Treatment of myocardial ischemia

  The treatment options for myocardial ischemia include thrombolysis, intervention, drug therapy and surgical treatment.  If the myocardial ischemia is short, it is manifested as angina pectoris, and the treatment is mainly based on drugs, and some patients need coronary intervention or surgical treatment; if the myocardial ischemia is long, it will lead to myocardial necrosis, that is, infarction, and can be treated by thrombolysis, intervention or surgery to restore myocardial blood supply on the basis of drug treatment.  1.Pharmacological treatment Myocardial ischemia patients are often treated with anti-platelet drugs and statin lipid-regulating drugs as the basic treatment, while risk factors such as hypertension and diabetes are controlled with drugs. If there are still symptoms of myocardial ischemia or electrocardiogram performance, anti-ischemic drugs, mainly including beta-blockers, nitrates and calcium channel blockers, should be used.  2.Thrombolysis Thrombolysis is a treatment method to dissolve the fresh thrombus in the infarct-related coronary artery by intravenous injection of thrombolytic drugs, so that the occluded artery can be reopened rapidly. Patients who have thrombolysis 1-2 hours after the onset of disease benefit the most.  Indications for thrombolysis: Thrombolysis is preferred when acute ST-segment elevation infarction is within 3 hours of onset and when emergency percutaneous coronary intervention is not available. Patients with ST-segment elevation infarction who are <12 hours old, ≤75 years old and have no contraindications to thrombolysis can be treated with thrombolysis.  Percutaneous coronary intervention For patients with acute myocardial infarction and recurrent ischemia despite drug treatment, percutaneous coronary intervention is feasible.  Interventional indications: Percutaneous coronary intervention (PCI), including coronary balloon dilation and stent implantation, can mechanically open the occluded or highly stenosed coronary arteries and improve or even restore the blood supply to the heart muscle. However, this technique requires an experienced medical team and an appropriately equipped medical center to perform. For patients with heart attack, especially those with contraindications to thrombolysis or bleeding complications, direct PCI is almost always considered; for those who are not successfully recanalized by thrombolysis, remedial PCI should also be performed. 4. Coronary artery bypass grafting For patients whose infarction cannot be resolved by intervention. It is to establish a channel between the proximal and distal ends of coronary artery stenosis by using blood vessels from other parts. Although heart bypass surgery has certain risks, the use of coronary artery bypass surgery is still one of the most effective means of treating coronary artery stenosis and myocardial ischemia worldwide.  Which treatment method is adopted for myocardial ischemia depends on the severity of the condition and the individual patient.