Coronary heart disease has become a common disease nowadays, young, major hospitals have patients with heart attack at the age of 20-30, how to prevent and treat coronary heart disease has become a hot topic of concern for patients. Now it coincides with the network era, patients like to Baidu, look at the WeChat circle of friends information, but the online information is as much as a cow’s hair, good and bad. We often see misleading articles such as “coronary heart disease does not require medication” and “stent surgery has been eliminated abroad”, so that patients are often troubled by the question of whether to have surgery or take medication after being diagnosed with coronary heart disease. Coronary heart disease, surgery or medication? Let’s talk about it today. It’s not a choice between the two: whether you do surgery or not, you have to take medication for a long period of time When you have coronary heart disease, should you take medication or do surgery? This question itself is misleading. As long as the diagnosis of coronary heart disease is clear, regardless of whether surgery is done or not, it is necessary to take medication for a long time, and there is no conflict between the two, not a matter of choosing one. The general diagnostic criteria for coronary heart disease is a stenosis of more than 50%, and there are three main treatment methods for coronary heart disease, namely drug therapy, interventional therapy and surgical bypass surgery. In layman’s terms, interventional therapy means putting in a stent, which, like bypass, is what patients call surgery. Medication is the basic treatment, and surgery only temporarily solves the problem of stenosis, but other blood vessels, such as those with stents or bypasses, may be stenosed again, so medication is needed to slow down the development of stenosis after surgery. Therefore, it is not right to think that we should not take medicine after stenting. In addition, in addition to taking medication, it is necessary to maintain good habits such as exercising and eating a light diet in order to better prevent blood vessel restenosis and blockage. So the question should be changed to “I have coronary heart disease, should I just take medicine? Or should I add surgery?” would be more appropriate. In general, on the basis of medication, coronary artery disease treatment can be divided into three categories: the first category is controlled by medication, the second category is necessary for surgical treatment, and the third category is considered for surgical treatment. Under what circumstances must surgery be done? Coronary heart disease is generally divided into acute coronary heart disease and stable coronary heart disease. Acute coronary artery disease is a must for surgical treatment, while stable coronary artery disease depends on the situation. What is acute coronary artery disease? Acute coronary artery disease includes acute heart attack and unstable angina, the common point is that the number and intensity of pain are increased compared to usual, and in severe cases, even shortness of breath, shock, syncope and other immediately life-threatening situations. This is equivalent to an “active volcano”, which may erupt at any time. Once the volcano erupts, it should be taken seriously: 1. Confirm the diagnosis through coronary angiography as soon as possible. Because the symptoms have changed (such as the number of pain, the intensity of the increase than usual), it means that the blood vessels may change from stenosis to blockage, especially in acute ST-segment elevation infarction, generally need to use emergency surgery. 2.Surgery as soon as possible after the diagnosis is confirmed. After the diagnosis of myocardial infarction, surgery should be done as soon as possible to open the blood vessels, and the sooner the better. Time is life, because the blood vessels are blocked, there is no blood supply in the heart and gradually necrosis, surgery can only save the heart muscle that is not dead, the dead heart muscle cells can not be restored, the longer the delay, the more dead cells, the more serious the damage to the heart function, post-operative heart failure and sudden death are likely to occur. This type of patient must have surgery, and the sooner the better! Why do some patients feel that the results are not good or even worse after surgery? However, during the consultation, many patients and family members are reluctant to have surgery because they hear other patients say that their symptoms are not reduced after surgery, “that’s all there is after surgery,” or even “they feel that their condition is not as serious before surgery as it is after surgery,” etc. In fact, this is mainly because This is mainly because: 1, from the onset to the surgery delayed for too long Many domestic patients were not sent to the hospital in time after the onset of the disease, delayed a lot of time; and so sent to the hospital after the diagnosis of heart attack, the family discussed for half a day to operate, and when agreed to do surgery, and delayed time. This leads to a discounted postoperative effect. 2, the heart itself is very poor Note that poor heart function is not the same as not being able to live normally. Such patients can’t save many heart muscle cells even if they have surgery, just like the ingredients are no longer fresh, it will lead to the chef’s play. It is important to understand that it is not surgery that leads to a worse post-operative situation than the pre-operative one; the situation could be worse without surgery. Therefore, when it’s time to operate, operate, don’t hesitate! What conditions are just controlled with medication? Unlike acute coronary artery disease, which is very aggressive, stable coronary artery disease is much milder to manage. Stable coronary artery disease refers to stable angina, which can have chest pain or no chest pain, but not much change from the usual symptoms, so it can be said that stable coronary artery disease is like a “dead volcano”, generally will not erupt acute myocardial infarction, will not suddenly form a blood clot blocking the blood vessels. The following is a list of two types of patients, basically do not need to do surgery, through drug therapy, improve lifestyle and other interventions. 1, angina pectoris is mild, usually life can do more intense physical work or exercise, through the activity plate test did not find serious myocardial ischemia, cardiac ultrasound examination also shows good cardiac function. These patients can be treated with medication and can also be exempted from the X-ray radiation of coronary angiography or coronary CT examination. 2.Coronary angiography shows that the stenosis is more than 70%, but as long as the stenosis is not a major vessel, or the vessel is small, the patient’s heart function is normal. This type of patient does not necessarily need surgical treatment, and the prognosis is also good through medication. When to consider surgical treatment? Not all patients with stable angina do not need surgery. Some young people who normally look normal can develop severe stenosis, which can easily cause plaque rupture leading to heart attack or even sudden death when performing intense exercise such as marathons. In general: patients with myocardial ischemia when they are slightly active, patients with obvious myocardial ischemia when they run a flat experiment, patients with shortness of breath or angina when they usually walk a few hundred meters or go up 3 or 4 floors. These patients are prone to accidents during exertion, excitement, mood swings, or when the weather changes a lot. These people then need frequent examinations and evaluations to decide whether they need surgical treatment based on the diagnostic results of coronary angiography.