Mr. Zhang, 63 years old, suddenly suffered a myocardial infarction and was sent from the emergency department to the catheterization room, and suddenly had ventricular fibrillation.
Thanks to the presence of doctors and defibrillators in the hospital, the patient's heart returns to beating only after an immediate electric shock to defibrillation. In fact, Mr. Zhang could have defused this heart bomb 1 month ago, but because he did not want to stent and did not believe in stent, he dragged it until now and almost lost his life.
More than a month ago, Mr. Zhang had symptoms of episodic chest pain, which occurred most of the time when he went upstairs, walked fast, and exerted force. There are also cases that occur during breaks. Moreover, the number of seizures at that time was also relatively large, and then I went to the hospital emergency department.
The cardiovascular doctor looked at it and confirmed that Mr. Zhang belonged to unstable angina and should be hospitalized and should be examined. Otherwise, there is a risk of myocardial infarction, but Mr. Zhang is very resistant to hospitalization, resistance to contrast, resistance to stents.
In the end, he was reluctant to be hospitalized and asked the doctor to prescribe him some medicine to eat first. Doctors then prescribed him aspirin and tertin to prevent myocardial infarction, as well as drugs such as diltiazem to control angina.
The patient went home after taking the medicine and took the medicine when he returned home, but he still had repeated seizures. Later, I heard that drinking soup medicine can be cured, so I found a master, opened 21 pairs of soup medicine, and said that after eating, I could control it, and after controlling it, I could eat it for half a year.
During this month, Mr. Zhang still had angina pectoris, basically did not dare to go downstairs, stayed at home, and sometimes did not dare to eat too much, otherwise he would have chest pain. The soup medicine was finished, but there seemed to be no obvious improvement, and I planned to go to the master again to see if it was necessary to adjust the medicine.
I didn't expect that at 10 a.m., I would have chest pain again, and it was significantly worse than before, accompanied by heavy sweating, and it did not relieve. Because 1 month ago, cardiovascular doctors said that if not hospitalized may have myocardial infarction, if the chest pain must be beaten 120, otherwise there is a risk of sudden death.
Therefore, after Mr. Zhang's chest pain for 15 minutes, he let his family immediately hit 120, which was sent to the hospital in time. If you are 5 minutes late, ventricular fibrillation occurs outside the hospital, and there is no defibrillator, Mr. Zhang will be gone today.
After defibrillation, the patient is sent into the catheterization chamber, and the contrast reveals that the proximal end of the right blood vessel is 99% stenosis, which we call subtotal occlusion. The blood vessels were then opened and the patient was taken back to the intensive care unit.
It's not good to say, I knew so, why did I have to do it in the first place? Tossing for 1 month, risking his life, and finally being treated with stents.
When is cardiac imaging required?
1. Patients with myocardial infarction
Just like today's patient, who has had an acute myocardial infarction, then we have to open the blood vessels. If you want to open the blood vessels through balloons and stents, you must first do an imaging to see which blood vessel is blocked and where it is blocked. Therefore, patients with acute myocardial infarction need to have an contrast examination to prepare for the opening of blood vessels.
2. Patients with angina who cannot be controlled by drugs
Or this patient, 1 month ago, in fact, already belonged to the unstable angina, when the patient also used a lot of drugs, whether it was aspirin, statin, or drugs to control angina, and later he took the decoction medicine. In fact, they are all used, but they still have angina. So what to do in this case?
Who can tell you what to do?
In addition to the contrast to see how narrow the blood vessels are, there is another way, obviously there is no, at this time the contrast is the only way.
If you have done the imaging a month ago, you have found a narrow blood vessel, and you have also solved this severe stenosis by stenting. Then there will be no myocardial infarction today, no ventricular fibrillation today, and no life-threatening. There will also be no myocardial necrosis, and there is no risk of heart failure later.
However, because he did not listen to the advice of the cardiovascular doctor, but thought that he could control it by taking medicine, he had a myocardial infarction and almost lost his life.
3. There is evidence of severe coronary heart disease: positive exercise test, coronary CT suggests severe stenosis, ECG suggests arterial STT changes, myocardial ischemia, ecG new complete left bundle branch block. Cardiac angiography is required for unexplained cardiomyopathy, unexplained left heart failure, unexplained arrhythmia, and unexplained chest pain.
Angina is a bomb, we dismantle it, we can be safe, we did not remove this bomb, it will explode at any time, that is, myocardial infarction, there will be life danger.
The omen of myocardial infarction is angina, what kind of pain is angina?
1. The part of pain: mainly chest pain, or anterior heart pain, but it will also have toothache, headache, shoulder pain, back pain, abdominal pain.
2. The nature of pain is more common than stuffy and squeezing pain, like a stone pressed on the chest.
3, there is also no pain in angina, just because some of the angina is not painful, so many people ignore, some angina is only manifested as chest tightness, sweating, nausea and vomiting, throat and eye tightness and other symptoms.
4, the duration of time: generally about 3-5 minutes, rarely less than 2 minutes, almost impossible is a few seconds. Generally angina does not exceed 15 minutes.
5. Accompanying symptoms, general angina In addition to the symptoms mentioned above, it is often accompanied by chest tightness and sweating.
There are more to say, it is difficult for everyone to remember, so is there an easier way to make a preliminary judgment?
The simple judgment is that there is no above discomfort in normal times, and recently in the case of activity, labor, fatigue, running, exercise, etc., the above uncomfortable performance will appear, which lasts for a few minutes each time, and needs to stop and rest for a while, and rest for a few minutes can be relieved. It is precisely because the angina will be relieved in a few minutes, so it will be ignored by many people and think that it is all right.
Don't you know that every time angina is a myocardial infarction in the police, once angina occurs, you must see a doctor in time, otherwise the next angina may develop into myocardial infarction! Some people also asked, what if the symptoms mentioned above do not alleviate for 15 minutes? Our old classmates (old fans) all know that it means that they may have died of myocardial infarction!
Mr. Zhang 1 month ago is a typical angina, go upstairs, go fast after the chest pain, rest will also occur, that is, unstable angina, it is easy to myocardial infarction, but do not want further treatment, but chose conservative drug treatment.
Some diseases have developed to a certain stage, and they can no longer rely solely on conservative treatment.
Missed the opportunity for conservative treatment, and later missed the opportunity of angina stents, do you have to wait until myocardial infarction to go to stents?
However, many people are not as lucky as Mr. Zhang at all, and they can't come to the hospital at all!