Sudden onset is the main feature and one of the most urgent diseases. Most patients have no premonitory symptoms before onset, and suddenly develop symptoms during activities. Most symptoms peak in a few seconds or minutes, and a few patients show gradual or progressive deterioration within a few days. About half of the patients have consciousness disorder at the onset, but the duration is short.
(2) Cerebral arteriosclerosis
Often appear dizziness, headache, irritability, inattention, memory loss, numbness of limbs, bleeding and other symptoms.
(3) Transient ischemic attack
One eye suddenly appears transient blackening, or vision loss, or white flashing, or visual field defect, or diplopia, which can be recovered in a few minutes. The contralateral limb has slight hemiplegia or abnormal slight hemiplegia. The dominant hemisphere is damaged and appears temporary aphasia or apraxia or alexia or agraphia, or facial muscle and tongue muscle weakness at the same time. Temporary dysphagia, choking, slurred speech or hoarseness.
(4) Heart disease
Common symptoms are: palpitation, dyspnea, cyanosis, cough, hemoptysis, chest pain, edema, oliguria and so on.
Etiology of cardiovascular and cerebrovascular diseases (1) Physical factors
Physical factors mainly include gender and age, overweight and heredity.
Gender and age
Generally speaking, the prevalence of coronary heart disease in men after 40 years old increases with age, and the incidence doubles with each increase of 10 years old; The average onset age of coronary heart disease in women is about 10 years later than that in men, and gradually approaches to men after menopause. The mortality rate of coronary heart disease in men is also higher than that in women. The incidence of cerebrovascular accidents increases with age, especially over 60 years old. The incidence of male is higher than that of female, but after 75 years old, the incidence of female is higher than that of male.
be overweight
Many data prove that overweight (10% of standard weight) and overweight are risk factors for cardiovascular and cerebrovascular diseases.
heritage
In countries and regions with high incidence of coronary heart disease, it is observed that coronary heart disease has certain family aggregation. The mortality rate of coronary heart disease in people with family history is 2.4 times that of the general population. The incidence rate of people with family history of cerebrovascular accident was significantly higher than that of the control group.
(2) Disease factors
The main disease factors are hypertension, hyperlipidemia, atherosclerosis, diabetes, heart disease and so on.
hypertension
Hypertension is one of the main risk factors of cardiovascular and cerebrovascular diseases. The earlier you get high blood pressure, the greater the risk of coronary heart disease. According to some research results in Japan, the risk of cerebrovascular accident increases with the increase of blood pressure.
hyerlipoproteinemia
Hyperlipoproteinemia refers to the increase of one or more lipoproteins in serum. Low density lipoprotein can promote the formation of atherosclerotic lesions.
diabetes
The most common and dangerous complication of diabetic patients is coronary heart disease. According to a retrospective survey, the probability of coronary heart disease in diabetic patients is not only twice as high as that in normal people, but also early onset and wide range of lesions. Diabetes as a risk factor of coronary heart disease, women are more dangerous than men.
heart disease
Cardiac dysfunction can directly or indirectly cause cerebrovascular accidents, especially in patients with coronary heart disease, which is five times higher than that without coronary heart disease.
(3) Life factors
Life factors mainly include smoking, drinking, diet and activities.
smoke
There is a dose-response relationship between smoking and cardiovascular and cerebrovascular diseases. For example, the follow-up data of a certain area 18 years shows that the risk of cardiovascular and cerebrovascular diseases among men who smoke heavily is three times that of non-smokers.
Drink wine/alcohol
People who drink heavily have an increased risk of coronary heart disease. On the basis of arteriosclerosis, if you are emotional and drink a lot, it can lead to cerebrovascular accidents.
prescribe a diet
The analysis of water and inorganic salts in many countries shows that the mortality of coronary heart disease is negatively correlated with the hardness of drinking water, and it is considered that different types and contents of inorganic salts in water have different effects on coronary heart disease. Such as magnesium, calcium, selenium, molybdenum and vanadium, have protective effects on coronary heart disease; Sodium, lead and arsenic can promote atherosclerosis; High dietary sodium load and insufficient calcium intake are risk factors for cerebrovascular accidents.
Cholesterol in lipids can cause atherosclerosis, and the diet based on animal food will consume more cholesterol, leading to an increase in the prevalence of coronary heart disease.
