1.Why coronary artery spasm can lead to myocardial infarction or sudden death? A large number of coronary artery selective angiography proves that coronary artery spasm can occur on the basis of lesions with different degrees of coronary artery atherosclerosis. If the spasm is severe or prolonged, it can lead to myocardial infarction or sudden death. It has been reported that some patients with myocardial infarction have normal or almost normal coronary angiograms. It is believed that the occurrence of such myocardial infarction without thrombus and myocardial infarction without obvious coronary artery disease may be due to the following three reasons: (1) there is coronary artery disease but it is neglected; (2) a transient obstructive thrombus is subsequently dissolved; and (3) there is an infarction caused by obstructive spasm. Recent research data show that the rate of sudden death is 3-4 times higher in men than in women. Some of them cannot be detected by systematic autopsy, which means that sudden cardiac death is not always caused by advanced coronary atherosclerosis, but may be the result of functional or ventricular fibrillation, which can be resuscitated. 2.When is coronary heart disease likely to occur? Coronary heart disease is the result of the long-term combined effect of many factors, such as hypertension, high blood pressure, high blood sugar, as well as smoking and obesity, because these risk factors directly damage the coronary vascular intima, causing coronary artery sclerosis, spasm, straight to block the blood vessels. If the blood flow supplying nutrients to the heart is not smooth, myocardial ischemia and hypoxia will occur, and coronary angina will occur, and myocardial infarction will occur if it is completely blocked. In addition, too little physical activity, mental tension is also a risk factor for the occurrence of coronary heart disease can not be ignored. 3.What is the relationship between drinking water and tea and coronary heart disease? Coronary heart disease patients are particularly important to drink water in the morning, to prevent heart attacks. Because early in the morning the patient’s platelet activity is increased, and therefore the cardiovascular thrombus is easy to form, easy to cause myocardial ischemia. Early in the morning is the time when the human physiological blood pressure rises, which makes it easy for the fatty tissue deposits that usually adhere to the cardiovascular wall to fall off and block the cardiovascular. As heart patients after a night of sleep, not only from the urine eliminated a lot of water, but also through the respiratory tract lost a large amount of water. The loss of water in the body will make the blood sticky and increase the possibility of thrombosis. Therefore, patients with coronary heart disease should drink some warm or cool water in the morning, which not only has a direct effect on diluting blood and replenishing blood volume, but also is extremely beneficial for promoting gastrointestinal motility and keeping stools open. Because constipation is also a contraindication for patients with coronary heart disease. Tea can be drunk in moderation, no need to worry more, because tea has the effect of reducing blood lipids and preventing atherosclerosis, but should not drink strong tea. 4, high blood lipids, atherosclerosis and coronary heart disease, cerebral thrombosis, what is the relationship between the occurrence of? To this question, first of all, we should understand that atherosclerosis is the root cause of cardiovascular diseases, atherosclerosis, vascular elasticity decreases or disappears, the arterial blood flow is not smooth and affects the blood supply. High blood lipid is the increase of total cholesterol, low-density lipoprotein and triglyceride in the blood, and the increase of lipoprotein and cholesterol in the blood can promote the formation of atheromatous plaque in the arteries, and this plaque and other metabolites can further damage the endothelium of the arteries, which will aggravate the accumulation of atheromatous substances in the blood vessels and promote atherosclerosis, causing blockage of the arteries in the heart and brain. Blocked coronary arteries form coronary heart disease, and blocked cerebral blood vessels will form cerebral thrombosis. 5.Why is prevention important in coronary heart disease? The saying “prevention is better than cure” is a constant truth for any kind of disease, and of course, the problem of coronary heart disease is no exception. The basic cause of coronary heart disease is atherosclerosis. The onset of atherosclerosis is insidious and can develop at an early age. When the symptoms of narrowing of blood vessels and insufficient blood supply appear, most of them have already reached the advanced stage of fibrosis with calcification and ulceration, which is difficult to be reversed by modern medical means. However, experimental studies have proved that for early atheromatous lesions, elimination of risk factors can make the atheromatous plaques subside. Certain drugs may have some inhibitory effect on the development of atherosclerosis, but they have no significant effect on the atheromatous plaques with complex lesions in the late stage. Therefore, to deal with atherosclerosis and coronary heart disease, we must focus on prevention and adhere to the prevention-oriented approach. It is enough to pay more attention to the condition of one’s heart in daily life, improve one’s attitude towards life and adapt to the living environment. In addition, young people are advised not to be indifferent to their heart because they are young, get rid of the concept that “coronary heart disease is an old man’s disease” and learn about their heart condition as early as possible. 