What is coronary heart disease?
A heart disease that occurs when the coronary arteries become narrowed due to atherosclerosis, resulting in ischemia and lack of oxygen to the heart muscle.
Is the incidence of coronary heart disease high?
In recent years, the incidence of coronary heart disease has been increasing year by year; the incidence of acute coronary heart disease was 21.6/100,000 in 1974, and now it is as high as 47.9/100,000, and the average annual growth of myocardial infarction has reached 4.32%; the highest incidence of coronary heart disease in China is in Beijing.
The danger of coronary heart disease
Coronary heart disease is the number one cause of death in most developed countries, accounting for 50% of all deaths, and more than 13 million people worldwide die from cardiovascular disease each year. 45 million people worldwide suffer from post-myocardial infarction; more than 40 million people suffer from angina pectoris.
Risk factors for coronary heart disease
Factors that can be modified/controlled
Hyperlipidemia
Hypertension
Diabetes mellitus
Overweight
Lack of exercise
Smoking
Mental stress
Excessive alcohol consumption
Factors that cannot be changed
Family history of coronary artery disease
Gender
Age
Common symptoms of coronary heart disease
1. Angina pectoris
2. Myocardial infarction
Chest pain
Other
Common symptoms of coronary heart disease
Chest pain.
Often associated with exertion, exercise, cold
Radiates to neck, shoulder and jaw
Relieved by itself or with nitroglycerin in 3-5 minutes
Chest tightness, shortness of breath
Palpitations, cold sweat
Burning sensation in the heart and stomach
How do you know you may have coronary artery disease?
Angina pectoris
Chest pain: often pressure, tightness or burning sensation
Myocardial infarction
Chest pain: same nature as angina pectoris
Systemic symptoms: fever, tachycardia, elevated white blood cells
Gastrointestinal symptoms: often with nausea, vomiting, epigastric distention and pain
Signs: arrhythmia, hypotension, shock, heart failure
Other tests
Electrocardiogram (note dynamic changes)
exercise tests (active plate, bicycle test).
Echocardiography.
nuclear myocardial imaging.
Medications
Be aware of all medications you are taking
Take your medications at the same time every day
If you occasionally forget to take a medication, do not take two at a time to try to make up for it
Do not stop or switch medications without your doctor’s permission
Tell your doctor even if you are taking over-the-counter medications
Take your medication with you when you go out and travel
Classification and treatment of coronary heart disease in Chinese medicine
The pathogenesis of angina pectoris in coronary artery disease is deficiency in the root and symptoms in the symptoms.
The original deficiency includes Qi deficiency (Heart Qi deficiency, Kidney Qi deficiency), Blood deficiency, Yin deficiency (Heart Yin deficiency, Liver and Kidney Yin deficiency, Heart and Kidney Yin deficiency), Yang deficiency (Heart Yang deficiency, Kidney Yang deficiency, Spleen Yang deficiency, Heart and Kidney Yang deficiency), Yang deficiency, Qi and Yin deficiency, Yin deficiency and Yang hyperactivity, while the standard actuality includes Phlegm turbidity, Phlegm heat, Water and Qi, Qi stagnation, Blood stasis, Cold condensation, Heat, Food stagnation, Phlegm and Blood stagnation. The deficiency evidence and the standard actual evidence can be seen together, presenting a combination of deficiency and actual, cold and heat mixed evidence.
It can also be accompanied by other internal organs, such as lung qi stagnation, internal qi obstruction, liver and spleen stagnation, heart and kidney disconnection, etc.
TCM coronary heart disease types and treatment
Chest Yang paralysis type: treatment should be to promote paralysis and promote Yang, expel drinks and subdue rebellion, regulate Qi and activate Blood. Formula: Gua Gua Bai Han Xia Tang plus or minus.
Cold clotting and blood stasis type: treatment is to warm Yang, dispel cold, activate blood circulation and relieve pain. Prescription: Gua Gua Bai Gui Zhi Tang with addition.
Heart vein stasis type: treatment is to invigorate blood circulation, resolve blood stasis, regulate Qi and relieve pain. Treatment: Peach-Hong Si-Wang Tang with Dan-Shen-Bing plus or minus.