The epidemiological investigation of vitamin C shows that vitamin C can reduce blood lipid and prevent atherosclerosis, so insufficient intake of vitamin C can increase the incidence of coronary heart disease.
activity
The incidence of coronary heart disease in mental workers is generally higher than that in manual workers. Mental workers usually have little activity, insufficient coronary artery exercise load and lipid deposition, and are prone to coronary heart disease.
(4) Social and psychological factors
occupation
Occupations that require high concentration of brain power and attention at work, and occupations that cause chronic stimulation to vision and hearing, will increase blood pressure, which will lead to an increase in the incidence of coronary heart disease and cerebrovascular accidents.
Personality and nerve type
Type A personality is a risk factor for coronary heart disease. Personality characteristics of type A personality affect the concentration of triglycerides in blood, thus promoting atherosclerosis and triggering cardiovascular and cerebrovascular diseases.
(5) Meteorological factors
The occurrence of cardiovascular and cerebrovascular diseases is related to meteorological conditions. The incidence rate in cold season is obviously higher than that in other seasons.
(6) The combined action of many factors
There are many influencing factors of cardiovascular and cerebrovascular diseases. When a variety of factors exist at the same time, they can have a combined effect, which can enhance the pathogenic effect and increase the incidence of cardiovascular and cerebrovascular diseases.
There are many causes of cardiovascular and cerebrovascular diseases, and genetic factors account for a small proportion. A large part of cardiovascular and cerebrovascular diseases are closely related to people's living habits and eating habits. Therefore, to prevent cardiovascular and cerebrovascular diseases, we should start from ourselves and put an end to unhealthy living habits!
Symptoms of cardiovascular and cerebrovascular diseases (1) feel dizzy and unstable.
Most patients with cerebral hemorrhage will have different degrees of dizziness before the onset, that is, they feel unstable, or dizzy, or even want to fall. Of course, there are still some people whose dizziness is not obvious, but as long as they have symptoms of dizziness, they must pay attention to it and go to the hospital in severe cases.
(2) inexplicable headache
This kind of headache is often very serious. Of course, because everyone's physique is different, the depth of pain is also different. Some people will have persistent headaches, some people will have intermittent headaches, and some patients will be accompanied by nausea and vomiting.
(3) The limbs often feel numb.
Numbness is a typical symptom of cardiovascular and cerebrovascular diseases. In other words, if a person feels numbness in limbs for a long time, or there is obvious numbness in some parts of the body, then it is necessary to consider whether there is something wrong with the cerebrovascular system!
(4) Recurrent head dizziness
Often dizzy, which is often caused by cardiovascular and cerebrovascular diseases such as hypotension, hypoglycemia and insufficient cerebral blood supply. If this happens for a long time, you must go to the hospital to do relevant examinations, clarify the cause and treat the symptoms.
(5) I can sleep anywhere.
Obviously, I have enough sleep at night, but I am still groggy during the day. I always feel that I don't want to sleep enough and my eyes are very tired. We should pay attention to this situation, which is also a symptom of drowsiness before the onset of cerebrovascular disease.
(6) Drinking water is easy to cough and choke.
I always feel that drinking water and eating is not smooth, which is mostly a precursor to cerebral hemorrhage. Of course, don't count occasionally, and observe whether this happens often.
(7) Physical fatigue and weakness
Fatigue is also one of the symptoms of cardiovascular and cerebrovascular diseases, and in severe cases, it will be accompanied by insomnia and palpitations. At night, even severe brain hypoxia, dyspnea, dizziness, loss of consciousness, convulsions and so on appear.
If the above symptoms appear, patients with hypertension, hyperlipidemia, etc. Attention should be paid. If one or more of the above symptoms often appear, you must do the relevant system check. Things related to health are really careless!
Hazards of cardiovascular and cerebrovascular diseases (1) Hazards of hypertension
Hypertension will not only cause dizziness, palpitation, dizziness and other discomfort, but also damage important organs such as heart, brain and kidney, and may cause complications such as myocardial infarction, heart failure, stroke hemiplegia and renal failure.
