Content Sources:
1. Zhao Mingyang, & Yang Guanying. (2019). Diagnosis and treatment of angina. Chinese Journal of Internal Medicine, 58(4), 282-285.
2. Dichen Liu, & Wei Wang. (2020). Recent advances in the treatment of myocardial infarction. Chinese Journal of Practical Internal Medicine, 40(1), 76-80.
3. Ma Xiaoguang, & Li Ming. (2018). New advances in the diagnosis and treatment of pericarditis. Chinese Journal of Cardiovascular Diseases, 46(3), 210-215.
In 2011, 47-year-old Li Wei was a salesman, who often drank alcohol for work and entertainment, and he also liked to eat something heavy. Since June, Li Wei has begun to have headaches at work, and sometimes when he is talking to others, he feels like his head is about to explode.
Since July, Li Wei has been numb in his hands and feet every morning, blurry when he sees things, and he can't see clearly. The numbness of the hands and feet is mainly caused by high blood pressure causing vasoconstriction and blockage, and the blood flow is reduced and cannot be supplied to the tissues in time. The difficulty in seeing is caused by ischemia of the optic nerve due to increased blood pressure, which damages the optic nerve.
The first few times, I thought it was because I slept for too long and pressed my hands and feet, but as the number of times increased, and even after numbness of my hands and feet and blurred vision every day, Li Wei finally realized the seriousness of the problem. After explaining the situation to his wife, Li Wei felt that he could not delay any longer, and immediately decided to go to the hospital for an examination.
After arriving at the hospital, the doctor immediately arranged for Li Wei to take blood and blood pressure. The blood test showed that everything was normal, and after measuring the blood pressure, it was found that Li Wei's blood pressure was 153/102mmHg, far exceeding the normal value of 140/90mmHg, and he was diagnosed with hypertension.
Li Wei was skeptical of the test results and asked the doctor tremblingly, how could he get high blood pressure at such a young age? The burden of the whole family falls on me, and this life with high blood pressure will not be affected. The doctor carefully inquired about Li Wei's life and finally found the "culprit" who caused the disease. ”
Li Wei has to socialize every day, and he inevitably drinks alcohol in entertainment, and often skips meals when he is busy with work, so he relies on instant noodles, self-heating hot pot and other foods with more salt to survive. However, high-salt foods and alcohol are high-risk factors for high blood pressure. In the face of Li Wei's worries about the future, the doctor said that although hypertension cannot be cured, it can be controlled by medication, and as long as he goes back and takes medicine according to the doctor's requirements, it will not affect his normal life.
The doctor prescribed valsartan and nifedipine for Li Wei's condition. Valsartan is an angiotensin II receptor antagonist, which controls blood pressure by inhibiting the contraction of angiotensin II. on blood pressure. Nifedipine is a dihydropyridine calcium channel blocker that lowers blood pressure by dilating peripheral and coronary blood vessels. The two drugs work differently.
Li Wei realized that if he was not healthy, what was the use of making so much money? After returning from the hospital, he took his medication on time every day, and made adjustments to his diet in his life, no matter how busy he was, he always brought his own meals, choosing corn, buckwheat and sorghum foods that are high in dietary fiber, and trying not to drink alcohol when socializing.
During the re-examination in October, Li Wei was very worried, worried that his blood pressure was getting higher and higher, and that his efforts were in vain. But when the results came out, Li Wei was very happy in his heart, because his blood pressure had reached the normal range, and Li Wei knew that it was all due to blood pressure medications.
However, on July 13, 2013, the happy life came to an abrupt end, and Li Wei went to the hospital again. It turned out that when Li Wei got up to wash his face this morning, he suddenly had a severe pain in his chest, like a heavy object pressed on his chest, and he couldn't breathe, and even felt like he was about to die. Li Wei immediately leaned in front of the sink, wanting to go to the hospital after the pain improved.