Qi stagnation and blood stasis: to regulate Qi, invigorate blood, remove stasis and relieve pain. Radicals: Blood stagnation and Blood stasis Tang with addition.
Qi deficiency and blood stasis: to benefit Qi, invigorate blood, and warm kidney yang. Prescription: Radix Codonopsis with compounding.
Heart and kidney deficiency of Qi and Yin: to benefit Qi and nourish Yin, invigorate Blood and remove blood stasis. Prescription: Shengwen San combined with Angelica Sinensis Blood Tonic Tang.
Yin deficiency and Yang hyperactivity: to nurture Yin and submerge Yang, pacify Liver and quench wind. Radix: Tianma and Hooked Vine Drink with addition and subtraction.
Water-drink stagnation in the lung: to strengthen the heart and clear the pulse, to purge the lung and expel drinks. Prescription: Ginseng-Su Drinking with Scape Drabble and Jujube Diarrhea Lung Soup with addition.
Heart-kidney-yang deficiency: treatment is to warm the heart and kidney and take into account qi and yin. Prescription: Roasted Glycyrrhiza glabra and Alloy Kuan Qi Wan.
Yang deficiency and emancipation: treatment is to return Yang to fix the emancipation and save the rebellion. Treatment: Ginseng and Longmu Tang with addition and reduction.
What is coronary angiography?
Coronary angiography is a procedure in which a special contrast catheter is punctured through the femoral artery or radial artery and sent to the opening of the coronary artery to inject a contrast medium into the coronary artery to make it appear.
When is a coronary angiogram necessary?
? When there is clinical suspicion of coronary artery disease and a clear diagnosis is needed
? Those who have already been diagnosed with coronary artery disease and the effect of drug treatment is not good, and interventional treatment is proposed
? Prepared for coronary artery bypass grafting and need to know the coronary artery condition before surgery
? Those who are ready to undergo heart valve surgery and are clinically suspected of having combined coronary artery disease
? Those who need to know the patency of the graft after coronary artery bypass grafting
? suspected coronary artery malformation or other coronary lesions
What are the indications for coronary angiography?
Clinical suspicion of coronary artery disease and the need for a definitive diagnosis
Those who have been diagnosed with coronary artery disease and are not well treated with medication and are ready for interventional therapy
Prepared for coronary artery bypass grafting and need to know the coronary artery condition before the procedure
Those who are planning to undergo heart valve surgery and have clinical suspicion of combined coronary artery disease
Those who need to know the degree of graft patency after coronary artery bypass grafting
Those with suspected coronary artery malformation or other coronary artery lesions
What do I need to do before coronary angiography?
Understand the purpose of the examination and sign the informed consent form; if there is a history of iodine allergy, please explain to the doctor
Arrange post-operative care and nursing staff
Eat a light, easy-to-digest diet; do not overindulge in a meal before the procedure; stop smoking and drinking
Continue to take the medication you are taking orally, usually no need to stop
Local skin preparation
Relax and ensure good sleep
Practice defecation in bed beforehand
What is interventional therapy for coronary artery disease?
It includes balloon dilation and stent placement
Features: Less invasive, faster recovery, better results
It has become the most common treatment for coronary heart disease.
When do I need interventional treatment?
Degree of stenosis: generally >70%, left main >50%
Complexity of the lesion: distortion, calcification, bifurcation, multiple branches, left main stem, chronic occlusion – making intervention more difficult, but now increasingly indicated
Patient and family wishes and financial situation
Advantages of coronary intervention
q Definite efficacy
q Less invasive procedure
q Short operative time
q Fast postoperative recovery
q Repeatable procedure
Clinical benefits of controlling risk factors
Reduced overall mortality
Reduced number of cardiac events
Reduced revascularization
Reduced hospitalizations
Improved quality of life
Lifestyle changes
Healthy eating
Watch your weight
Regular exercise
Medication
Reduce life stress
Quit smoking
Reduce alcohol consumption
Healthy diet
Low cholesterol, low fat
Reduce salt in food
Reduce sugar
Increase starch and fiber in food
Eat more
Grains
Fruits, vegetables
Poultry, fish
Eat less
Pork, beef
Fried foods
Egg yolk (< three a week)
Diet control
Eat more vegetables
Watch your weight
Body mass index = weight (kg)/height (m) squared
BMI=Kg/m2
Obesity causes an increased burden on the heart and is a risk factor for many diseases such as hypertension, hyperlipidemia and diabetes
Weight loss should be carried out gradually and should not exceed 1 kg per week
Healthy diet
Control life stress
Excessive mental stress can put the body in a state of stress, resulting in a rapid heartbeat and increased blood pressure, causing adverse effects on the body.
