Symptoms of coronary heart disease
Precardiac pain is a typical symptom of coronary heart disease, which should be paid attention to by patients. However, atypical symptoms of coronary heart disease in a few patients make patients take it lightly, which often leads to misdiagnosis by doctors, thus delaying the diagnosis and treatment of coronary heart disease.
(1) Some patients with coronary heart disease have no chest pain, only various arrhythmias such as atrial fibrillation, ventricular premature beats and atrioventricular block, or heart failure such as shortness of breath at night and paroxysmal dyspnea as the first symptom, which is clinically called "arrhythmia heart failure coronary heart disease" and is a rare type of coronary heart disease.
(2) Angina occurs outside the chest, showing headache, toothache, sore throat, shoulder pain and leg pain, which often need to be differentiated from the discomfort caused by the corresponding organs.
(3) A few patients with coronary heart disease, especially patients with acute myocardial infarction, only show symptoms of cerebrovascular diseases, such as dizziness, limb paralysis, sudden loss of consciousness, convulsions, etc. The reason is that when myocardial infarction occurs, the cardiac output decreases, which leads to the decrease of blood supply to the brain. Severe arrhythmia often leads to the decrease of blood supply to the brain. Therefore, when the elderly have cerebrovascular manifestations, they should be examined by ECG and followed up in a short time to rule out the possibility of acute myocardial infarction.
(4) Gastrointestinal symptoms such as epigastric pain and discomfort, especially severe pain often accompanied by nausea and vomiting, are easily misdiagnosed as acute gastroenteritis, acute cholecystitis and pancreatitis.
(5) If coronary heart disease is complicated with other acute diseases, such as diabetic ketoacidosis, acute infection and surgical emergency, even if acute myocardial infarction occurs, the symptoms are often covered up. Therefore, patients and their families should report the condition of coronary heart disease to doctors in time for reference.
(6) Because the elderly often have poor memory, insensitive feelings and poor expression of symptoms, they are easily ignored by their families and doctors. Therefore, don't forget to do a routine electrocardiogram when doing related tests for the elderly. Once there is evidence of myocardial ischemia, it should be treated symptomatically and diagnosed through further examination.
Treatment of coronary heart disease
The treatment of coronary heart disease is based on the principle of improving coronary blood supply and reducing myocardial oxygen consumption, and at the same time treating and preventing the development of atherosclerosis. The treatment of coronary heart disease includes drug therapy, reperfusion therapy (thrombolysis, heart bypass surgery and heart stent surgery) and heart transplantation. The specific choice of treatment methods is based on the results of coronary angiography.
One of the treatment methods of coronary heart disease: drug treatment of coronary heart disease
Drug treatment is the basic treatment of coronary heart disease, mainly according to the condition and under the guidance of doctors. Drug treatment can relieve symptoms and stabilize the disease. Some drugs can also delay or alleviate the development of coronary atherosclerosis, actively control the risk factors causing atherosclerosis, and achieve the dual effects of treatment and prevention.
1, drug therapy for angina pectoris of coronary heart disease
When angina pectoris occurs, nitroglycerin or nifedipine can be taken to rapidly dilate coronary artery, increase myocardial blood supply, improve the status of myocardial ischemia and prevent myocardial ischemia and necrosis. Nitroglycerin: Nitroglycerin 1 tablet (0.3 ~ 0.5 mg per tablet) is taken sublingually after chewing. 1 to 2 minutes later, angina pectoris can be relieved. If the pain is still not relieved after 5 minutes, you can take 1 tablet again. Xintongding: It can treat and prevent angina pectoris and arrhythmia. Usage: 1 ~ 2 tablets each time, 1 tablet after symptoms are relieved, three times a day.
2. Drug treatment of coronary heart disease in remission stage
The following drugs can be used for the treatment of coronary heart disease in remission:
① mixture of nitrates and traditional Chinese medicine dilates coronary artery;
② calcium antagonists and β receptor tissue agents were used to relieve coronary artery spasm and reduce myocardial oxygen consumption;
③ Using ACEI to reduce cardiac afterload;
④ Anticoagulants, such as aspirin, should be used to prevent thrombosis;
⑤ Use drugs that reduce heart rate, such as betaloc, to reduce myocardial oxygen consumption.
The second treatment of coronary heart disease: reperfusion therapy
The method of reperfusion therapy is to recanalize the occluded coronary artery, restore myocardial perfusion, save ischemic myocardium and reduce infarct area, thus improving hemodynamics and restoring blood supply to the heart. There are three main methods.
1. Thrombolytic therapy of coronary heart disease reperfusion
Thrombolysis is achieved by intravenous infusion of thrombolytic drugs, such as urokinase and streptokinase.
2. Interventional therapy of coronary heart disease reperfusion.
The basic principle of interventional therapy is to put a balloon catheter into a narrow blood vessel through blood vessel puncture, expand the balloon in vitro, open the narrow blood vessel wall, and make the diseased blood vessel unblocked. 1-2 is narrow and easy to place stents, so interventional therapy can be used.
Indications of percutaneous coronary intervention (PCI) (1-2 is narrow and easy to place stents).
1. Acute myocardial infarction
2. Angina pectoris (stable and unstable) is not effective, and coronary angiography shows that the vascular stenosis is more than 75%.
3. The application of coronary artery bypass grafting in coronary heart disease reperfusion therapy.
The main principle of coronary artery bypass surgery is to establish a bypass ("bridge") between the aorta and the diseased coronary artery by using its own blood vessels (internal mammary artery, radial artery, right gastroepiploic artery and great saphenous vein), so that the blood in the aorta can be directly perfused to the narrow distal end, thus restoring the blood supply to the myocardium.
Indications of emergency coronary artery bypass grafting
1. Left main lesion
2. Lesions in the left trunk and three branches
3. Within 6~8 hours of acute myocardial infarction, the vascular anatomy is suitable for coronary artery bypass grafting.
4. Complications such as papillary muscle rupture and ventricular free wall rupture occurred in acute myocardial infarction.
5. Intractable arrhythmia occurred in acute myocardial infarction, and active medical treatment was ineffective. Vascular anatomy is suitable for coronary artery bypass grafting.
6. Anatomy, heart or blood vessel rupture, pericardial tamponade, etc. It happened at 6. PCI diagnosis or drug therapy.
Indications of selective coronary artery bypass grafting (heart bypass surgery)
1. Left main lesion
2. Most bi-vascular and tri-vascular diseases involve the proximal left anterior descending branch.
3. Three-vessel disease of left ventricular dysfunction
4. Combined with meaningful valvular disease, ventricular aneurysm and other lesions.
5. Diabetes complicated with multi-vessel disease.
6. Partial single-branch and double-branch lesions of chronic total occlusion
The third treatment for coronary heart disease: heart transplantation.
In view of the following situations: coronary heart disease develops to the advanced stage and is ineffective after drug treatment; Surgery or interventional therapy cannot be corrected, repaired or dredged; Persistent heart failure or recurrent arrhythmia is life-threatening, and it is estimated that the risk of death within 1 year is extremely high, so heart transplantation should be carried out as soon as possible.
Through the above analysis of the treatment of coronary heart disease, I believe everyone has understood the treatment of coronary heart disease. To treat coronary heart disease, we should choose different treatment methods for coronary heart disease according to the specific conditions of patients.
I hope the above reply is helpful to you, and I wish your father good health.