He has a history of myocardial infarction, cardiac dysfunction (LVEF < 0.40) and ventricular late potential (VLP).
Polymorphic ventricular tachycardia or ventricular fibrillation induced by positive and electrophysiological examination, frequent records of dynamic electrocardiogram or exercise stress test, and complex ventricular arrhythmia are all high-risk groups of sudden cardiac death. These patients should be actively treated. In order to prevent sudden cardiac death with drugs, beta blockers should be selected first, which can significantly improve the survival rate of patients with myocardial infarction (relative risk reduction 19%). For patients with congestive heart failure, beta blockers can significantly reduce their mortality, but there is no data to prove that beta blockers can prevent sudden cardiac death in patients with congestive heart failure.
In fact, sudden death of coronary heart disease can be prevented. As long as you pay attention to the following matters, sudden death can be greatly reduced or even eliminated.
(1) Keep warm in winter. Cold can cause vasoconstriction and spasm and raise blood pressure. For example, the original coronary heart disease is prone to acute myocardial infarction. Therefore, the elderly should pay attention to adding clothes when they go out in winter to avoid cardiovascular and cerebrovascular accidents caused by catching cold.
(2) Maintain emotional stability and psychological balance. Mental stress and emotional excitement can cause a sudden increase in blood pressure, increase the heart load, and thus induce acute myocardial infarction. Any of the following situations may lead to sudden death: patients with coronary heart disease watch fierce sports competitions; Or serious psychological imbalance caused by unsatisfactory things; Or because of something overjoyed, the so-called "joy begets sorrow" and so on; To maintain emotional stability, we should avoid emotional excitement and mental tension, so as to avoid sudden myocardial ischemia caused by enhanced endocrine function.
(3) Strengthen self-cultivation. Strive to be broad-minded, optimistic and open-minded. When encountering difficulties, don't worry, treat each other coldly and don't get into trouble. People who are easy to get angry or act rashly because of their bad temper have violent blood pressure fluctuations and are prone to acute myocardial infarction.
(4) Avoid overwork. Some retired people are addicted to playing mahjong, even to the point where they forget to eat and sleep and stay up all night. Due to the influence of excessive fatigue and winning or losing on mood (blood pressure), it is easy to induce acute myocardial infarction. The old man who died suddenly on the mahjong table has been reported frequently in the media.
(5) Exercise should be moderate. Exercise should be done according to your ability. Generally, it is advisable to take a walk and hit Tai Ji Chuan. Don't run fast and do quick activities or spins. If you bow your head and hold your breath, you may fall down. Don't do competitive sports.
(6) Quit smoking and limit alcohol. Smoke contains nicotine, a toxic substance, which can cause contraction or spasm of coronary artery and induce acute attack of coronary heart disease. Although a small amount of drinking can reduce the sudden onset of coronary heart disease, the harm of drinking too much is great. Therefore, drinking enough is enough, and patients with coronary heart disease should stay away.
(7) Treating hypertension. Hypertension will not only lead to sudden death caused by cerebrovascular diseases, but also increase the risk of "sudden cardiac death". Therefore, the treatment should start from the early stage of hypertension. Its specific methods are: relax, live regularly and ensure sleep; Under the guidance of a doctor, choose mild antihypertensive drugs; People who take antihypertensive drugs for a long time should never stop taking them suddenly, so as not to rebound and be dangerous.
(8) regulating blood lipids. Abnormal blood lipid is an important reason for the occurrence and aggravation of coronary heart disease, so it is not suitable to eat foods rich in cholesterol and high-sugar foods that easily increase triglycerides, such as butter, animal fat and internal organs, especially brain, liver, intestine and bone marrow, as well as turtles, squid, squid, eel, shrimp, crab roe and bacon in aquatic products. Eat more high-cellulose foods, such as coarse grains, miscellaneous grains, rice bran, wheat bran, kelp, dried fish and so on.
(9) control diabetes. Diabetes can promote or aggravate coronary heart disease, so blood sugar should be controlled to keep it within the normal range.
(10) lose weight. Obesity will aggravate the heart load, which is not good for coronary heart disease. Therefore, it is necessary to limit the intake of total calories in the diet, exercise properly to consume calories and lose weight. However, the best way to lose weight is not to go on a hunger diet, but to keep exercising. Of course, exercise should be moderate and lasting, not intense. For example, walk for half an hour in the morning and walk for half an hour after dinner.
Modern medicine believes that atherosclerosis, especially in the early stage, is a reversible process, which can be from scratch, from light to heavy, from there to nothing, from heavy to light. Sticking to the regular walking exercise of 1 year can make the atherosclerotic plaque fade by more than 10%.
(1 1) reduces blood viscosity. Middle-aged and elderly people often have thick blood (dyslipidemia), rough blood vessels (atherosclerosis), and platelets are easy to aggregate and rupture, which will lead to blood coagulation and thrombosis, thus leading to cardiovascular and cerebrovascular diseases. Therefore, we should often take small doses of drugs that can inhibit platelet aggregation and reduce blood viscosity, such as aspirin or sodium alginate tablets.
(12) Prevent constipation. If you have constipation, you need to hold your breath when defecating and increase abdominal pressure, which will affect your blood pressure, so you must keep your stool unobstructed. Because the stool is dry and blocked, it can often cause abdominal distension, abdominal pain and irritability. These symptoms will increase the oxygen consumption of the heart and increase the burden on the heart. Especially due to constipation and excessive defecation, myocardial oxygen consumption can increase sharply, which is easy to induce angina pectoris and even lead to rupture of myocardial infarction area, aneurysm and ventricular aneurysm. Some patients can induce severe arrhythmia. It is not uncommon for patients with coronary heart disease to have symptoms relapse and even myocardial infarction due to defecation. Therefore, patients with coronary heart disease, especially those with myocardial infarction, should drink more water, pay attention to the habit of defecation regularly, often eat fruits, especially bananas, and eat coarse grains properly to facilitate defecation. Acute myocardial infarction 1 month, patients can take laxatives, such as phenolphthalein tablets 0.2g per day, every night 1 time, or take Maren Runchang pills to keep their stools unobstructed. Do not use laxatives such as rhubarb and croton.
(13) Drug self-help. Patients with coronary heart disease should carry a health care box containing nitroglycerin, Suxiao Jiuxin Pill, Xiaoxintong Pill, Guanxin Suhe Pill and other crown-expanding and antispasmodic drugs, so that they can be used at the onset and reduce the severity of the disease. In addition, patients with coronary heart disease take enteric-coated aspirin tablets 50mg every day, which also has a good effect on preventing sudden death.
(14) Get up slowly at night. Don't go to the ground immediately after waking up and opening your eyes at night. You should continue to lie flat for half a minute, then sit on the bed for half a minute, then sit along the edge of the bed with your legs drooping for half a minute, and then move on the ground. Because sudden death of coronary heart disease often occurs at night. This is mainly due to the sudden change of body position at night, which leads to insufficient blood supply to the heart and blood vessels, especially for the elderly, whose nerve regulation is slow and more prone to danger.