Chest pain is no small matter!
So now many hospitals have built "chest pain centers"!
In fact, chest pain is not a disease name, chest pain is only a symptom, there are many kinds of diseases that may cause chest pain, and there are actually 3 kinds of doctors who are worried about the position: acute myocardial infarction, aortic dissection, and pulmonary embolism.
So why are these 3 diseases most worried about doctors, and what are the dangers of these 3 diseases? How to discover? How is it treated? How can it be prevented?
Acute myocardial infarction, aortic dissection, and pulmonary embolism, also known as the "chest pain triad", are a major cause of the establishment of chest pain centers, because these 3 diseases are all emergencies, mortality rates are high, and are often manifested by chest pain. Therefore, the chest pain center has been established to develop standards for early detection and early diagnosis and treatment of chest pain, save time, and open green channels.
1. Acute myocardial infarction
1. What is myocardial infarction
Acute myocardial infarction is the arterial blood vessels of the heart, and suddenly a blood clot occurs, and the blood clot blocks the large blood vessels of the heart. At this time, the heart will stop suddenly or have ventricular fibrillation at any time, that is, sudden death. In the first hour of onset, the risk of cardiac arrest is 25 times higher than that of subsequent ventricular fibrillation, so myocardial infarction is more important in the first hour, and rescue is more important, and the vast majority of sudden death is caused by myocardial infarction. Even if there is no cardiac arrest, the myocardium will continue to necrosis, the larger the blood vessels in the infarction, the later the time to open the blood vessels, then the larger the area of myocardial necrosis, even if the blood vessels are opened in the hospital, the risk of subsequent heart failure will be greater, once the heart failure, it will affect the patient's life span, chronic heart failure 5 years mortality rate of 50%.
2. How to diagnose myocardial infarction
When a patient develops chest pain, or symptoms similar to angina, if the chest pain lasts more than 15 minutes, it is suspected that a myocardial infarction may occur, but myocardial infarction cannot be diagnosed based on chest pain. Because we said that chest pain is just a symptom, there are many diseases hidden behind it.
At this time, you need to do an electrocardiogram, through the ELECTROCARDI observation, if the ECG has ST segment arched dorsal elevation, or T wave high tip, then you can combine chest pain + ELECTROCARDI, and then confirm the diagnosis of myocardial infarction.
Of course, there is also a non-ST-segment elevation myocardial infarction, which cannot be diagnosed by electrocardiogram, and requires blood testing for troponin or myocardial enzymes, and then combined with the symptoms of chest pain to confirm myocardial infarction.
3. How to rescue myocardial infarction
When myocardial infarction is suspected, it is recommended to lie down or sit down first, and then dial 120.
After 120 arrives, an electrocardiogram will be performed, and most of the myocardial infarction can be diagnosed after the ECG is done, and 120 will contact the chest pain center and start the catheterization chamber. After the patient is taken to the hospital, thrombolytic or stenting is recommended. This is currently the only two ways to rescue myocardial infarction.
4. How to prevent myocardial infarction
The essence of myocardial infarction is that the blood clot blocks the heart vessels, and the predecessor of the thrombus is a plaque.
Therefore, to prevent myocardial infarction, we must first prevent blood clots, and preventing blood clots is to prevent the rupture of plaques of angina, and if you have symptoms of angina, you must see a doctor immediately. Angina is myocardial infarction in the police, angina is treated regularly, then it can prevent angina from developing to myocardial infarction.
Of course, the basic prevention of myocardial infarction is to prevent plaque, and the cause of plaque formation is related to the three highs of hypertension, diabetes, hyperlipidemia, etc., so the prevention and control of three highs is the basis for preventing myocardial infarction. At the same time, we must develop a healthy lifestyle: stay away from tobacco and alcohol, adhere to exercise, eat healthy, control weight, do not stay up late, etc. These are the basis for preventing myocardial infarction.
Second, aortic dissection
1. What is aortic dissection
Acute myocardial infarction is when the arteries of the heart are blocked, and the aorta is a blood vessel that is several times larger than the heart artery, and it is also the largest artery in the human body.
Dissection is simply that there are several layers in the inner wall of the blood vessel itself, but now the aortic blood vessel is ruptured, a hole is broken, and there is an extra layer inside the blood vessel, which is called aortic dissection.
You think that the pressure of the human arterial vessels is very large, this aorta is the largest blood vessel in the human body, the pressure is greater, at this time it ruptures, it will bleed after rupture, under high pressure, the more the opening is torn, the mortality rate of the aortic dissection within 24 hours is 25%.
2. How to diagnose aortic dissection
When chest pain persists, especially tear-like chest pain, aortic dissection is highly suspected.
In addition to persistent pain in the forebreast, it may also present with interscapular area, or back and abdomen pain, which is severe and unbearable, and may be knife-cut or tear-like. It is often accompanied by hypertension, especially when there is a large difference in blood pressure between the two sides. At this time, the use of ECG can exclude acute myocardial infarction, then the chest enhancement CT can be performed immediately to confirm the diagnosis of aortic dissection.
3. How to rescue aortic dissection
In the case of chest pain, it is possible to prevent and control blood pressure and control heart rate treatment.
After the diagnosis of aortic dissection, according to the classification, the method of immediate surgery and selective surgery is differentiated. The surgical method can be a stent or a surgical procedure.
4. How to prevent aortic dissection
50.1% to 75.9% of patients with aortic dissection have a history of hypertension. Therefore, controlling blood pressure is an effective way to prevent most aortic dissection.
3. Pulmonary embolism
1. What is pulmonary embolism
Pulmonary embolism refers to the blockage of pulmonary blood vessels by blood clots. The function of the lungs is breathing, when the pulmonary blood vessels are blocked, the lung function will be restricted, then there will be difficulty breathing, and even sudden death.
2. How to diagnose pulmonary embolism
When pulmonary embolism occurs, it may also present with chest pain, or chest tightness, difficulty breathing, fatigue, and sweating. Blood pressure decreases, heart rate increases, and oxygen saturation decreases.
At this time, an ELECTROCARDI is required, and the ECG of pulmonary embolism is manifested as: I-lead S-wave, lead III Q-wave + T-wave. At the same time, the diagnosis needs to be confirmed by enhanced CT!
3. How to rescue pulmonary embolism
When pulmonary embolism is confirmed, thrombolytic therapy or anticoagulation is chosen, depending on the degree of risk of pulmonary embolism.
4. How to prevent pulmonary embolism
For people who have no other diseases, prevention is actually to be active, because sedentary and inactive, slowing down blood circulation, is prone to thrombosis, especially pulmonary embolism. Patients who are bedridden for a long time mainly turn over and pat their backs to assist in activity; people with clear blood clots need formal treatment to prevent thrombosis from falling off.
In short, chest pain is no small matter, when chest pain occurs, especially chest pain that lasts for 15 minutes and is still not relieved, we must see a doctor immediately, at this time we would rather believe that it has, not trust it, at least do an electrocardiogram, measure a blood pressure, no harm!