Family Medicine,2024,(02):4-5.
Family Medicine,2024,(02):6.
[3] Zhang Hao, Zhang Rong.Yuhuan: Rushing for the "first kilometer" of myocardial infarction treatment[N].Taizhou Daily,
52-year-old Uncle Zhang is a farmer, down-to-earth and capable. In the eyes of his neighbors, he didn't shirk asking him for help, and in the eyes of his family, he was a representative of thrift. But this is also his problem, every time he is unwell, he neither takes medicine nor goes to the doctor. In his words, it's just a small problem, just bear with it.
In June 2012, because of the hot weather, the vegetables in the field were dried, so Uncle Zhang would pick time to water the field every day. The summer rain is coming, Uncle Zhang because he didn't avoid it in time, he caught a cold in a heavy rain, and when he got home, his head was dizzy, he touched his head, he didn't feel a fever, and he thought that a small cold would get better on his own, so he didn't take it seriously.
Since then, Uncle Zhang will always be dizzy and chest tight. He thought it was because he caught a cold from the rain last time, and because he was old and his body had become weak, he would be like this. So I asked my wife to stew chicken soup for herself, and I ate chicken soup for a few days in a row, and then I didn't feel unwell, so I didn't take it to heart.
On September 12, 2012, when Uncle Zhang was planting vegetables in the field, he suddenly had a burning sensation behind the sternum, accompanied by a feeling of suffocation, and the pain was so painful that he couldn't stand it, his facial meridians burst out, and he was sweating profusely, so he quickly sat down to rest, and disappeared in about 3 minutes. For the first time, Uncle Zhang realized that death was so close to him, and he didn't grow vegetables anymore, so he hurriedly went home and asked his son to take him to the hospital quickly.
After arriving at the hospital, the electrocardiogram showed no abnormality, Uncle Zhang breathed a sigh of relief, and thought there was no problem, the doctor told him that it was useless for him to do an electrocardiogram in this situation, and his symptoms were similar to angina, angina pectoris is caused by insufficient blood supply to the coronary arteries, temporary ischemia and hypoxia of the myocardium, and is common in middle-aged and elderly people.
It is recommended to stay in the hospital for observation, and it is best to do a 24-hour Holter ECG, which is a 24-hour long-term record of the ECG changes of the human heart in active and quiet states, which can determine the frequency of angina attacks and the location of myocardial ischemia.
After listening to the doctor's words, although Uncle Zhang felt that it was very troublesome, he still did it under the persuasion of his son. Unexpectedly, the second chest pain came so quickly, my son hurriedly rang the bedside bell to call for help, and the medical staff came quickly, and immediately asked Uncle Zhang to take nitroglycerin and lie down to rest.
After a few days in the hospital, Uncle Zhang had nothing to do every day, and he felt uncomfortable, so he wanted to go home, and when he was discharged from the hospital, the doctor told him that angina attacks were very frequent, and he must take nitroglycerin with him, and take it out immediately when he had an attack, which can save his life.
Uncle Zhang listened to the doctor's words very much, and immediately did it when angina occurred, but the only bad thing was that he was dizzy every time he ate it, and he thought that the doctor also prescribed Danshen Dripping Pills, and read the instructions on this medicine, which can also be used for coronary heart disease and angina, and then there were several angina pectoris, and taking this medicine also had an effect, so he took this medicine with him.
On May 12, 2013, Uncle Zhang's chest pain recurred while working in the fields, and he immediately sat down to rest and took out his medicine. But unlike before, this time the chest pain was not relieved after more than ten minutes, and the pain also radiated to the left shoulder, this person couldn't breathe, his face was pale, he broke out in a cold sweat, and he didn't even have the strength to call for help, and finally he was found by the passing Lingju, and immediately called 120 and sent to the hospital.
After the ambulance arrived, the medical staff gave Uncle Zhang cardiopulmonary resuscitation, and immediately did an electrocardiogram examination, which showed that the ST segment was significantly elevated, the T wave was inverted, and the pathological Q wave occurred.
This situation is critical, and coronary artery stenting is required through the emergency green channel. Coronary artery stent implantation is to permanently place a metal stent at the coronary artery lesion, and the balloon dilation release supports the blood vessel wall, so that the stenosis is expanded, blood flow is restored, and the myocardial ischemia site is reperfused, thereby reducing the mortality rate of acute myocardial infarction.
After Uncle Zhang woke up 6 hours after the operation, he wondered why he had taken Danshen Dripping Pill to no avail. During the doctor's rounds, he raised his doubts, and the doctor didn't understand his behavior very much, and said: "Why do you take Danshen Dripping Pills, didn't you tell you to take nitroglycerin with you before, if you don't send it in time, ventricular fibrillation occurs, and Daluo Immortal will not be able to save you!"
Uncle Zhang listened to the doctor's words, he didn't expect angina pectoris to become a heart attack, and he didn't expect that Danshen Dripping Pill could not be used for first aid, and he felt that this time it was simply an escape from death, and the doctor joked that Uncle Zhang would not die in a big disaster, and also told Uncle Zhang that in the event of a myocardial infarction, Danshen Dripping Pill could not be used for first aid, and the most suitable drugs for first aid were these two medicines!
Although Danshen Dripping Pill is clinically used to treat cardiovascular diseases such as coronary heart disease and angina, and has the effect of invigorating blood circulation and removing blood stasis, and relieving pain through menstruation, when acute myocardial infarction occurs, oral Danshen Dripping Pill does not have the effect of sublingual nitroglycerin, because sublingual administration is a rapid blood flow through the vein, but oral administration must be digested and absorbed through the digestive tract.
Although Danshen Dripping Pill can eliminate chest tightness and precordial pain caused by blood stasis, the blood circulation and stasis removal effect of Danshen Dripping Pill in myocardial infarction is not enough to open the occlusion of coronary arteries and restore the blood supply to myocardium, therefore, for rescuing patients with acute myocardial infarction, taking Danshen Dripping Pill is useless, and may even delay the timing of treatment and increase the danger of patients.
The first type of rescue medicine is nitroglycerin
The reason why it can be used as a first-aid drug is that nitroglycerin is taken sublingually, absorbs quickly, can have a rapid effect, and by dilating the coronary arteries, increasing blood flow, so that the supply of myocardial oxygen and reducing ischemia, thereby reducing angina, but in the event of angina, if nitroglycerin is not relieved after 5 minutes, it can be repeated every 5 minutes, and if it is not relieved after three consecutive times, it is necessary to be alert to myocardial infarction and go to the hospital immediately. For example, nitroglycerin may cause low blood pressure, so it is best to lie down and rest when taking the medicine to avoid dizziness and falls.
The second type of rescue medicine is aspirin
Aspirin helps inhibit platelet aggregation and prevent thrombosis, and can also dilate coronary arteries, promote blood flow to the heart, improve myocardial oxygen supply, and in addition to emergency medication in myocardial infarction, after ischemic stroke, aspirin can also delay the disease and prevent blood clots from continuing to grow. And it can reduce the incidence of cerebral infarction again and reduce the mortality rate of myocardial infarction, but aspirin may cause gastric ulcers and tinnitus for the elderly, so in the event of adverse reactions, the doctor should be informed in time and the drug cannot be discontinued privately.
If there are middle-aged and elderly people in the family, it is still recommended to include these two in the family first aid kit. In case of a heart attack, the first aid time can be extended. When a heart attack occurs, the patient should immediately call 120 or go to the nearest hospital for treatment, instead of taking medicine indiscriminately like Uncle Chen.