6.What are the preventive measures for atherosclerosis? ①Reasonable diet: The main dietary treatment principle is to limit fat intake. The intake of animal fat (mainly containing saturated fatty acids) should not be too much, less fatty meat and large oil, can eat more fish and meat, vegetable oil, soybean products, etc. containing more unsaturated fatty acids. In addition, eat less sweets, eat more fresh vegetables and fruits, ensure adequate supply of vitamins and beneficial nutrients such as potassium and calcium and plant fiber, moderate salt intake ( 6 to 8 grams/day), do not smoke, drink less or no alcohol. ② Physical activity: actively participate in physical exercise and physical activity, the best choice is jogging, walking, swimming and other aerobic exercise, which has the best effect on the prevention of cardiovascular and cerebrovascular diseases. Reasonable and scientific exercise can increase high-density lipoprotein in the body, which is beneficial to cardiovascular protection. ③ Combination of work and rest and mental regulation: learn to relax, avoid mental tension, worry and anxiety, and have a regular life. Use your brain often, but prevent excessive brain use. ④ Active prevention and treatment: for people with family history of hypertension, coronary heart disease and diabetes, it is advisable to pay attention to the changes in blood pressure and blood lipids in time and take early measures. 7.When should the prevention of coronary heart disease start? Coronary heart disease is a cardiovascular disease caused by atherosclerosis and narrowing of the coronary arteries that supply blood to the heart, resulting in an impairment of blood supply to the heart itself. Although coronary heart disease is a common disease among middle-aged and elderly people, coronary atherosclerosis has a long-term process, often starting when a person is young. Coronary atherosclerosis begins in childhood and adolescence, so the prevention of coronary heart disease should start from childhood, early prevention, as well as early detection and early treatment. To prevent coronary heart disease from children, the focus is to make sure that children are not overly obese, to prevent high blood pressure in children and to prevent them from becoming smokers. 8.Can angina pectoris be prevented? Coronary angina can be prevented by taking appropriate measures to reduce the incidence of coronary heart disease in the population (primary prevention) and stop the further development of angina. Prevention includes: first, control risk factors, including active treatment and control of hypertension, effective measures to reduce blood lipids, treatment of obesity and diabetes. The second is to improve lifestyle including stopping smoking, gradually increasing physical strength and physical activity in a planned manner, limiting alcohol consumption, and adjusting diet structure by adopting low-fat and low-sodium foods. For patients who have developed coronary heart disease, they should be transferred to secondary prevention, actively take preventive measures and strengthen the guidance of conditioning to prevent or delay the development of the disease, and strive for improvement and prolong life. The main measures are: life conditioning angina attack should be rested. In general, patients should adjust their daily life and workload during the remission period, and maintain appropriate physical activity and exercise (to the extent that no angina attack) to improve physical strength and cardiac compensatory function. Generally, bed rest is not required, but patients with frequent angina or prone angina or variant angina should rest in bed. And quit smoking and alcohol and other bad habits. 9.What is the primary prevention and secondary prevention of coronary heart disease? The primary prevention of coronary heart disease is to prevent risk factors for children with early-onset coronary heart disease and family history of cardiovascular disease, and the purpose of prevention is to “prevent the onset”. In fact, coronary heart disease begins in young children, and the early changes of atherosclerosis – lipid streaks – begin to appear in their arteries under the effect of coronary heart disease risk factors. At this time, the main thing is to prevent risk factors. The main risk factors for coronary heart disease include hypertension, hyperlipidemia (hypercholesterolemia and low HDL cholesterol), smoking, diabetes, overweight, obesity, and too little exercise. Therefore, children with positive family history, or children with obesity or diabetes should be prevented from risk factors early. The effect of these risk factors on the development of coronary heart disease is multiplied, which increases the morbidity and mortality rate exponentially. If a child has hypertension, smoking and hyperlipidemia but does not have coronary artery disease, it is important to eliminate as many risk factors as possible to reduce or avoid the development of coronary artery disease. The development of coronary heart disease includes angina pectoris and myocardial infarction. The secondary prevention of coronary heart disease is to prevent the occurrence of “cardiac events” when the patient has coronary heart disease or subclinical atherosclerosis, peripheral vascular disease or cerebrovascular disease. Cardiac events include unstable angina, fatal or nonfatal myocardial infarction, sudden cardiac death, heart failure, myocardial revascularization, and hospitalization for coronary heart disease resulting from these events. Carotid ultrasonography can detect carotid atherosclerotic plaques, while measurement of carotid intima-media thickness can reflect the average level of systemic atherosclerosis, and measurement of incremental changes in brachial artery internal diameter after pressure blockade can reflect arterial endothelial cell function and early changes in atherosclerosis. Both of these tests can reflect the lesion load of coronary arteries. 