In the world of medicine, there is an interesting saying: "the last straw that broke the camel's back". Meaning, sometimes a seemingly insignificant factor can aggravate a disease situation, like the last straw that crushes the camel's back. In the daily practice of doctors, it is often encountered that a seemingly inconsequential detail can become the key. Today I am going to talk about a real case of a patient with a myocardial infarction, which tells us that patients with a myocardial infarction should not ignore the "last straw" that breaks the camel's back - no reflow of myocardium.
A patient in his 50s came to our hospital with symptoms such as chest tightness and shortness of breath. After examination, acute myocardial infarction was confirmed, and we immediately gave relevant treatments, including thrombolysis and anticoagulation. However, after treatment, the patient's symptoms did not improve, and instead he developed persistent chest pain, difficulty breathing, etc. At this point, we realized that there might be a condition in which the myocardium did not reflow. After further examination, it was confirmed that there was no reflow of myocardium, and the treatment plan was immediately adjusted, and the patient's symptoms were significantly improved.
There is no cause of myocardial reflow
Vasospasm: After myocardial infarction, the surrounding myocardial tissue is damaged, releasing substances such as acetylcholine, which may cause coronary artery spasm, which in turn affects blood flow.
Thrombosis: After a myocardial infarction, damaged vascular endothelial cells release substances that cause blood to clot into blood clots, which can block the coronary arteries and prevent blood from flowing to the infarcted area.
Microcirculatory disorders: After myocardial infarction, the microvasculature around the infarcted area may be damaged, and microcirculatory disorders can lead to obstruction of blood flow, which in turn affects the blood supply to the infarcted area.
Reperfusion injury: in some cases, re-establishing blood flow may cause further damage to the myocardium in the infarcted area, a phenomenon called reperfusion injury, which may also result in no reflow of the myocardium.
Vascular structural abnormalities: Some patients have structural abnormalities of the coronary arteries, such as narrowing and crookedness of the arteries, which may increase the risk of myocardial non-reflow.
Myocardial reflow is a serious complication after myocardial infarction, which will seriously affect the prognosis and quality of life of patients. Therefore, it is important for patients with myocardial infarction to detect and treat myocardial reflow in a timely manner.
There is no sign of myocardial reflow
Persistent chest pain: Patients may experience chest pain, especially when active or emotionally agitated. This pain may be more persistent and difficult to relieve than during a heart attack.
Cardiac insufficiency: Because the heart muscle does not receive adequate oxygen supply, the heart's pumping function may be impaired, leading to symptoms of cardiac insufficiency, such as shortness of breath and fatigue.
ECG abnormality: the absence of myocardial reflow may lead to ECG abnormality, manifested as ST-segment changes, T wave inversion, etc.
Elevated markers of myocardial injury: serum markers of myocardial injury, such as troponin and creatine kinase, may be elevated, reflecting myocardial injury caused by the absence of myocardial reflow.
Arrhythmias: Some patients may have arrhythmias, such as ventricular arrhythmias, atrial fibrillation, etc.
Other symptoms: Non-specific symptoms such as nausea, vomiting, and sweating may also occur.
Myocardial reflow is one of the common complications of myocardial infarction patients, if the above symptoms occur, you should seek medical attention in time and follow the doctor's instructions for treatment to reduce the damage to the heart without myocardial reflow.
How to prevent myocardial reflow
Standardized medication: Take regular antiplatelet drugs (such as aspirin) and other drugs for cardiovascular disease as recommended by your doctor to prevent blood clots and further damage to the heart muscle.
Control blood pressure and blood sugar: Keeping blood pressure and blood sugar within the normal range can help reduce the occurrence and progression of cardiovascular disease.
Quit smoking and limit alcohol: Try to avoid smoking and alcohol abuse, which can increase the risk of cardiovascular disease.
Eat a healthy diet: Maintain a balanced diet, eat less high-fat, high-sugar foods, and eat more fruits and vegetables, whole grains, and low-fat dairy products.
Moderate exercise: Regular moderate aerobic exercise, such as brisk walking, swimming, etc., can help improve cardiovascular health.
Weight control: Maintaining an appropriate weight can help reduce the burden on the heart and reduce the risk of cardiovascular disease.
Regular physical examinations: Regular cardiovascular health check-ups to identify and control risk factors for cardiovascular disease in a timely manner.
Reduce stress: Avoiding excessive tension and stress and maintaining a good mood are beneficial for cardiovascular health.
In short, through a healthy lifestyle and active treatment measures, we can effectively prevent the occurrence of myocardial reflow, reduce the burden on the heart, and improve cardiovascular health.