"When you walk into the hospital, the wards and even the corridors are full of elderly people who come because of coronary heart disease."
Every year when the cold wave comes, the cardiology department and interventional department of the hospital are overcrowded, and the reason is the high incidence of "coronary heart disease" in winter. Coronary heart disease is a common cardiovascular disease that seriously endangers human health worldwide, and is known as the "number one killer" in many more developed regions of Europe.
With the improvement of the living standards of the Chinese people, its incidence is also increasing year by year, according to statistics, since the 50s of the 20th century, coronary heart disease has become the main cause of death in the mainland and even in the world. Subsequently, one of the main treatments for coronary heart disease, percutaneous coronary intervention (PCI), commonly known as "stent surgery", became known. When it comes to "stent surgery", the common people are also happy and worried.
1. What is cardiac stent surgery?
The actual full name of "stent" surgery is percutaneous coronary intervention (PCI), that is, the stent is implanted into the coronary artery stenosis through radial artery or femoral artery puncture to support the blood vessels at the lesion site to achieve the purpose of improving myocardial ischemia and hypoxia.
As early as the 1970s, foreign medical workers tried to use minimally invasive methods, using a catheter as thin as a syringe needle, through the puncture of the patient's peripheral blood vessels, into the heart, to find the location of the narrowed blood vessels in the coronary arteries, and then insert a balloon through the catheter to crush the atherosclerotic plaque.
More than 50 years later, this method of opening through the balloon has been replaced by metal implants, but the principle remains the same, which is the so-called "stent" surgery, which is the past and present of the so-called "stent" surgery.
2. Is there excessive medical treatment?
Any surgery always has its own indications for surgery, and judging whether you need to do stent implantation can be roughly judged from the following aspects:
1. Symptoms of acute myocardial infarction: The symptoms of acute myocardial infarction are mainly manifested in patients who often have severe pain in the precordial area or a feeling of suffocation, which mainly occurs in the chest, and some can radiate to the left ribs and left upper limbs.
This spontaneous feeling of suffocation, pressure, and pain lasts for more than 30 minutes, and the symptoms are not quickly relieved by rest or with medications such as nitroglycerin. For patients with acute myocardial infarction, it is recommended to go to the hospital immediately for PCI thrombolysis therapy.
2. Severe symptoms of heart failure: for patients with heart failure after myocardial infarction, the KilliP grading method proposed in 1969 is usually used for grading, for patients with grade 3 and above, it is recommended to undergo PCI treatment to improve the symptoms of cardiac ischemia, and the KilliP grading standard is: the patient is unable to complete daily work and activities, and the pulmonary crackles are > 50%, for such patients, it is also recommended to go to the hospital for PCI treatment.
In addition, for the people who are usually at home, there is a simple way to judge the heart function, that is, the 6-minute walk test (6MWT): that is, let the patient use the walking method to test the distance he can walk at the fastest speed he can bear within 6 minutes, which can better reflect the cardiac function of the patient's physiological state, and the commonly used grading method is:
Class 1 <300m ;
Level 2 300-380m;
Grade 3 380-450m;
Level 4 ≥450m
3. Patients who still cannot improve the symptoms of myocardial ischemia after adequate drug treatment.
3. Will the bracket affect my normal life?
Rumors about "stent surgery" can be said to be flying all over the sky, but for patients with coronary heart disease, the most concerned thing must be: after the stent is placed, will the myocardial infarction be repeated, will it affect daily life, and even how long can you live after surgery?
The answers to these questions can be explained from the following aspects:
1. Regular activity and exercise
First of all, after cardiac stenting, most patients can complete daily activities, or coronary heart disease patients with stent implants should be encouraged to exercise, exercise helps alleviate many risk factors of coronary heart disease, such as obesity, hypertension, hyperlipidemia, diabetes, etc., thereby reducing the progression of atherosclerosis and reducing the recurrence of severe ischemic disease.
For general coronary heart disease angina, the cardiac function is generally normal, the blood vessels are not completely blocked, and the problem of re-patency of the original severely stenotic blood vessels is completely solved after stent implantation.
For patients with acute myocardial infarction, after stent implantation, it is necessary to evaluate the status of other blood vessels in detail and the status of overall cardiac function, so as to formulate individualized exercise rehabilitation training, follow the guidance of doctors, and exercise step by step. One week after discharge, aerobic training 4-5 times a week for 30 minutes each time is appropriate, with slight sweating and no obvious discomfort as the judgment standard.
2. Continuous drug-assisted control
In addition, for some patients with chronic diseases, intensive drug therapy is also necessary. Secondary prevention of coronary heart disease has been one of the basic strategies for the prevention and treatment of coronary heart disease.
Since the 60s of the 20th century, cardiovascular doctors in various countries have also conducted large and small trials on the secondary prevention of coronary heart disease.
At present, specific measures for the secondary prevention of coronary heart disease include smoking cessation, healthy diet, weight control, appropriate physical exertion, weight control, blood lipid regulation, blood pressure control, antiplatelet and anticoagulation therapy
3. Have a good and optimistic attitude
Many patients will always have uneasiness, fear, anxiety, worry about the recurrence of myocardial infarction, worry about the side effects of long-term medication, etc.
A good attitude after surgery has always been one of the key points of attention for various diseases and post-operative rehabilitation, and an optimistic and positive life is always a good medicine with significant results.
conclusion
Overall, the purpose of "stent implantation" is definitely to make the patient's life better and more comfortable, and everyone does not need to talk about the color change of heart stents.
Through the overall assessment of your own situation, you can roughly judge whether you have to put a stent, after putting the stent, you don't have to be anxious, through scientific health management and life Xi, you can enjoy a good life.