirin because of chest pain.
The practice of chewing aspirin 300 mg is for patients who are new to acute coronary syndrome and have not previously taken aspirin (acute coronary syndrome includes acute myocardial infarction).
This is because the main cause of acute myocardial infarction is the thrombosis in the coronary arteries, completely blocking the blood vessels, interrupting the blood supply to the myocardium, and the myocardial infarction. In thrombosis, the main cause is a blood clot formed by platelet activation. Therefore, intensive antiplatelet therapy is required.
Antiplatelets are the first to promote aspirin.
Therefore, for patients who did not originally take aspirin, it is necessary to chew aspirin 300 mg for the first time.
Why chew it? In order to absorb quickly, it works quickly. And now aspirin is mostly enteric-coated tablets, oral absorption in the intestine is slow, slow onset of action, but also to chew up to eat.
Why a dose of 300 mg? Because I have not taken it before, the small dose of 100mg usually has a weak effect. Therefore, the first dose should be large enough to have a strong effect.
For patients with acute myocardial infarction, in addition to aspirin, additional antiplatelet drugs should be added. For example, ticagrelor, the first time is also doubled dose, 180 mg; or clopidogrel, the first dose is 4 times or even 8 times the conventional dose, 300 mg or 600 mg.
However, these are in patients whose chest pain episodes are determined to be coronary heart disease, unstable angina, or acute myocardial infarction.
However, chest pain is not only acute myocardial infarction, but also other conditions, as well as cardiovascular emergencies that do not take aspirin, such as aortic dissection aneurysm.
The aorta is the aorta that connects to the heart. Aortic dissection aneurysm, in which the inner and outer layers of the aortic vessel wall are torn open. Generally speaking, the intima ruptures, and the blood gushes in to separate the inner membrane and the outer membrane of the blood vessel wall, becoming a sandwich. In this way, the blood vessel wall is thin and not strong. Such a patient's blood pressure is very high, once the outer membrane is broken, the person with heavy bleeding in an instant is gone. Such patients need to be rescued in time, it is very likely to have surgery, the risk of bleeding is high, and it is impossible to take antiplatelet aspirin.
Studies have shown that 94% of patients with myocardial infarction have chest pain or chest discomfort; aortic dissection aneurysms, the main manifestation is also chest pain. Some people have counted that 50 cases of aortic dissection aneurysms, 32 cases of acute chest pain, and 16 cases of chest and abdominal pain, which is also more than 90%. Of course, in general terms, the pain of the aortic dissection is more intense.
To say that the history of hypertension, patients with coronary heart disease can have, dissected aneurysm patients are also seven or eight out of ten.
If you want to talk about the causes of the disease, there will also be similarities, strenuous exercise, exertion, emotional agitation, excessive blood pressure, and so on.
In this way, when acute chest pain occurs, it is difficult for the patient himself, or family and friends, to judge on the spot that chest pain is myocardial infarction.
Moreover, when the dissection aneurysm compresses the coronary artery (because the opening of the coronary artery is in the aorta), there can also be manifestations of myocardial ischemic damage, and even myocardial infarction can occur, and sometimes the doctor will also misjudge, which needs to be well distinguished. When I wrote this article, I happened to see this case and posted it below.
Therefore, when chest pain attacks, be sure not to chew aspirin yourself!
Nitroglycerin can be taken, and both diseases can be used. Nitroglycerin can not only relieve angina, but also lower blood pressure.
Call 120 for first aid.
Keep a quiet rest, wait for the doctor to arrive, and then take the medicine according to the doctor's instructions after the doctor's judgment.
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