(2) the harm of coronary heart disease
Once the acute attack of coronary heart disease, it can cause sudden death: arrhythmia, too fast or too slow heart rate, angina pectoris, acute myocardial infarction, cardiac insufficiency and cardiac arrest. If cardiovascular disease occurs in the heart, it is called coronary heart disease and angina pectoris. With the deepening of arteriosclerosis, the blood vessel wall will further harden and the garbage on the blood vessel wall will gradually increase. In addition, the blood in the body is sticky at this time. Under certain conditions, this may cause a blood vessel blockage, blood can not pass normally, and become a thrombus. Occurred in cerebral vessels, known as cerebral thrombosis; It occurs in the heart and is called myocardial infarction. Myocardial infarction will cause myocardial necrosis, and the necrotic myocardium will permanently lose its function and cannot regenerate.
(3) the harm of stroke
Stroke is more harmful and can cause the following adverse consequences: mouth and eyes are skewed and speech is not smooth; Limited physical activity and unstable walking; Paralyzed in bed, defecation out of control; If it is serious, it will lead to death.
Cardiovascular and cerebrovascular diseases examination (1) consultation
Inquiry is the first step of general examination, which can provide necessary reference materials for further examination and make doctors make a diagnosis more quickly and accurately. For example, describing the doctor's own detailed symptoms, medical history, medication history and the effect after medication will help the doctor make a correct diagnosis.
(2) measuring blood pressure
Hypertension will aggravate heart disease in most cases, so it is also important to take blood pressure. However, some people may be too nervous when taking blood pressure in the hospital, leading to an increase in blood pressure. In this regard, patients with electronic sphygmomanometer at home can also take measurements at home, record them and show them to doctors later.
(3) Blood examination
Through blood examination, we can master the health status of the whole body and obtain hidden information related to heart disease. For example, if you find these risk factors of heart disease, you should actively control blood lipid and blood sugar to avoid the development of heart disease; For example, the increase of white blood cells and serum C- reactive protein (CRP) may cause endocarditis.
(4) ECG examination
Electrocardiogram (ECG) can record the potential changes of the heart and is an essential examination for patients with heart disease. There are three kinds of common electrocardiogram:
Conventional ECG can quickly diagnose arrhythmia, myocardial hypertrophy, myocardial infarction and other diseases through waveforms.
When patients are suspected to have fatigue angina pectoris, exercise stress ECG examination is essential, which can be carried out by walking or running on the treadmill, riding a special bicycle and other methods.
Wearing a portable ECG recorder and recording arterial ECG for 24 hours continuously can detect transient arrhythmia, angina pectoris and atypical angina pectoris at night or at dawn.
(5) Chest X-ray examination
Chest X-rays can detect these symptoms when the heart is enlarged or dilated due to hypertension or valvular heart disease, or when the lungs are congested due to heart failure. In addition, X-ray examination can also obtain various information such as whether the aorta is dilated, whether there is aortic aneurysm and ventricular aneurysm in the chest.
(6) Echocardiographic examination
Echocardiography can detect the size of the heart, the position and thickness of cardiac hypertrophy, the contraction state of the heart, the inner wall of the ventricle and the valves. This kind of examination is also often used to diagnose heart load or heart failure, myocardial infarction or ischemia, valvular heart disease, congenital heart disease and other diseases. This kind of examination that uses ultrasound to display heart images is not available in the diagnosis of heart disease, nor will it cause pain to the human body and increase the patient's physical burden.
(7) electrocardiogram
We often hear that coronary angiography is a kind of cardiac angiography, which is to insert a catheter into the blood vessel at the root of thigh or wrist, and then inject contrast agent into the small mouth in front of the catheter, by continuously photographing the state of large blood vessels and the heart (cardiovascular angiography) or checking whether the tubular artery is narrow and its degree (coronary angiography).
Because this examination method can determine the location and degree of vascular stenosis, it is very important in the diagnosis of coronary heart disease, but this examination will bring harm to blood vessels, and patients should comprehensively weigh the advantages and disadvantages before deciding whether to choose this examination.
In addition to the above-mentioned basic examination items, there are MRI examination (magnetic resonance imaging), CT examination and other examination items, and patients can make targeted choices under the guidance and advice of doctors according to their illness.
