Letter A
A includes two words, the first is the familiar aspirin, and the second is anti-angina medicine. That is, A stands for aspirin and antianginal drugs.
For the treatment of coronary heart disease, the clinical practice is generally divided into two parts, namely the treatment of symptoms and the treatment of the cause.
In the past, the drugs used in the clinical treatment of coronary heart disease were all symptomatic, such as nitroglycerin, which everyone is very familiar with, which can quickly relieve angina pectoris after sublingual administration. At this time, the patient's angina is improving, but the underlying cause of the angina is not resolved. That is, the survival rate of patients does not improve by improving the onset of angina.
Later, it was found that coronary heart disease is a disease caused by arteriosclerosis, in which the blood vessels first harden, then slowly narrow, and finally thrombosis blocks the blood vessels, causing myocardial infarction.
Therefore, improving arteriosclerosis is the first priority, and avoiding thrombosis is the second. Aspirin is an antiplatelet drug that has a certain effect in reducing thrombosis and can improve the prognosis of patients to a certain extent, that is, it can prolong the survival of patients, but no amount of aspirin can relieve angina.
It's always not good if people get sick and don't relieve their symptoms, so anti-angina drugs are still needed. Although antianginal drugs do not necessarily provide a longer survival time, they can relieve symptoms and reduce suffering.
Therefore, for the treatment of coronary heart disease, it is necessary to focus not only on the etiology, pathology, but also on the symptoms. It is necessary to treat both the symptoms and the root causes!
Letter B
B also includes two words, the first is β receptor blocker (β-blocker), which has anti-angina effects and improves prognosis. In addition to improving myocardial oxygen consumption and relieving angina, these drugs can also reduce the occurrence of arrhythmias. Myocardial infarction causes the most frequent deaths within the first 24 hours. Sudden death is caused by a sudden malignant arrhythmia, such as ventricular tachycardia (ventricular tachycardia) and ventricular fibrillation (ventricular fibrillation). β blockers, on the other hand, can reduce the risk of arrhythmias, thereby reducing mortality.
The second is blood pressure control. If high blood pressure (the precursor to coronary heart disease) is not well controlled, persistently high blood pressure can lead to arteriosclerosis. As soon as the walls of the blood vessels were wiped clean, the dirt immediately grew back on, don't you say?
Letter C
C also includes two words, the first is cholesterol. Atherosclerosis is caused by damage to the endothelial cells of the blood vessels due to various causes, followed by the deposition of cholesterol on the walls of the blood vessels to form plaques and finally blockages. Therefore, cholesterol control is also an upstream problem in the treatment of coronary heart disease, especially to reduce LDL a little.
C also stands for cigarette. Smoking can make the walls of people's blood vessels no longer smooth, so that cholesterol can easily adhere and deposit in the blood vessels.
Letter D
D also includes two words, the first is diabetes, which is also talking about the control of upstream diseases. If the high blood pressure in B, the cholesterol in C, and the diabetes in D are not controlled, then the whole treatment of high blood pressure is only aimed at the result, not the cause. Therefore, the control of diabetes is also a very important link.
D also stands for diet, that is, a diet that requires high protein, high dietary fiber, low salt, low fat, and low sugar.
Letter E
This time, the two are not drugs, the first is exercise. If you want to treat coronary heart disease well, you must make lifestyle changes in addition to taking medication, including diet and exercise. Adults are advised to get at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity (or equivalent combination of moderate-intensity and vigorous-intensity physical activity) per week, and reduce sedentary lifestyles to reduce cardiovascular risk!
E also stands for education, that is, doctors or medical service institutions should popularize the knowledge of coronary heart disease prevention and treatment to the public, so that everyone can understand the logic behind these practices, so that patients will consciously adjust their lifestyles (diet, exercise, work and rest, etc.), and will better understand the treatment plan prescribed by the doctor, know why to take this medicine, and take the medication compliance will be better.
Summary: A is aspirin and antianginal drugs, B is β blockers and hypertension control, C is cholesterol control and smoking abstinence, D is diabetes control and diet control, and E is active exercise and patient education.
Doctor-patient Q&A
patient
Some time ago, there were three treasures of myocardial infarction first aid, namely a needle, a pill, and a glass of water.
doctor
A needle?!Prick your finger with a needle and bleed, it's unreliable!
In ancient times, there were needles that prick the fingers, mainly used to treat people who have fainted. The anxiety and tension caused by strong stimulation will increase the body's myocardial oxygen consumption!
An aspirin?!
Aspirin can only inhibit platelet activity 5~7 days after taking it. For immediate action, you need 3 capsules (300mg), and you must chew it! This is only a temporary inhibition of platelet aggregation, and it is useless for blood clots that have already formed!
patient
I've heard that nitroglycerin works better, is that really the case?
doctor
If your blood pressure is very high at the time of the onset, you can take nitroglycerin under the tongue, but not more than 2 capsules! Nitroglycerin will cause side effects such as low blood pressure and headache! If you have a blood pressure monitor at home, you may wish to measure your blood pressure, if your blood pressure is already very low, you can't take nitroglycerin.
patient
Patients with myocardial infarction can't sit, can only lie down, is it reliable?
doctor
When a person has a myocardial infarction, the heart is very fragile and has no strength to support the sitting position, so how to lie down comfortably! The above content is only applicable to angina pectoris or myocardial infarction of coronary heart disease!
patient
Does chest pain have to be angina or myocardial infarction?
doctor
Chest pain can also be caused by pneumothorax, pleurisy, lung cancer, pulmonary embolism, aortic dissection, acute pericarditis, esophagitis, diaphragmatic hernia, fractures, neurosis, ......
patient
What should we do if we have chest pain?
doctor
Finding a comfortable position to lie down and calling the "120" emergency number is the right way!
Content Sources:
People's Medical Publishing House published "Cardiac Instruction Manual"
Author:
Cui Song, an expert of the National Health Science Popularization Expert Database and chief physician of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine
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