Is premature beat a heart attack?

There is no direct correlation between premature beats and heart disease, and more than 70%~90% of normal people will also have premature beats. If there is no other diagnostic basis, it is extremely wrong to diagnose heart disease only by premature beats. For children or adolescents, if they see premature beats, they are diagnosed as myocarditis; For the elderly, if they are diagnosed with coronary heart disease when they see premature beats, the consequences will inevitably increase their psychological burden and produce iatrogenic psychological diseases. These consequences are much more serious than premature beats themselves. For example, ventricular premature beats are very common in patients with myocardial infarction and cardiomyopathy. But premature beats are not uncommon in normal hearts. Simple premature beats cannot be equated with heart disease. Benign premature beats are found in patients with normal heart, or at least in patients with abnormal heart structure and function that cannot be found by using existing diagnostic methods. Patients with premature beats should go to the hospital to check whether they have heart disease. The main examination methods include doctor consultation and physical examination, X-ray chest film, echocardiography and exercise test electrocardiogram. The occurrence of benign premature beats increases with age. Many patients with premature beats have no conscious symptoms, but they are discovered unintentionally in the process of study, employment or physical examination. Some patients will feel palpitations and chest tightness, similar to the feeling of going up and down quickly in the elevator or the occasional strong beating of the heart. Whether there are symptoms or the severity of symptoms is not proportional to the number or frequency of premature beats. Some people have asymptomatic premature beats thousands of times a day, while others have many symptoms dozens of times a day. The frequency of premature beats in the same person at different times of the day varies greatly, and the severity of patients' symptoms is often irrelevant to the frequency of premature beats at the same time. Most patients have some symptoms related to psychological factors, that is, they are nervous and anxious because they don't understand the meaning of benign premature beats. On the ECG of various physical examinations, the conclusion of detecting premature beats is often abnormal ECG and ventricular (or atrial) premature beats. When this kind of report is given to the patient and the doctor has no patience to explain it to the patient, the mental stress caused by these provisions can be imagined. Coupled with some popular sayings, such as ventricular premature beats are more dangerous than atrial premature beats, and may die suddenly, which has a greater impact on the patient's spirit. A healthy person with a normal working life may be worried, bedridden or even have a complete mental breakdown when he encounters the above situation in physical examination. It is called benign because it will not bring the risk of sudden death to patients, nor will it cause damage to the heart, and the prognosis is good. For patients without symptoms directly related to premature beats, antiarrhythmic drugs are not needed. For those with symptoms, it is necessary to analyze them in detail. If the symptoms are mainly caused by mental stress and anxiety, we should fully relieve our concerns. Undeniably, premature beats themselves can cause symptoms in some patients. If the symptoms are directly caused by premature beats, drugs with little side effects should be selected, such as propranolol, bradycardia, propafenone and morexizine to treat ventricular premature beats and propranolol, propafenone or morexizine to treat atrial premature beats. Do not use amiodarone (also called amiodarone) which is too toxic to organs. Oral medication is enough, and intravenous medication is not needed. The criterion for evaluating the curative effect is the relief or disappearance of symptoms, not the change of the number and frequency of premature beats. There are often many patients with benign premature beats, who feel their pulse constantly every day, and the more they feel, the more nervous they become. There are also many doctors or patients who repeatedly use the expensive 24-hour dynamic electrocardiogram records to analyze the number of premature beats, without correctly understanding the significance of premature beats, which not only wastes medical resources, but also increases the mental burden of patients.