Ways to relieve stress.
Rationalize the time of day
Adapt to the environment, maintain an optimistic and open-minded attitude
Adhere to a moderate amount of exercise, rest and entertainment every day
Enjoy life and control the stress of life
Enjoy life
Exercise regularly
Reduce fatigue, lose weight, and lower blood pressure
Choose the right type of exercise and pay attention to the amount of exercise
Exercise at least three times a week for more than 20 minutes
Walking, dancing, household chores
Full-body aerobic exercise: swimming, cycling
Stop exercising immediately if you experience dizziness or chest pain
Stop smoking and alcohol
The four risk factors of atherosclerosis!
Smoking
High blood cholesterol
High blood sugar
High blood pressure
Possible reasons for unsatisfactory lipid control
Patient’s cooperation
No symptoms per se
Lack of awareness of the disease
Insufficient adherence to long-term treatment
Choice of medication
Implementation of target lipid levels
How to control hyperlipidemia?
Dietary control
If dietary control is still not satisfactory, medication
Statins: Sulforaphane
Betablocker
Depending on the patient’s disease status, different lipid treatment goals are set
Lipid lowering goals
Lower LDL (low density lipoprotein)
Normal <3.2mmol/L
Atherosclerosis <2.6 mmol/L
Control of diabetes mellitus
Coronary heart disease mortality in diabetics is 2-4 times higher than in non-diabetics
75% of diabetic patients die from cardiovascular disease
Control of blood glucose, blood pressure and blood lipids are equally important
Target levels of lipids and blood pressure are more stringent in diabetic patients than in non-diabetic patients
Hypertension
Misconceptions in the treatment of hypertensive patients
I. Estimating the level of blood pressure by self-perception
This is often inaccurate, especially in people who have suffered from hypertension for a long time, because they have “adapted” to hypertension, so they do not feel any discomfort even if their blood pressure rises significantly. If the decision to take medication is based on self-perception alone, it can be harmful. The correct approach is that patients should take the initiative to measure their blood pressure regularly, at least once a week.
Irregular medication
Some patients can not adhere to the medication, sometimes take the medication, and sometimes not, resulting in unstable blood pressure, resulting in long-term damage to the heart, brain, kidneys and other important organs.
Third, as soon as the blood pressure is normal, the drug is stopped
This leads to an unstable situation where blood pressure appears to rise – lower – rise. As the blood pressure appears more substantial ups and downs, it will cause serious complications in the heart, brain and kidney, such as cerebral hemorrhage. The right way is, after taking the medication appears to fall in blood pressure, can use the maintenance amount to continue to take medication, or under the guidance of the doctor will adjust the medication, can increase or decrease the variety of drugs or dose of medication, rather than categorically stop the medication.
Fourth, “blind treatment”
Some patients take medication for a long time without going to the hospital regularly, which is prone to drug side effects or drug resistance. Different patients need to choose the appropriate drugs and appropriate dosage under the guidance of doctors according to their disease duration, age, individual differences, organ function and other conditions.
V. Relying solely on antihypertensive drugs without comprehensive treatment
Hypertension is caused by a variety of factors, and treatment also requires comprehensive measures. In addition to the selection of appropriate drugs, but also pay attention to the combination of work and rest, diet should be light, less salt, appropriate participation in sports and cultural activities, weight loss, etc..
