Coronary heart disease is a common disease in the elderly, which can cause acute myocardial infarction, arrhythmia and other serious complications, affecting the health and quality of life of the elderly, the following is a brief introduction to some basic knowledge of coronary heart disease.
First, the nine risk factors that cause coronary heart disease.
1, smoking: smoking is likely to cause vasospasm, blood sticking, coronary heart disease patients should resolve to quit smoking.
2, obesity: body mass index should be controlled at 25 or less. More than 20% of the standard body weight, the risk of heart disease increased by one, the rapid increase in weight is even more.
3, age: coronary heart disease is mostly seen in middle-aged people over 40 years old, and progresses more rapidly over 49 years old.
4, gender: in China, the incidence and mortality ratio of coronary heart disease in men and women is 2:1, but the incidence of coronary heart disease in women after menopause has increased significantly.
5, diabetes: diabetes can cause vascular damage, leading to atherosclerosis, the incidence of coronary heart disease in diabetic patients is 2 times that of non-diabetic patients.
6, hypertension: hypertension damage to the blood vessel wall can often lead to plaque rupture, thrombosis. Patients with coronary heart disease should strive to control blood pressure below 130/80 mmHg through low salt and low fat diet and regular exercise.
7, high blood lipid: especially the deposition of LDL cholesterol in the subcutaneous of blood vessels, is the basis of plaque formation in blood vessels. Patients with hyperlipidemia should adhere to a low-fat diet and control greasy food.
8, mental stress: the incidence of coronary heart disease is greater in mental workers than in physical workers, life section Qin tension, often have a sense of urgency of workers prone to coronary heart disease.
9, lack of exercise: reduced exercise can also lead to the occurrence of coronary heart disease. Try to choose aerobic exercise is beneficial to reduce the risk of coronary heart disease.
Second, the common complications of coronary heart disease.
1, arrhythmia. Coronary artery disease complicating arrhythmia is the most common complication of acute myocardial infarction, especially ventricular arrhythmia, common ventricular tachycardia, frequent ventricular asystole, ventricular fibrillation, etc., is one of the main causes of death in the acute phase.
2.Heart failure: It is a common and important complication of acute myocardial infarction, which is a critical illness with high mortality.
3, cardiogenic shock: a serious syndrome directly due to the impairment of ventricular pump function resulting in a drop in blood pressure and circulatory failure.
Third, the common non-invasive tests for coronary artery disease.
1, electrocardiogram: about 50% or more of patients with stable angina have normal resting electrocardiogram. ST-T changes are common in elderly patients, mostly showing non-specific changes.
2.Exercise ECG: The purpose of the test is to screen patients with atypical symptoms or normal resting ECG for myocardial ischemia or to stratify patients for risk to decide further treatment. The incidence of abnormal exercise ECG is significantly higher in the elderly.
3. Echocardiography: It can be used as a basic test to assess cardiac function and cardiac structure in the elderly. The specificity and sensitivity of echocardiographic stress test for the diagnosis of coronary artery disease are higher than those of exercise ECG stress test.
4.Exercise nuclear myocardial imaging: It can improve the positive rate of coronary heart disease diagnosis in the elderly, and is more accurate than ECG in determining the extent of myocardial ischemia, and the coronary artery involved in the lesion can be inferred from the site of abnormal ventricular wall motion.
5.Coronary CT: It is a non-invasive method commonly used to diagnose coronary artery disease in recent years.
6.Cardiac magnetic resonance imaging (MRI): non-radiation, observation of myocardial perfusion images after injection of contrast agent and significant progress in coronary vascular imaging technology, which may become an important examination means for coronary artery disease in the future.
Fourth, minimally invasive examination of coronary artery disease (coronary angiography).
Coronary angiography is a minimally invasive examination, which is the gold standard for the diagnosis of coronary artery disease and can accurately understand the location, degree of stenosis, lesion morphology and collateral circulation of coronary artery disease, providing a reliable basis for clinical diagnosis, selection of treatment methods and prognosis judgment of coronary artery disease. Coronary angiography should be performed as early as possible in high-risk patients. Coronary angiography can be performed directly for chest pain caused by suspected myocardial ischemia, when relevant noninvasive tests cannot be performed or when there is a special need. Coronary angiography in the elderly is mainly used for patients who are ready for hemodynamic reconstruction therapy or need to determine further therapeutic strategies, and not only to clarify the diagnosis of coronary artery disease.
V. Common methods of coronary artery disease treatment.
1, drug therapy: drug therapy is the most basic treatment plan, once patients are diagnosed, drug therapy should be maintained for life. When drug therapy is ineffective or ineffective, coronary angiography should be done as soon as possible to make accurate assessment of coronary artery lesions, and then decide whether to perform coronary intervention or coronary artery bypass grafting.
2.Interventional treatment: Interventional treatment is less traumatic, quick recovery, can quickly solve coronary artery stenosis, relieve myocardial ischemia and improve the quality of life. The disadvantage is that some patients are not suitable for interventional treatment, and a small number of patients may have restenosis after surgery.
3.Coronary artery surgical bypass surgery (bypass surgery): bypass surgery has reliable results, but requires open-heart surgery, which is more traumatic, more expensive and has a longer recovery time.