Mr. Wang, aged 42. Suffering from high blood pressure for more than five years, some time ago I occasionally saw chest tightness, but after a while it eased on its own, Mr. Wang did not care, this morning suddenly felt chest tightness and breathing difficulties, after a while there was still no relief, the family saw the situation, and rushed Mr. Wang to the cardiovascular disease ward of the hospital.
After 10 minutes of oxygen inhalation, the symptoms of chest tightness and dyspnea disappeared, and the blood pressure was measured at 125/90mmHg, and the blood lipids were measured, and the blood sugar was normal. Through the ELECTROCARDI, the St-t segment abnormality was found, the coronary angiography CT found that the blood vessels were narrowed, affecting blood flow, the degree of coronary artery stenosis was about 50%, and the coronary heart disease was diagnosed, and the exercise balance test confirmed that Mr. Wang was coronary heart disease myocardial ischemia.
Through consultation, it was decided to control myocardial ischemia by means of drug therapy, drug therapy through antiplatelet drugs and β receptor blockers, while conducting health education for Mr. Wang, reducing the risk of myocardial ischemia by changing lifestyle, after three months of review, Mr. Wang's indicators are all normal, Mr. Wang's treatment plan is very effective, let us follow Mr. Wang's cardiovascular doctor to understand how to treat myocardial ischemia in coronary heart disease, before that we need to know what causes myocardial ischemia.
Causes of coronary heart disease myocardial ischemia
When we have coronary heart disease myocardial ischemia, there will be some symptoms, the most important state is manifested as chest pain, chest tightness, shortness of breath, palpitations, etc., and sometimes there will be difficulty breathing.
Sometimes the symptoms of dyspnea can be relieved by themselves, dyspnea symptoms, critical situations may lead to myocardial infarction, so when there are symptoms of dyspnea, we must first rest immediately, there is no relief after five minutes, call the emergency telephone in time, chest pain, chest tightness, shortness of breath, palpitations symptoms, to go to the hospital in time for relevant examinations.
In addition to these obvious symptoms, there will be fatigue, lack of energy, etc., this symptom is not easy to detect, it is difficult to be found by patients, there are some asymptomatic myocardial ischemia patients, asymptomatic patients occasionally have nausea, toothache and other conditions, family history of coronary heart disease, we should have regular physical examination.
Myocardial ischemia is not strictly a disease, but a pathological critical state of coronary heart disease. Myocardial ischemia refers to the inability of blood supply to meet the consumption, so the causes of myocardial ischemia can be divided into two types, one is myocardial ischemia caused by reduced blood supply, the other is myocardial ischemia caused by increased consumption, myocardial ischemia caused by reduced blood supply is endogenous causes, and myocardial ischemia caused by increased consumption is exogenous.
1. Endogenous causes
(1) Cardiogenic factors
People with lower heart function and abnormal energy conversion function of cardiomyocytes are more likely to develop myocardial ischemia. Cardiogenic factors can be simply understood as congenital heart disease, congenital heart disease is an important cause of myocardial ischemia, the main treatment methods of cardiogenic myocardial ischemia are two, one is through drug control and heart pumping function exercise, enhance myocardial oxygen supply, and the other is to rebuild heart function through heart transplantation.
Most patients are mainly drug control, heart transplant surgery has a high risk of rejection, low adaptability, and greater risk, while long-term control of drugs is safer, and with other ways can also avoid myocardial ischemia.
(2) Blockage of blood vessels
Blood vessel blockage is one of the important causes of myocardial ischemia, and blocked blood vessels mean that blood cannot pass normally, resulting in a decrease in blood supply to the heart area. There are many reasons why blood vessels are blocked, of which thrombosis and lipid plaques are important reasons, thrombosis is related to too many platelets, blood lipid plaque formation is related to blood lipids, high blood sugar, so some primary diseases may lead to myocardial ischemia, hyperlipidemia, diabetes, etc. May induce myocardial ischemia.
(3) Insufficient blood flow power
Insufficient blood flow power will affect the speed of blood flow, resulting in a decrease in the blood flow supplied to the heart per second, resulting in insufficient blood flow power mainly because of large blood resistance, the main reason for the increase in blood resistance is because of high blood viscosity, the higher the viscosity of blood, the greater the resistance of blood vessels, the hematocrit is an important factor that determines the blood stickiness system, the more platelet cells, the higher the blood viscosity, the greater the vascular resistance.
In addition to the hematocrit affecting blood viscosity, the size of the diameter of blood vessels and body temperature also affect blood viscosity, which increases with decreasing temperature.
Therefore, it is necessary to ensure that the blood flow is sufficiently motivated, to ensure that the platelet cells are normal, and to ensure that their own temperature is normal and not too low.
(4) Abnormal vasoconstriction
Blood pressure is also an important cause of myocardial ischemia, excessive blood pressure will lead to insufficient blood flow, so patients with hypertension should control blood pressure in time to avoid muscle ischemia.
Mr. Wang mentioned above has more than five years of hypertension, there is no precursor to the occurrence of myocardial ischemia type, and it is not until the breathing difficulty is sent to the hospital to be diagnosed with myocardial ischemia, which means that the risk of myocardial ischemia in patients with hypertension is higher than that of ordinary people, so patients with hypertension should closely observe their own body changes, and when there is mental poorness, fatigue, chest tightness and other phenomena, they should go to the hospital in time.