Sixth, is blindly long-term use of a kind of antihypertensive drugs, taking drugs as a “habit of life”, do not pay attention to the effectiveness
Any drug taken for a long time will reduce the efficacy, produce drug resistance, and prone to drug side effects. Different patients need to choose the appropriate medication according to their disease duration, age, individual differences, organ function and other conditions. Taking the same drug for a long period of time without any change and without knowing the level of blood pressure is actually a kind of “blind or ineffective treatment”. Under the guidance of a doctor, adjust the medication in a timely manner according to the needs of the condition.
Seven, do not seek medical advice to buy their own medicine treatment
Simplify the treatment of hypertension. Scientific and rational treatment should be done under the guidance of a doctor. The purchase of drugs on your own carries a certain degree of danger.
Eight, think that blood pressure is only high, not worth treatment
Generally speaking, adults with blood pressure over 140/85 mmHg are considered to have hypertension. Borderline blood pressure is often not taken seriously. Comprehensive treatment, including medication, should be given. It is worthwhile to speculate on the choice of drugs, such as drugs that mediate the balance of the vegetative nerves or diuretics in the initial stage.
Options and superiority of TCM treatment
Acupuncture
Moxibustion method – moxibustion with moxa sticks
Qigong
Single herbal medicine – Hawthorn, Cockscomb, Pu Huang
Ginkgo biloba, mulberry, long white rhizome
Lanjian Xianxin, Di Long, Leeches
Food therapy
The method of using food with medicinal properties and making medicinal meals to treat diseases through reasonable preparation is called dietary therapy.
It includes drinking therapy, congee therapy, soup therapy, cake therapy, soup therapy, cake therapy, gum therapy, powder therapy, egg therapy and hunger therapy. It is one of the traditional therapies in Chinese medicine, which has various effects such as helping to dispel evil, adjusting yin and yang, and curing diseases.
Fresh mulberry or mulberry honey is taken regularly.
10g of Chinese mulberry, 30g of water chestnut or 30g of celery, in decoction, taken regularly.
50g of Ulva lactuca, 60g of shredded lean pork, add water and boil soup for consumption.
Hawthorn 20g, decocted with water, divided into several times daily, and taken for 1 month as a course.
30g of black fungus, washed with water, 100g of lean meat, sliced, stir-fried and consumed.
2g of lotus seeds, 15g of hawthorn slices and cassia seeds, 3g of Hanging chrysanthemum, drink with boiled water.
5 pieces of red hawthorn, pitted and chopped, mixed with 1 spoon of honey, add to cornmeal porridge and take 1 to 2 times daily.
250g of old pumpkin, cut into 3cm pieces, 100g of millet, 10 red dates, boil together and put a little brown sugar in the porridge, eat in the morning and evening.
100g of round-grained rice, 7 red dates, 30g of Radix et Rhizoma Polygoni, brown sugar or rock sugar. Decoct the thick juice of Radix Polygoni, remove the dregs, and cook the porridge with round-grained rice and red dates in a casserole, add brown sugar or rock sugar to taste when the porridge is ready, and then boil.
Dried mud carp, head and tail burned ashes or dried and powdered, dried lotus leaf also powdered, mix the powdered mud carp and lotus leaf powder in equal amounts, 10g per serving, cool boiled water mix down, 3 times a day.
Qi and Yin deficiency type
Symptoms: palpitation and shortness of breath, chest tightness and pain, dizziness and tinnitus, insomnia and dreaminess, light red or dark red tongue, white or less coating, sunken or fine pulse.
Treatment: Benefit qi and nourish yin, invigorate blood and promote blood circulation.
Food therapy formula.
① Fresh kudzu root, 100g of japonica rice. slice and grind kudzu root, add water, stir, precipitate and extract powder, take 30g of kudzu root powder, cook porridge with japonica rice, take it every morning and evening, it should be taken regularly.
②30g of sea cucumber, 5 jujubes, appropriate amount of rock sugar. After stewing the sea cucumber, add dates and rock sugar and stew for 20min, take on an empty stomach before breakfast.
③Fish 250g, black sesame, 1 egg, minced onion, salt, monosodium glutamate, starch and wine. Cut the fish into strips and put them in a bowl with starch, salt, egg yolk and chopped green onion. Boil 500ml oil to six mature, stick the fish strips with sesame seeds into the frying pan, deep fry until the fish strips are slightly yellow at both ends and put out on a plate, serve with meals.
