After myocardial infarction, treatments that need to be adhered to include medication, including lifestyle. It's really about living long.
There are really some patients with myocardial infarction, feel that there is nothing to do, they stop the medicine, eat and drink do not care. However, myocardial infarction is not a lifelong immune infectious disease, and it will recur without paying attention to prevention.
The purpose of treatment after myocardial infarction is to prevent coronary heart disease, prevent recurrence of myocardial infarction, protect heart function, and ultimately reduce the disability and death of cardiovascular disease.
Although the stent is placed and the blood vessel is opened in the acute myocardial infarction, the atherosclerosis is still there, the risk factors of the individual are still there, the myocardium of the infarction is still there, and the myocardium will have problems in the repair, which cannot be solved by the stent. Therefore, follow-up treatment must be adhered to.
To sum up, there are four main aspects of drug treatment:
★ Anti-atherosclerosis, prevention of thrombosis treatment
It is cholesterol lowering and antiplatelet resistance, these two treatments are the basic treatment for patients with coronary heart disease.
LDL cholesterol is the pathological basis of atherosclerosis, coronary heart disease patients are required to drop to less than 1.8 mmol / L, more than one myocardial infarction, or myocardial infarction combined with stroke, risk factors patients, such as diabetes, hypertension, renal insufficiency patients, previously let go of stent bypass, family history, smoking patients, but also required to drop to less than 1.4 mmol / L. It has been proven that lowering LDL cholesterol can reduce the occurrence of myocardial infarction. Therefore, it is not only necessary to take medicine, but also to check whether the blood cholesterol is up to standard.
Antiplatelets are designed to prevent arterial thrombosis. After the stent is placed, in order to prevent the formation of blood clots in the stent, it is also necessary to strengthen the antiplatelet resistance. Two antiplatelet drugs are generally used, aspirin plus clopidogrel, or aspirin plus tigrelor, usually taken for 1 year, and then changed to a single drug.
★ Anti-myocardial ischemia, prevention of sudden death treatment
Although patients with myocardial infarction have opened blood vessels, sometimes the opening is incomplete, and multiple vascular lesions cannot be stented, so there may also be myocardial ischemia. Ischemia and infarction of the myocardium can affect the function of the heart, can also cause arrhythmias, and even cause sudden death. Therefore, many patients also need anti-ischemic therapy.
Among the anti-myocardial ischemia drugs, "lol" β blockers such as metoprolol and bisoprolol have both anti-myocardial ischemia effects and improve cardiac function, and can also prevent sudden death. Therefore, patients after myocardial infarction should adhere to the drug as long as there are no contraindications.
Other antianginal drugs, such as isosorbide mononitrate mononitrate (imdo, xinkang) of the nitrate class, isosorbide nitrate (analgesia), etc., can be discontinued without angina and without myocardial ischemic attacks.
★ Treatment that prevents "reconstitution" of the heart muscle and protects cardiac function
After myocardial infarction, the heart will be repaired, but the repair material is obviously not as good as the "original". Because the myocardium cannot regenerate after necrosis, the repair material is some matrix and scar tissue, which is called cardiac "remodeling" (remodeling). The use of such materials will affect the function of the heart, so it is necessary to resist. It is necessary to suppress the excessive proliferation of the heart during the "reconstruction" process to prevent the heart from expanding and reducing the function of the heart. Drugs mainly include "lore" β blockers and inhibitors of the angiotensin system such as "puly" or "satan".
These drugs are also the basic drugs for the treatment of heart failure, but they all have the effect of lowering blood pressure. After myocardial infarction, some patients will have lower blood pressure, which is not that hypertension is cured, but that heart function is impaired. Therefore, when using these drugs, pay attention to the start of small doses.
★ Control of treatment of associated risk factors
Patients with coronary heart disease often combine many risk factors such as hypertension, diabetes, hyperlipidemia, etc., as well as some lifestyle problems, such as smoking and drinking, obesity, inactivity, mental and emotional problems, which are related to atherosclerosis progression and organ lesions, which need to be carefully controlled. For patients with coronary heart disease, heart failure, or diabetes, blood pressure is required to drop below 130/80mmHg.
Say a little bit about the problems that should be paid attention to in the review.
That is, be sure not to do nothing, just to see how many coronary cords are blocked to do coronary CTA (contrast).
After the death of myocardial infarction, if the condition has changed, angina recurs, and the drug control is not good, it is necessary to review. But it's important to note that don't just look at the blood vessels and do coronary CTA. Because the coronary CTA is to create a contrast agent, the contrast agent is excreted by the kidneys, which will increase the burden on the kidneys, which is even more unfavorable to patients with poor kidney function, and a small number of people will also cause "contrast agent (contrast agent) kidney disease". Patients with coronary heart disease, the renal artery itself can have lesions, there may be renal function loss, hypertension, diabetes patients will also have kidney damage, elderly patients kidney function is also reduced, so be careful.
A healthy lifestyle is indispensable in the treatment of myocardial infarction.
We'll talk about that in the next article.
Note: All treatments must be carried out under the guidance of a doctor!
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