A, the prevention and treatment of coronary heart disease
1.What is coronary heart disease
”Coronary heart disease” is the abbreviation of coronary arteriosclerotic heart disease.
The heart is an important organ of the human body, its role is like a pump that never stops working, adults generally 70-80 times per minute heartbeat, with each contraction of the heart will carry oxygen and nutrients through the aorta blood flow to the whole body, in order to supply the tissue cells metabolic needs.
How does the heart get its own oxygen and nutrients?
At the root of the aorta there are two arteries that are responsible for the circulation of blood to the heart itself, called coronary arteries.
As a result of abnormal lipid metabolism, lipids in the blood are deposited on the otherwise smooth inner lining of the arteries, forming a number of scattered white plaques of atherosclerotic-like lipid accumulation in the inner lining of the arteries, called atherosclerotic lesions. The gradual increase of these plaques causes narrowing of the arterial lumen and obstruction of blood flow, resulting in ischemia of the heart and angina pectoris. If the plaques on the artery wall form ulcers or rupture, a thrombus will be formed, which will completely interrupt the blood flow of the whole blood vessel, resulting in acute myocardial infarction and even sudden death.
2.The etiology and risk factors of coronary heart disease
The cause of coronary heart disease is coronary atherosclerosis, but the cause of atherosclerosis is not fully understood and may be the result of a combination of factors. It is believed that the risk factors for the occurrence of this disease are: age and gender (men over 45 years old, women over 55 years old or postmenopausal), family history (father and brother died of heart disease before 55 years old, mother/sister died of heart disease before 65 years old), dyslipidemia (LDL-C too high, HDL-C too low), hypertension, urinary glucose disease, smoking, overweight, obesity gout, etc.
3.Clinical manifestations of coronary heart disease
There are five clinical types: asymptomatic, angina pectoris, myocardial infarction, ischemic cardiomyopathy and sudden death, the most common of which is angina pectoris, and the most serious are myocardial infarction and sudden death.
Angina pectoris is a group of syndromes due to acute temporary myocardial ischemia and hypoxia caused by.
(1) a feeling of pressure and suffocation in the chest, stuffiness, and severe burning-like pain, usually lasting 1-5 minutes, occasionally up to 15 minutes, which may resolve on its own.
(2) Pain often radiates to the left shoulder, the anterior medial aspect of the left arm up to the little finger and ring finger.
(3) The pain appears with increased cardiac burden (e.g., increased physical activity, excessive mental stimulation, and cold) and resolves after a few minutes of rest or sublingual nitroglycerin.
(4) Pain attacks may be accompanied (or not) by symptoms of weakness, sweating, shortness of breath, apprehension, palpitations, nausea, or dizziness.
Myocardial infarction is a critical symptom of coronary artery disease, usually based on frequent and aggravated angina attacks, but there are also cases of sudden myocardial infarction without a history of angina (this is the most dangerous situation, often resulting in sudden death due to lack of preparedness). The manifestations of myocardial infarction are.
(1) Sudden onset of severe pain in the retrosternal or precordial region, radiating to the left shoulder, left arm or elsewhere, and the pain lasts for more than half an hour and cannot be relieved by rest and nitroglycerin.
(2) Shortness of breath, dizziness, nausea, chills, excessive sweating, and a fine pulse.
(3) Cold, clammy, gray, and gravely ill skin.
(4) The only manifestation in about one in ten patients is syncope or shock.
4, prevention of coronary heart disease from daily life
(1) Regular living. Early to bed and early to rise, avoid staying up late to work, before going to bed, do not watch stressful, scary novels and television.
(2) happy body and mind. Avoid anger, panic, excessive thinking about the tiger and too happy.
(3) control the diet. Diet and light, easy to digest, eat less greasy, fat, sugar. To use enough vegetables and fruits, eat less and more meals, less dinner, for the desirability of drinking strong tea, coffee.
(4) Quit smoking and less alcohol. Smoking is an important factor causing myocardial infarction, stroke, should absolutely quit smoking. Drink a small amount of beer, yellow wine, wine and other low-grade wine can promote blood flow, Qi and blood reconciliation, but can not drink strong wine.
(5) Combine work and rest. Avoid excessive physical labor or sudden exertion, and should not exercise after a full meal.
(6) physical exercise. Exercise should be selected according to each person’s own physical condition, interests, such as playing tai chi, table tennis, gymnastics, etc.. To do according to the strength, so that the whole body circulation, reduce the burden on the heart.
5.ABCDE of secondary prevention of coronary heart disease
The so-called secondary prevention refers to pharmacological and non-pharmacological interventions to delay or stop the progression of atherosclerosis in patients with definite coronary artery disease (including post-stenting and post-bypass surgery).
Aspirin acts as an antiplatelet aggregator. Patients taking aspirin have a significantly lower incidence of cardiovascular disease and mortality. The side effect of vomiting blood occurs in 1 out of every 5,000 patients treated with aspirin, but prevents 95 serious cardiovascular events per year.
Aspirin should not be used in patients with gout, as it inhibits uric acid excretion. For gout patients and those who really cannot tolerate aspirin for various other reasons, they can switch to Pansentine at 50 mg three times a day, or oral ticlopidine 250 mg once a day, or the more effective Poliovel 75 mg once a day.
Aspirin is taken 75-150 mg daily for secondary prevention of coronary heart disease; for acute myocardial infarction, acute ischemic stroke and acute episodes of unstable angina, the dose may be increased to 150-300 mg daily.