Take for 5 to 7 days.
Yin and Yang deficiency type
Symptoms: Stuffy pain in the precordial region or behind the sternum, with frequent occurrence at night, shortness of breath and palpitations, sweating and fear of cold, irritable heat in the five hearts, dark purple tongue or red tongue, white or less coating, thin pulse or knotted generation.
Treatment: Nourishing Yin, tonifying Yang, activating blood circulation.
Recipe.
30g of kudzu powder, 25g of egg yolk powder and brown sugar. Mix well with water, steam and take once a day.
②Cucumber juice 30ml, lotus leaf juice 15ml, ginger juice 3ml. mix well, take once, 2-3 times a day.
③150g onion, 50g lean pork, sliced pork, stir-fried in veggie oil, add onion and stir-fried for a few minutes, season to taste, eat with meals.
Yin deficiency and Yang hyperactivity type
Symptoms: pain or stuffiness in the anterior chest area, mostly triggered by fatigue or irritation, palpitations, dizziness and headache, insomnia and dreaminess, dry mouth and numbness, red tongue with yellow coating, thin pulse.
Treatment: Nourish Yin and submerge Yang, promote circulation and relieve pain.
Food therapy recipe.
The first is the use of the water, and the second is the use of the water, and the second is the use of the water, and the third is the use of the water.
The actual fact is that you will be able to get a lot more than just a few of these. Soak peanut rice and cinnamon in vinegar for 24 hours and take 10-15 capsules every day after waking up.
Add 60g of black sesame, 60g of mulberry, 30g of rice, 10g of sugar, wash and pound the first 3 ingredients, add 3 bowls of water, boil and add sugar, when the sugar dissolves and boils again, slowly add the pounded sesame, mulberry and rice, boil into a paste and take it once a day.
Heart Yang deficiency type
Symptoms: palpitations, shortness of breath or shortness of breath, chest tightness or heart pain, cold fear of cold limbs, pale white tongue, purple or purple dark or light tongue with white fur, sunken pulse or knotted generation.
Treatment: Tonify the temperature and Yang, dispel cold and open the veins.
Food therapy formula.
① 30g of mutton, 30g of beef, 30g of dog, 30g of venison, 15g of pork, 250g of round-grained rice. stew the meat first, then add round-grained rice and cook into a congee for breakfast, once a day.
A pair of pig kidney, 7 white onion, 3g of ginseng, 60g of round-grained rice, peel off the kidney, cut into shreds, grind ginseng, cook the porridge with round-grained rice, add the shreds of kidney, grated ginseng and green onion and mix well.
When the porridge is ready, add the kidney, ginseng and green onion, mix well and take it after cooking.
③ 10g of ginger, 6g of angelica, 100g of mutton, 12g of wine, 6g of green onion, 3g of salt. wash and slice mutton, add 1000ml of water, boil it on a high flame, then stew it for 50min on a low flame, once a day, eat the meat and drink the soup.
Phlegm paralysis type
Symptoms: Stuffiness and pain in the precordial region, dizziness and nausea, poor appetite and abdominal distension, palpitations and little sleep, fat tongue with teeth marks, white greasy moss, sunken and thin pulse.
Treatment: Eliminate phlegm and dampness, promote Yang and open paralysis.
Therapeutic formula.
①30g of garlic with purple skin, 100g of rice with stalks. peel the garlic and put it in boiling water for 1min and take it out.
When the porridge is ready, add the garlic and cook for a few minutes, take it warm in the morning and evening.
(2) 6g of black fungus, 50g of lean pork, 9g of foxglove, 20g of coix seeds, boil and drink soup together, 1 dose daily.
③Hawthorn 50g, lotus leaf 50g, coix seed 50g, green onion 30g. Boil soup together and drink it as tea.
Qi stagnation and blood stasis type
Symptoms: Pain in the precordial region or behind the sternum, fixed, stopping at times, worse at night, accompanied by pain in both hypochondrium, chest tightness and breathlessness, mood disorder, dark tongue or stasis, string pulse.
