At 4:00 a.m., I had just squinted for a while and was awakened by the ringing of the phone in the duty room!
The phone rings in the middle of the night, and there are only 3 possibilities: emergency rescue, the patient's condition in The Corey is unstable, and the emergency consultation between departments.
Either way, it's a critical emergency.
Fortunately, having been a cardiologist for more than ten years, I have already practiced the ability to enter the state in an instant and wake up immediately.
The call came from the emergency room, me: Hello!
Over there: emergency consultation, myocardial infarction, hurry down!
Me: Received!
Just so crisp, not more than a word, not wasting a second. Dressed in white, he ran to the emergency room.
The patient is a 38-year-old man, who is uncomfortable before going to bed at night, chest tightness and breathlessness, but feels that it is too late, does not want to come to the hospital, and has been carrying, thinking that it is cold to go to the hospital.
But lying down has not been asleep, turning over uncomfortable, until 3 a.m., really can't help it, so I had to get up and go to the hospital.
Go to the hospital and do an electrocardiogram immediately, indicating acute anterior myocardial infarction. Measuring blood pressure 98/64 mmHg, the emergency department doctor contacted the cardiologist for consultation, and followed the clinical path, giving the patient 300 mg of aspirin, 180 mg of tigrelor, and 3000 u of heparin. Establish liquid channels, inhale oxygen, and ask the patient's family to sign a critical illness notice.
As I ran to the emergency room, I called the catheter room at the same time, activated the catheter room, and prepared for the operation.
After running to the emergency department, after the confirmed patient is acute myocardial infarction, explain the condition to the patient's family and inform them that they need to immediately thrombolysis or contrast. The family agrees to the angiography and the patient is then taken to the catheter room. Angiography revealed complete occlusion of the middle segment of the anterior descending branch of the left anterior blood vessel of the patient's heart, followed by the passage of the guide wire, the expansion of the balloon, the implantation of the stent, the recovery of the vascular lumen, and the recovery of blood flow.
Escort the patient back to the intensive care unit after surgery.
Although the patient came to the hospital more timely, but because it is anterior wall myocardial infarction, necrotic myocardium is more, so whether there will be heart failure in the future, but also have to continue to observe.
After settling the patient, he and the family will explain the condition again and inform the operation process.
The family asked: How can I die of myocardial infarction, and no one in the family has ever had this disease.
1. Is there a relationship between myocardial infarction and heredity?
The patient's family said that no one in the family had this disease, which means that there is no heredity, why do they get myocardial infarction.
Myocardial infarction has a certain relationship with heredity, but it is not a genetic disease in the traditional sense.
Genetic diseases in the traditional sense are brought from the womb of the mother, that is, when they are born, they are destined to occur. However, myocardial infarction only has a certain genetic predisposition, that is, heredity will have a certain influence, but it is not a determining factor.
In general, if a parent has a myocardial infarction or cerebral infarction before the age of 55, the risk of cardiovascular and cerebrovascular disease in the child will increase. If the parents did not have a myocardial infarction or cerebral infarction before this age, then the myocardial infarction in the child has little to do with heredity.
2. How does myocardial infarction occur?
Myocardial infarction is actually a blockage of the arteries and blood vessels of the heart.
So what is blocking the blood vessels of the heart arteries? It's a blood clot!
How did the blood clot come about? Blood vessels are formed because after the plaque ruptures, a blood clot is formed, so the predecessor of the thrombus is the plaque.
So under what circumstances does the plaque rupture? Plaques in blood vessels, after being stimulated, are easy to rupture, such as strenuous exercise, staying up late, smoking a lot, alcoholism, cold stimulation, mood swings, etc. Plaque is easy to rupture, blood clots occur, and myocardial infarction occurs.
So where did the plaque come about?
The plaques in the blood vessels are what the people usually call "vascular garbage". This plaque is caused by multiple factors, such as mainly related to hypertension, diabetes, hyperlipidemia, and hyperhomocysteinemia. If a person has these 4 heights, but does not find 4 high, or found 4 highs, there is no active and regular control, then 4 high will lead to increased vascular endothelial inflammatory response, increased vascular sclerosis, small cracks in blood vessels, and accumulation of lipid-like substances in the inner wall of blood vessels, which will become plaques over time.
In addition to the 4 highs, our unhealthy life is also the main cause of vascular plaque: smoking and alcoholism, sedentary, unhealthy diet, obesity, staying up late, stress, etc. can lead to an increased risk of vascular plaque.
Look at the 38-year-old patient
Usually never check the body, after admission to check blood sugar, blood lipids, homocysteine are higher than normal values, is a typical 3 high patients. However, because the patient never went to the physical examination, he did not find it at all, and naturally he never controlled blood sugar, blood lipids, and cysteine.
Why do patients have lipid and blood glucose abnormalities at such a young age? Patients have been smoking since they were teenagers, weighed overweight and obese since the age of 20, never had the habit of exercising, and often stayed up late to play. These are the initiators of plaques.
So the family said that there was no such disease in the family, why did he get myocardial infarction at such a young age?
That's because his life determines his outcome. And if he had a myocardial infarction at such a young age, the risk of myocardial infarction in his offspring increased.
Fourth, prevention is the last word
We know the causes of myocardial infarction and naturally know how to prevent myocardial infarction. Removing the factors that cause plaque exacerbation is the basis for preventing myocardial infarction.
Especially young people, don't smoke so much, don't drink so much wine, don't stay up so many nights, don't eat so many unhealthy foods, don't be lazy and not moving, don't be so fat.
At a certain age, or even if you are not middle-aged, but you have the above risk factors, usually unhealthy life, then 20 years old should monitor blood pressure, blood sugar, blood lipids, to see if you have three highs. If there is a need for active formal control, can not be careless!