2. Exogenous causes
Endogenous myocardial ischemia is caused by insufficient blood supply, exogenous myocardial ischemia is mainly caused by too much blood consumption, strenuous exercise, overwork and other myocardial oxygen consumption of the exercise induced myocardial ischemia, so patients with myocardial ischemia should not be overworked, prone to myocardial ischemia people should also pay attention to rest, reduce myocardial oxygen consumption, you can prevent exogenous myocardial ischemia.
When we have symptoms of myocardial ischemia, we must go to the hospital in time and treat it as soon as possible to avoid myocardial infarction in critical situations.
The best way to treat myocardial ischemia in coronary heart disease
The most effective way to treat coronary heart disease and myocardial ischemia is to take drugs for prophylactic treatment for a long time, and the other is to reconstruct blood vessels through surgery and other methods.
(1) Medication
Drugs for myocardial ischemia are basically the same as drugs for coronary heart disease, we know that too high blood concentrations can lead to myocardial ischemia, so we need to ensure that the blood concentration is normal, prevent too many platelets, and do not use antiplatelet drugs to prevent thrombosis and prevent blood clots from blocking blood vessels.
In addition to antiplatelet drugs, we also need to use β receptor blockers, blockers can effectively reduce myocardial oxygen consumption, fundamentally solve the problem of large oxygen consumption and supply, blockers generally need to be taken for a long time, when using to monitor the heart rate, during the medication there is a slow heart rate, please immediately stop the drug to go to the hospital for examination, under the guidance of the doctor, adjust the dose according to the change in heart rate.
In addition to β receptor blockers can slow down oxygen consumption, calcium antagonists can also reduce oxygen consumption, but also have the effect of dilating blood vessels to increase myocardial blood supply, the specific use of which drug needs to be used under the guidance of a doctor according to the cause of medication.
(2) Blood circulation reconstruction
Reconstruct blood transport through interventional surgery or surgical coronary artery bypass surgery, which is suitable for patients with severe vascular blockage, as well as for patients with critically ill myocardial ischemia.
In addition to the necessary drug therapy and revascularization therapy, it is also very important to reduce the risk of myocardial ischemia in daily life, and we should maintain a healthy lifestyle and reduce the risk of myocardial ischemia.
How can the risk of myocardial ischemia be reduced in daily life?
1. Avoid irritating the heart and avoid bad habits
Myocardial ischemia is a heart disease state, in order to prevent myocardial ischemia, we must stimulate the heart less, and maintain a good mood in ordinary life and lose less tantrums. Patients with myocardial ischemia should do less stimulating exercise to ensure that the heart runs smoothly.
Patients with myocardial ischemia should ensure adequate sleep, insist on going to bed early and getting up early, not staying up late, smoking and drinking alcohol have great damage to blood vessels, smoking and drinking will also affect the functional transformation of cardiomyocytes, so we should smoke less and drink less.
2. Healthy eating
Diet has a great impact on cardiovascular disease, a healthy diet is conducive to preventing the occurrence of cardiovascular diseases, is conducive to reducing the risk of myocardial ischemia, myocardial ischemia patients to ensure that the daily diet should be less salt and less fat light diet, do not eat spicy and stimulating food, do not eat high fat, high sugar food, trans fatty acid food.
We should eat more fresh vegetables and fruits, high-quality protein, etc., vegetables and fruits are rich in vitamins and trace minerals, which are conducive to scavengering free radicals in the body, improving cell activity, and the cellulose in vegetables and fruits can promote the increase of the body's metabolic rate, which is conducive to cell metabolism and effectively reduces the risk of myocardial ischemia.
3. Exercise in moderation
Myocardial ischemia may be caused by overwork, which leads most people to believe that patients with myocardial ischemia cannot exercise, that patients with myocardial ischemia can exercise in moderation, and that moderate exercise can help reduce the risk of myocardial ischemia.
Patients with myocardial ischemia should choose exercise under the guidance of rehabilitation therapists, find a suitable exercise for themselves, myocardial ischemia patients can not do strenuous exercise, just before the beginning of the system exercise, it is recommended to take anaerobic exercise as the mainstay, the later stage can add gentle aerobic exercise, exercise should adhere to the gradual, before exercise to fully warm up, activate the body activity, stretch in time after exercise, improve muscle tolerance, enhance physical fitness to reduce the risk of myocardial ischemia.
4. Control the "three highs"
Control of hypertension, hyperlipidemia, hyperglycemia is conducive to reducing the risk of myocardial ischemia, to avoid critical situations of myocardial ischemia.
Blood pressure, blood lipids, blood sugar has a great impact on blood vessels, these three highs will affect the blood flow dynamics, so that the blood supply is reduced, the supply can not keep up with the consumption will make myocardial ischemia occur, so we should strive to control the three highs, so that it is controlled within the normal range, does not affect the normal blood supply.
The purpose of drug treatment is also to reduce the risk of myocardial ischemia, in daily life to do the above points can also reduce the risk of myocardial ischemia, to achieve the purpose of auxiliary treatment of myocardial ischemia, economic ischemia patients should strictly ensure a healthy lifestyle.
Coronary heart disease myocardial ischemia, the best treatment is to control the risk of myocardial ischemia for a long time through drugs, or to reconstruct blood circulation through surgery to reduce the risk of myocardial ischemia through a healthy lifestyle.
Mr. Wang mentioned above through drug treatment and healthy living habits, within three months to control the indicators of myocardial ischemia to the normal range, we can learn from Mr. Wang, in daily life to strictly demand ourselves.