Hello! According to the medical history you provided, the patient still has recurrent symptoms of chest tightness and shortness of breath after PCI, so there is a lot of doubt, and we are giving the following advice: 1, the symptoms of chest tightness and shortness of breath after surgery may be as follows: a, problems with the stent itself, i.e., restenosis within the stent or the distal proximal end, or compression of other vessels, but according to the results of the dual-source CT of your second hospitalization, the possibility of this problem is However, according to the results of your second inpatient CT, this problem is less likely; b, problems with the rest of the vessels, because the patient still has stenosis in the proximal segment of the RCA and the OM opening, although it does not meet the criteria for stent implantation, it may occur at any time, resulting in insufficient blood supply or reduced blood flow due to spasm on the basis of the stenosis, and the possibility of this problem cannot be ruled out. further observation (see below for specific recommendations), it is really uncontrollable, can be considered to perform intracoronary angioplasty or stent implantation again; c, the patient also has a myocardial bridge in the middle segment of the LAD, so this is also likely to be the cause of the symptoms, for this problem, because it is a congenital anatomical malformation, in fact, there is no good solution in the cardiovascular industry now, and can only rely on limited drug treatment ;d, so overall, the hospital’s surgical and pharmacological treatment of the patient is still very much in line with the norms. 2, the causes of chest tightness and shortness of breath in patients, in addition to the coronary arteries themselves, also need to consider the following factors: a, arrhythmias, various types of premature beats, paroxysmal atrial fibrillation, atrial tachycardia, atrial flutter and other arrhythmias can cause the above symptoms, and this is also a common accompanying problem in patients with coronary heart disease; b, some neurosis in patients after PCI, that is, the patient’s own subjective symptoms are dominant, which requires patients A period of adaptation process; c, the problem of cardiac function, there are some patients because of the decline in cardiac function caused by pre-myocardial ischemia, which is relying on stent surgery can not be repaired, specific recommendations see below; 3, comprehensive consideration of the above factors, I give the following subtle adjustment recommendations, I hope to bring the actual value of treatment to patients: a, Emdo changed to cardiac pain, 5mg, 3 times a day; b, plus Diltiazem Thiodro, 30mg, 3 times a day; c, if repeated electrocardiograms and ambulatory electrocardiograms suggest the possibility of arrhythmia, add relevant antiarrhythmic drugs; d, if there is chest tightness and shortness of breath after activity due to decreased cardiac function, the patient can be explained that he must have a strict low-salt diet, control fluid intake, avoid fatigue, cold, alcohol, mental burden, quit smoking, etc., and at the same time, if necessary 4, the rest of the treatment should be said that the hospital has given a standardized treatment plan, there is no problem; if there is a need to add some adjuvant treatment, in order to exclude the patient subjective factors caused by complaints of discomfort, you can give ginseng pine heart capsule, 2 capsules, 3 times a day, or Yi Xin Shu, 2 capsules, 3 times a day, sometimes can bring unexpected results; 5, as for the preservation of the stomach As for the treatment of stomach protection, it is recommended to add omeprazole tablets, 1 tablet, 2 times a day. Aspirin tablets taken in the evening according to the hospital has minimized the stimulation of the gastric mucosa, but attention can be paid to taking them after meals, the stimulation of the stomach will be relatively less.