Cardiovascular and cerebrovascular diseases are divided into conservative treatment and surgical treatment. Details are as follows:
Conservative treatment includes drug treatment, acupuncture treatment and so on. For mild cerebral hemorrhage, conservative treatment is generally used, and drugs such as improving brain metabolism and scavenging oxygen free radicals are used in acute stage. The recovery period is mainly to improve limb function, using acupuncture, rehabilitation and other treatment methods; In the sequela period, acupuncture can improve the symptoms of limb spasm, paralysis and so on, improve the quality of life of patients and restore their self-care ability;
Surgical treatment, such as heart disease, can take coronary artery bypass grafting; Cerebrovascular diseases, such as acute cerebral hemorrhage, need hematoma drainage.
Cardiovascular and cerebrovascular disease nursing (1) diet nursing
Dietotherapy guides patients to improve their eating habits while removing the etiology and drug treatment. Cholesterol is controlled in the range of 5.2mmol/L, mainly through diet regulation. The diet is light, eat more fresh vegetables, melons and coarse grains, eat less greasy and high-fat foods, such as animal fat, viscera, fat, roe, egg yolk and high-fat milk powder, and eat more onions, soybeans, mung beans, peanuts, ginger, corn, celery, kelp, spinach and jujube.
The daily intake of cholesterol should be controlled within 300mg, and the intake of fatty acids should not exceed 30% of the total calories. Saturated fatty acids (S) can increase plasma cholesterol, so it should be controlled within 10% of total calories, while polyunsaturated fatty acids (P) can reduce cholesterol and triglycerides, so it is recommended to eat foods with high P/S ratio and low cholesterol content. Don't be too full and salty, and eat less sweets. If the effect of diet therapy is not ideal, most of them still need drug intervention.
(2) Rational use of immunosuppressants
Rational use of immunosuppressants Because immunosuppressants are one of the important causes of hyperlipidemia, rational use of immunosuppressants is an important measure to prevent and treat hyperlipidemia. Removal of adrenocortical hormone and continuous application of CsA and azathioprine in renal transplant recipients can reduce plasma total cholesterol and LDL-C by 65,438 07% and 65,438 06%, respectively, and HDL-C by 65,438 08%.
(3) Rational use of lipid-lowering drugs
Lipid-lowering drugs According to the recommendation of NCEP in the United States, there are three kinds of cholesterol-lowering drugs as the first choice: HMG-CoA reductase inhibitors, fibrous acid derivatives and nicotinic acid. Fibrous acid derivatives are mainly used in patients with extremely high plasma triglycerides, and antioxidants are only used in patients who cannot tolerate other cholesterol-lowering drugs. The interaction with immunosuppressive drugs should be considered when using the above drugs.
(4) Health education and exercise
Health education and exercise play an important role in circulatory system function and blood lipid regulation. For people with low blood lipids, all kinds of activities can be unrestricted, but for those with organ involvement, especially those with insufficient blood supply to the heart and obvious symptoms, it is necessary to control activities and gradually increase the amount of activities after drug treatment to prevent accidents.
(5) Other nursing care
Patients should also be educated to pay attention to the principle of combining medicine, food and behavior. Especially those who have long-term mental work and work pressure, some are impatient, overweight, or have ingested the inducing elements of hyperlipidemia (lead, cobalt, cadmium), so we should reduce the inducing factors of hyperlipidemia while treating hyperlipidemia.
Prevention of cardiovascular and cerebrovascular diseases and rational diet With the improvement of people's living standards in China, the quality of life of residents is constantly improving. But many people's diet is not scientific, thinking that big fish and big meat is the improvement of quality of life, but it is not. People's health is different, so is their diet. It is suggested that patients with cardiovascular and cerebrovascular diseases develop the following eating habits.
Increase fiber diet
Dietary fiber can reduce serum cholesterol concentration. Foods rich in dietary fiber mainly include miscellaneous grains, rice bran, wheat bran, dried beans, kelp, vegetables and fruits. 35-45 grams of fiber per day. Common foods with lipid-lowering function are onion, garlic, mushrooms, fungus, celery and so on.
Eat more fish and fish oil.