Treatment: Dispersing Qi and removing blood stasis.
Therapeutic formula.
①3g of dried Panax ginseng flowers, appropriate amount of rock sugar. Brew and drink frequently as tea.
② 5g of peach kernel and sweet almond, 100g of round-grained rice. cook porridge, divide it into porridge in the morning and evening, 1-2 times a day, 5-6 days for a course.
③Cabbage 250g, balsamic vinegar, sugar in appropriate amount. Stir-fry the fried cabbage in the sugar and vinegar sauce, wait for it to be cooked and season it. Serve with meal, once a day or once every 2 days.
Heart Yang deficiency type
Symptoms: palpitations, shortness of breath or shortness of breath, chest tightness or heart pain, cold in the extremities, pale face and purple tongue or purple and dark tongue or light tongue with white fur, sunken pulse or knotted generation.
Treatment: Tonify the temperature and Yang, dispel cold and open the veins.
Food therapy formula.
① 30g of mutton, 30g of beef, 30g of dog, 30g of venison, 15g of pork, 250g of round-grained rice. stew the meat first, then add round-grained rice and cook it into a congee for breakfast once a day.
A pair of pig kidney, 7 white onion, 3g of ginseng, 60g of round-grained rice, peel off the kidney, cut into shreds, grind ginseng, cook the porridge with round-grained rice, add the shreds of kidney, grated ginseng and green onion and mix well.
When the porridge is ready, add the kidney, ginseng and green onion, mix well and take it after cooking.
③ 10g of ginger, 6g of angelica, 100g of mutton, 12g of wine, 6g of green onion, 3g of salt. wash and slice the mutton, add 1000ml of water, boil it on a high flame, then stew it for 50min on a low flame, once a day, eat the meat and drink the soup.
Food therapy for coronary heart disease
Heart and blood stasis type: this evidence should avoid eating cold diet, treatment should be to move Qi and activate blood, medicinal food to give peach kernel porridge (10g of peach kernel and 50g of round-grained rice decoction into porridge, take on an empty stomach, 1 time to 2 times a day), peach kernel safflower soup (10g of peach kernel, 10g of safflower with appropriate amount of water, boil for 10min, filter dregs and 100g of lotus root powder into soup, take on an empty stomach, 1 time to 2 times a day).
Phlegm congestion type: In this case, pay attention to the diet should not be too sweet, avoid eating oily and thick-flavored products, and give the medicine to coix rice porridge (raw coix rice is 2-3 times more than white rice, boil coix rice first, then add rice to the porridge, once or twice a day), or use fresh sea jelly 30g, 10 water chestnuts decoction to drink as tea.
Yin cold stagnation type: this evidence avoid cold melons and fruits, medicine to give sheep spinal cord soup (sheep spine 200g chopped into 2 pieces, cistanches 15g wine soaked overnight, scrape off the coarse skin; cuscuta 15g wine soaked for 3 days, cool dry and pounded. (Use appropriate amount of water, stew the sheep backbone with Cistanches until cooked, mix in Cuscuta and seasonings, 100ml each time, 2-3 times a day, take on an empty stomach), Allium congee.
Heart and kidney yin deficiency type: Avoid spicy, coffee, strong tea and other stimulating foods. The medicine can be given as longan and ginseng drink (30g of longan, 3g of sugar, 6g of American ginseng, put the three in a bowl with a lid and steam them repeatedly in a rice pot until they become paste, take one spoonful each time, 2-3 times a day) or raw pulse congee (6g of ginseng, 15g of maitake, 10g of schisandra and 50g of japonica rice, add water and cook the congee, take it on an empty stomach, 1 to 2 times a day).
Qi and Yin deficiency type: this evidence avoid eating spicy, greasy and thick-tasting products, medicinal food to give Poria cake (Poria 500g grinded, flour, add water and flour, make small cakes 50g a, fire branding, 2 times a day, taken on an empty stomach) or Yam porridge (Yam 100g, washed and chopped, with japonica rice 50g, add appropriate amount of sugar, decoction into porridge, taken on an empty stomach while hot, 1 time to 2 times a day).