However, after waiting for more than 20 minutes, and seeing how to knock on the door and there was no response, Li Wei's wife kicked open the door of the bathroom and found that Li Wei was about to faint in front of the washstand, and Li Wei's wife immediately dialed 120. After arriving at the emergency department of the hospital, the doctor looked at the painful face on Li Wei's face and immediately did an electrocardiogram and blood test.
ECG results showed ST-segment elevation, creatine kinase 294 IU/L, and creatine kinase isoenzyme 46 IU/L, suggesting myocardial infarction. After hearing the doctor's announcement of the results of the examination and the decision to immediately undergo cardiogram and percutaneous coronary intervention, Li Wei and his wife were shocked and could not recover for a long time.
The most common cause of myocardial infarction is coronary atherosclerosis, after the coronary artery is blocked, the blood cannot pass through the tissues needed for vascular nutrition in time, and the part of the muscle that lacks blood supply will die, causing the heart function to be impaired. Before the onset of the disease, there may be a feeling of chest discomfort and breathlessness, and then there may be a sudden crushing pain in the precordial area, as if it has been pressed by a heavy object, and the pain lasts for a longer time.
Li Wei's wife knew that the condition could not be delayed any longer, and finally signed the informed consent form for the operation, and Li Wei was sent to the operating room. The doctor arranged cardiogram and percutaneous coronary intervention for Li Wei, and the cardiogram showed that the coronary artery occlusion was more than 75%, which met the indications for percutaneous coronary intervention, and the operation was started immediately.
The wife, who was waiting at the door, was very worried when she saw that her husband had not been sent out, and her heart was pounding, and she kept walking at the door to relieve her tension. At the same time, he was also full of doubts about myocardial infarction, "He is very good except for high blood pressure, and he usually doesn't hear him say where he is uncomfortable, and his high blood pressure is well controlled after taking medicine for a period of time, and his diet is also under control, how can he still get such a serious disease as myocardial infarction, these are two completely different diseases." ”
When the doctor came to check on the ward after the operation, Li Wei's wife still asked her doubts. The doctor asked about the recent diet and lifestyle habits, and found that it was well controlled, but after asking about the medication, the doctor immediately found a problem. Do you wonder why other people's high blood pressure is well controlled and there are no other problems, only you are hospitalized with cerebral infarction again, this is because you have these three problems when you are taking blood pressure medication, and these three problems have harmed you.
It turned out that Li Wei often had the following problems when taking medicine. The first one does not take blood pressure medication on time. Li Wei often forgets to take his medication due to work reasons. Irregular medication will affect the concentration of drugs in the blood, and the effect of the drugs will be affected, and the blood pressure will be high and low, and the situation will be unstable.
The second often does not take blood pressure medication in the right amount. Since the results of the re-examination showed that everything was normal, Li Wei has become more and more obsessed with antihypertensive drugs. Every time I eat a little salty or drink a little wine, I will always increase the dose of blood pressure medication, and I can comfort myself from the heart that I can make up for the previous loss, but I don't know that this method is completely wrong. This behavior of blindly increasing the dosage of drugs will not only not increase the efficacy of drugs, but will increase the risk of adverse drug reactions.
The third is to take it with other medications. Antihypertensive drugs should not be taken with tricyclic antidepressants and nonsteroidal anti-inflammatory drugs. Some time ago, due to a cold, Li Wei found aspirin in the drawer, and after taking it, he remembered that he forgot to take the antihypertensive drugs and took them together, aspirin is a non-steroidal anti-inflammatory drug, and taking it at the same time will reduce the therapeutic effect of antihypertensive drugs, resulting in an increase in blood pressure.
The occurrence of coronary atherosclerosis is related to a variety of factors, such as smoking, overweight, genetics, obesity, etc., and hypertension is also one of the common causes. Taking the medicine without the doctor's advice will lead to an increase in blood pressure, and a break will appear in the lining of the blood vessel under the impact of high blood pressure, and cholesterol will enter the intima along the breach to form atherosclerotic plaque. The gradual expansion of the plaque causes narrowing of the lumen, which leads to thrombosis and eventually myocardial infarction.