Diagnosis and treatment of myocardial ischemia

  Myocardial ischemia, a pathological state in which the blood perfusion to the heart is reduced, resulting in reduced oxygen supply to the heart, abnormal myocardial energy metabolism, and inability to support the normal work of the heart. The blood supply to the heart is not constant, but always fluctuates, but this fluctuation is regulated by the body itself to promote a relatively constant blood supply and demand, ensuring the normal work of the heart. If myocardial ischemia is caused by any of the causes, and the regulation by the body cannot meet the working needs of the heart, this constitutes myocardial ischemia in the true sense.  Myocardial ischemia impairs diastolic function. The combination of poor systole and poor diastole predisposes to an increase in ventricular filling pressure, causing pulmonary congestion, and can also lead to complex disorders of substance metabolism and derangement of myocardial electrical activity. Therefore, once myocardial ischemia occurs, the right cause should be identified and treated symptomatically in order to avoid potentially serious consequences. Cardiac ischemia is a kind of coronary heart disease, and the treatment plan is to choose nitrates (such as isosorbide mononitrate or its extended-release form), which act to dilate the coronary arteries of the heart and increase the blood supply to the myocardium; statins (such as atorvastatin and simvastatin) should also be taken to lower the cholesterol in the plasma on the one hand, and stabilize the arterial plaque on the other hand to prevent the plaque from falling off and forming blood clots, causing strokes, etc.  At present, medical science classifies asymptomatic myocardial ischemia into the following three types: Type I: safe asymptomatic myocardial ischemia: this type is asymptomatic and is found to have myocardial ischemia by chance, and some people estimate that it accounts for 2%-5% of middle-aged men (general population) who have no symptoms of coronary heart disease at all. The prognosis is similar to that of patients with angina pectoris.  Type II: asymptomatic myocardial ischemia after myocardial infarction: the presence of myocardial ischemia is more common after myocardial infarction although there is no angina. The prognosis of patients with this type is worse than type I, especially when the left ventricular function is abnormal, and the mortality rate is 5-6%.  Type III: angina with asymptomatic myocardial ischemia: Studies have shown that asymptomatic myocardial ischemia is present in 70-80% of patients with angina and can occur in different types of angina. It is important to note that patients with unstable angina with asymptomatic myocardial ischemia can often cause fatal arrhythmias, and the presence of myocardial ischemia despite the disappearance of symptoms after treatment is an important indicator of poor prognosis.  Therefore, asymptomatic myocardial ischemia should be given sufficient attention. It can affect the prognosis of all types of coronary heart disease, so it should be actively diagnosed and treated. People with myocardial ischemia should pay attention to their diet, six words, low fat and high fiber. Emotionally, we should pay attention not to be very happy and sad, and keep enough sleep. Develop good habits, have regular bowel movements, and not overexert yourself.  Chinese patent medicines for myocardial ischemia The following Chinese patent medicines are commonly used at home for the treatment of myocardial ischemia: Danshen tablets: with the effect of dilating coronary arteries, increasing coronary flow, reducing blood viscosity and blood clotting. It is suitable for patients with chest paralysis caused by blood stasis.  Compound Danshen Tablets: It is composed of Danshen, Panax ginseng and ice chips. It has the effects of dilating coronary arteries, increasing coronary flow, inhibiting platelet aggregation, protecting ischemic heart muscle and improving microcirculation. There are two kinds of tablets and drops. It is suitable for acute attacks of angina pectoris and also used to prevent angina pectoris attacks.  Musk Heart Protection Pill: It is composed of musk, sulforaphane ester, nux vomica, cinnamon, toadstool, ice chips and ginseng extract. It has the effects of inhibiting the rise of serum total cholesterol and LDL cholesterol level, reducing vascular endothelial cell damage, inhibiting arterial endothelial proliferation and improving myocardial ischemia, etc. It has a rapid onset of action and is suitable for acute attacks of angina pectoris, or for preventing or alleviating angina attacks.  Dioscorea: refined from the total steroidal saponins extracted from unique medicinal plants. It has the effect of increasing coronary flow and myocardial nutrient blood flow, reducing blood lipids, blood viscosity and platelet aggregation rate. It is especially suitable for patients with chest tightness or patients with chest paralysis of qi stagnation and blood stasis. It should be used with caution in patients with bradycardia.  Heart Keshu: It is composed of Salvia miltiorrhiza, Pueraria Mirifica, Panax ginseng, Mucuna pruriens and Hawthorn. It is used to improve myocardial ischemia and microcirculation, enhance myocardial contraction and improve ventricular diastolic function. It is suitable for patients with qi stagnation and blood stasis type chest paralysis.  Coronary Artery Nurse: It is composed of Salvia miltiorrhiza, Radix Angelicae Sinensis, Safflower, Blood Dried, Gynostemma spp, Yanyuanhuosuo, Peach kernel, He Shou Wu and Huang Jing. It has the effects of increasing coronary flow, improving myocardial ischemia, inhibiting platelet aggregation and reducing blood viscosity. It is suitable for patients with chest paralysis of Qi stagnation and blood stasis type. Not to be used for pregnant women.  Tongxinluo: It is composed of ginseng, leech, scorpion, turtle worm, centipede, cicada molting, red peony and ice chips. It has the effects of increasing coronary flow, improving myocardial ischemia, regulating blood lipids, lowering blood viscosity, inhibiting platelet aggregation, and improving vascular endothelial cell function. It is suitable for patients with unstable angina pectoris.  Nordicum: It is a Tibetan medicine (sacred rhodiola). It has the effects of improving myocardial ischemia, regulating blood lipids, reducing blood viscosity and inhibiting platelet aggregation. It is suitable for patients with Qi stagnation and blood stasis type of chest paralysis.  Ginkgo biloba preparations: (Bailuada, Stelon, Brain En, Tianbao Ning, Apricot Ling granules) are natural active substances extracted from Ginkgo biloba, which can improve myocardial ischemia, reduce blood viscosity and protect the function of vascular endothelial cells. It is suitable for patients with qi stagnation and blood stasis type of chest paralysis. See the instruction manual for the specific method of taking the above drugs.