10.How to effectively prevent sudden death from coronary heart disease? As there is no cure for coronary heart disease, in order to avoid sudden death of coronary heart disease, experts recommend patients to take nine preventive measures, which are the nine “magic weapons” to resist sudden death of coronary heart disease. ① Keep emotional stability: tension and excitement can cause a sudden rise in blood pressure to induce an acute heart attack. If a patient with coronary heart disease watches a tense and intense sports competition, or encounters a serious psychological imbalance due to bad things, or because of something big sadness and joy, etc., it may lead to sudden death. Therefore, we should pay attention to avoid emotional excitement, mental tension, and strengthen their own cultivation efforts to achieve broad-mindedness, emotional optimism, cheerfulness, open-mindedness, treating people with peace and peace of mind, so as to avoid the enhancement of endocrine function and cause sudden myocardial ischemia. ② avoid overwork, exercise moderate: some retired elderly playing mahjong addiction, forgetting to eat and sleep, all night long, due to overwork and win or lose on the emotional (blood pressure) impact, induced acute heart attack sudden death on the mahjong table, the media has repeatedly reported. Other forms of sudden death from exertion also occur. The elderly should exercise according to their ability, generally walking, playing taijiquan and playing gateball is appropriate, coronary heart disease patients should not overload exercise. ③ Quit smoking and ban alcohol: to completely quit smoking and ban alcohol. Studies have confirmed that 21% of deaths from heart disease are caused by smoking. People who smoke 1 to 14 cigarettes a day have a 67% higher risk of dying from coronary heart disease than non-smokers; those who smoke more than 25 cigarettes a day have a 3 times higher risk of dying. However, after quitting smoking, this risk can be gradually reduced to the level of non-smokers after 3-5 years. Nicotine, a toxic substance contained in cigarettes, can cause contraction or spasm of the coronary arteries and induce an acute attack of coronary heart disease. Therefore, smokers should resolutely quit. Although a small amount of alcohol has the effect of reducing the sudden onset of coronary heart disease, however, the danger of alcohol abuse is great, people should stop in moderation, not bullying binge drinking, people with coronary heart disease should be more respectful and far away. ④ Maintain the ideal weight: medical doctors found that if more than 20% of the standard weight, the risk of sudden onset of coronary heart disease increased by 1 times. Therefore, overweight, especially obese people, it is necessary to lose weight. However, the best way to lose weight is not starvation dieting, but to adhere to the exercise. People who like to exercise, the risk of sudden onset of coronary heart disease is 35% to 55% less than those who are used to sedentary. Of course, exercise should be moderate and sustained, not strenuous. ⑤ Treatment of hypertension: Hypertension can not only lead to sudden death due to sudden stroke, but also increase the risk of “sudden cardiac death”. Therefore, from the early stage of hypertension should start treatment, specific methods are: relax, regular life, ensure sleep; under the guidance of a physician, choose a gentle antihypertensive drugs; long-term use of antihypertensive drugs, do not suddenly stop the drug, in order to avoid rebound and dangerous. ⑥Lowering blood lipids: Increased blood lipids (triglycerides and cholesterol) are an important reason for the occurrence and aggravation of coronary heart disease, so it is not advisable to eat foods rich in high cholesterol and high sugar foods that can easily raise triglycerides and drink a lot of alcohol. (7) control diabetes: diabetes can promote or aggravate coronary heart disease, such as the original diabetes, should control blood sugar, so that blood sugar levels within the normal range. ⑧ prevent constipation: holding your breath when defecating will increase abdominal pressure, raise blood pressure, affect the heart and trigger an acute attack of coronary heart disease, so you should usually eat more fruits and foods containing more fiber and vegetables, and if necessary, you can also take laxatives or anal injection of cork, etc., to keep bowel movements smooth. ⑨ drugs to help themselves: people with coronary heart disease, to carry a health care box with nitroglycerin, heartburn, quick-acting heart pills and other drugs, in the beginning of the disease can be taken immediately to reduce the severity of the disease. In addition, coronary heart patients take enteric aspirin tablets 50mg daily, to prevent sudden death also has a good effect.