Fish oil has obvious effects of regulating blood lipid and preventing arteriosclerosis. A large intake of fish oil rich in omega-3 has a positive preventive effect on cardiovascular diseases. International nutrition organizations suggest that people should consume 2,500 kilocalories per day, and accordingly, they should consume 0.6 to 1 g of -3 fatty acids in the form of EPA and DHA. Take the fish oil of Hongyangshen for example, and take it at least three times a day. Five 700mg fish oil capsules with 30% content can ensure the basic needs of human body.
Eat more soy products
Soybean is rich in many kinds of phospholipids necessary for human body. Eating more bean products such as bean curd, bean sprouts, dried bean curd and soybean oil is beneficial to human health and can prevent cardiovascular and cerebrovascular diseases.
(4) In addition, the intake of fat and cholesterol should be reduced appropriately.
Fat intake should be strictly limited to no more than 30 grams per day or less than 15% of total calories. Cholesterol intake should be controlled below 200 mg to 300 mg per day. Try to avoid eating foods with high cholesterol, such as brain, spinal cord, viscera, egg yolk, shellfish (such as mussels) and mollusks (such as squid, cuttlefish and roe).
Live scientifically, quit smoking and limit alcohol: long-term smoking and drinking will interfere with blood lipid metabolism and increase blood lipid.
Strengthen physical exercise: keep exercising every day 1 hour, the heart rate should not exceed the difference between 170 and age, or feel slightly sweaty, tired and relaxed after exercise, and keep exercising for at least 5 days every week.
Avoid mental stress: emotional excitement, insomnia, overwork, irregular life, anxiety, depression, these factors will make lipid metabolism disorder. Middle-aged and elderly people should not play mahjong or chess for a long time, keep calm and try to be less angry.
Drug attention: Try to take less drugs that interfere with lipid metabolism, such as receptor blockers, propranolol, diuretics, dihydrograms, furosemide, steroid hormones, etc. , can raise blood lipids.
Disease prevention and treatment actively treat related diseases that affect blood lipid metabolism, such as diabetes, hypothyroidism, nephrotic syndrome, alcoholism, pancreatitis, lupus erythematosus, etc. , will interfere with blood lipid metabolism.
Middle-aged people over 45 years old, obese people, people with a family history of hyperlipidemia, people who often take part in eating, drinking and entertainment, and workers with high mental stress are all high-risk targets. Blood lipid and blood pressure should be checked regularly (at least once a year).
Diets for cardiovascular and cerebrovascular diseases should be avoided (1). The intake of cholesterol in food should be controlled.
Long-term excessive consumption of foods with high cholesterol content will destroy the balance of cholesterol in the body. Foods with high cholesterol content include fat meat, animal brains and viscera, fish eggs, yolk, cream and some crustaceans such as mussels, snails and crab roe. However, soybean lecithin can lower blood cholesterol and prevent atherosclerosis.
(2) Control the consumption of fat.
Long-term excessive intake of fat will lead to obesity due to excessive calories. Obesity will not only increase the burden on the heart, but also easily complicate or aggravate hypertension, coronary heart disease and diabetes.
(3) Supplementing sufficient high-quality protein.
Protein has sufficient supply, complete amino acids and proper proportion, which is the material basis for strengthening the body's resistance and preventing arteriosclerosis. Protein, a kind of bean, has a more obvious protective effect on arteriosclerosis. Some people use soybean protein instead of animal protein and supply it to patients with hyperlipidemia every day, which obviously reduces cholesterol. It is believed that this is related to the composition of amino acids.
(4) Eat more foods rich in vitamins.
Experts believe that increasing the intake of vitamin C, vitamin E and carotene can effectively prevent arteriosclerosis. Therefore, in daily life, people should pay attention to eating more fruits and vegetables rich in vitamins such as citrus, jujube, cauliflower and red pepper.
(5) Eat more foods rich in folic acid.
If folic acid and vitamins B6 and B 12 are lacking in diet, the level of cysteine in blood will increase, which will easily damage vascular endothelial cells and promote the formation of atherosclerotic plaques. Folic acid supplementation plays an important role in reducing the incidence of coronary heart disease and stroke. Experts suggest that middle-aged and elderly people, especially those with cardiovascular diseases, should eat more foods rich in folic acid, such as amaranth, spinach, asparagus, beans, yeast, apples and oranges.
(6) Eat more natural anticoagulant and lipid-lowering foods.
Eating this kind of food helps to reduce myocardial infarction and ischemic stroke. Auricularia auricula can inhibit platelet aggregation and prevent thrombosis. Garlic, onion, shallot, chrysanthemum, mushroom, Gracilaria lemaneiformis, strawberry and pineapple also have certain anticoagulant effects. Tomatoes, grapes and oranges contain a small amount of salicylic acid anticoagulants. Lipid-lowering foods include spirulina, coriander, carrot, hawthorn, seaweed, kelp, walnut, olive oil and sesame oil.
The dietotherapy formula is (1) Ge Fen 250g, Schizonepeta 50g, and Douchi150g. Mashing Ge Fen into fine powder, boiling Schizonepeta tenuifolia and fermented soybean in water for 6-7 times, removing residue to get juice, and then boiling Ge Fen in the juice to make noodles. Eat on an empty stomach every day 1 time. Has effect of clearing away heat, promote fluid production, expelling pathogenic wind and inducing resuscitation, and is suitable for treating dysphoria and delirium hemiplegia caused by apoplexy, or preventing apoplexy and cerebrovascular sclerosis in middle-aged and elderly people.
(2) Three soft-shelled turtles (fist-sized) with appropriate amount of rock sugar. Take the blood of three turtles at a time, add water and crystal sugar, put them in a bowl and steam cooked food in a pot. Daily 1 time, 7 times for 1 course of treatment, with the effects of nourishing yin and blood and dredging collaterals, and is suitable for hemiplegia and limb paralysis after stroke.
(3) Spike of Schizonepeta tenuifolia, 50g of mint leaves, 50g of lobster sauce150g, and white millet. First, the Schizonepeta spike, mint leaves and fermented soybean are cooked, the residue is removed to get juice, and millet is added to cook porridge. Eat on an empty stomach every day 1 time.
Diet for cardiovascular and cerebrovascular diseases
(4) Millet150g, Fructus Cannabis 50g, Folium Menthae 50g and Herba Schizonepetae 50g. Stir-fry pockmarked winter wheat, peel and grind. Boil mint leaves and Schizonepeta tenuifolia in a casserole, remove residues to get juice, and add Fructus Cannabis and millet to cook porridge. Take it on an empty stomach every day 1 time, which is suitable for apoplexy and large intestine stagnation.
Precautions for Cardiovascular and Cerebrovascular Diseases (1) Prevention of Embolism
Blood vessels, especially coronary arteries, tend to contract and spasm in cold winter, leading to insufficient blood supply and possible embolism, so we should pay great attention to keep warm.
(2) manage blood pressure.
Brain damage can lead to stroke; Heart damage can lead to coronary heart disease; Kidney damage can lead to renal failure. Patients with hypertension should take antihypertensive drugs in strict accordance with the doctor's advice and monitor their blood pressure every day; The diet should be light, the amount of salt eaten every day should be controlled below 6 grams, and less processed food should be eaten; Eat more fruits and vegetables, such as onions, kelp, seaweed, fungus and so on. Can help lower blood fat and control blood pressure.
(3) tonic should be moderate.
Our people have the habit of tonic in winter, and exercise less in winter. In addition, a large number of tonic hot foods and medicinal liquor can easily lead to elevated blood lipids and cardiovascular and cerebrovascular diseases. Therefore, winter tonic must be carried out according to personal physique.
(4) Quit smoking and drink moderately.
Smoking is one of the most important risk factors of coronary heart disease. Studies have found that compared with non-smokers, the incidence and mortality of coronary heart disease increase by 2~6 times, which is directly proportional to the number of cigarettes smoked every day.
(5) Psychological balance
Emotional excitement is a taboo for cardiovascular and cerebrovascular diseases. Patients with coronary heart disease and hyperlipidemia should especially relax their mentality and not let their emotions fluctuate too much.
(6) Proper exercise
Middle-aged and elderly patients with cardiovascular and cerebrovascular diseases are not unable to exercise, but should exercise properly. The reduction of exercise will also cause slow blood flow and high blood lipid. It is necessary to arrange exercise time reasonably and control the amount of exercise. In winter, you should wait until the sun rises before exercising. At this time, the temperature rises, which can prevent the body from suddenly getting sick due to cold stimulation.