When the coronary arteries of the heart are excessively narrowed due to atherosclerosis, the supply of blood and oxygen to the heart is insufficient, resulting in symptoms of ischemia and hypoxia in the heart muscle.
Common symptoms of coronary heart disease?
1, angina: chest pain during exertion, lasting 3-5 minutes, relieved after rest, accompanied by shortness of breath, chest tightness, panic, but also accompanied by upper jaw or back pain, nausea, burning sensation in the stomach, excessive sweating, etc.
2. Myocardial infarction: chest pain that lasts and cannot be relieved
What are the examination methods for coronary heart disease?
Commonly used are electrocardiogram, exercise test, echocardiogram, and nuclear myocardial imaging, but only coronary angiography is the “gold standard” for the diagnosis of coronary heart disease. Coronary angiography can clarify the presence or absence of coronary artery stenosis, the degree, location and extent of stenosis, and the doctor can make further treatment plans accordingly.
What are the main treatment methods for coronary artery disease?
Currently, the main treatments are drug therapy, interventional therapy and surgical therapy. In most cases it is a comprehensive treatment including lifestyle changes, reasonable exercise, etc. For end-stage coronary artery disease that has lost the opportunity of interventional and surgical treatment gene therapy and stem cell therapy have achieved initial results and are the current direction of research.
Intracoronary PTCA + stenting.
A balloon catheter is delivered into the coronary artery stenosis, the balloon is filled, and the stenotic segment is dilated, i.e., PTCA is performed. To prevent retraction, a mesh alloy stent is inserted into the stenosis to expand the stent and support the vessel, i.e., stenting.
Preoperative preparation.
1.Pre-operative examination: cardiac duplex film, electrocardiogram, cardiac ultrasound, blood routine, blood coagulation routine, liver and kidney function, electrolytes, lipid glucose, blood type, immunological examination, etc.
2. Pre-operative preparation: penicillin skin test, iodine allergy test, bilateral inguinal skin preparation (please take a bath and change clean clothes after skin preparation), training bed bowel movement (you need to lie down for 24 hours after surgery to prevent defecation difficulties) should be performed before surgery. Empty urine and stool half an hour before surgery, remove body ornaments and wait to enter the catheterization room.
3. The day before the operation, you should take Corydalis or Ceclopidine, aspirin, etc. If necessary, take oral Valium to ensure sufficient sleep and relaxation.
How long does the surgery take? Will it be painful?
It takes about 1.5 hours, and the whole procedure is painless. The patient is completely awake, and only a little painful when a small amount of anesthesia is injected into the arterial puncture, basically the same feeling as an intravenous needle.
Where do I enter the surgery? What problems should I pay attention to after surgery?
1.Femoral artery puncture is commonly used. After the operation, the puncture is compressed with local sandbag for 6-8 hours, and the limb on the operated side is braked for 12 hours, and then you can move around lightly at the bedside after 24 hours.
2, raphe artery puncture, postoperative compression and bed rest are not required, local upper limb braking is sufficient. Drink as much water as possible after the operation to facilitate the rapid excretion of the contrast agent and to avoid vagal reflexes and insufficient blood volume.
Surgical treatment of coronary artery disease?
Surgical coronary artery bypass grafting is performed by using one’s own blood vessels (usually the left internal mammary artery and the saphenous vein) to access the distal end of the stenotic lesion of the coronary artery, allowing blood flow to bypass the stenotic lesion, and then providing adequate blood supply to the heart muscle through this vascular bridge.
Gene therapy and stem cell therapy for coronary heart disease?
For patients with recurrent angina pectoris or severe heart failure, and who have lost the opportunity of intervention and bypass, or whose life needs are still far from being met by intervention and bypass with standard medication, i.e. patients with end-stage coronary artery disease, the use of gene or stem cells (autologous or allogeneic) injected directly into the myocardium to grow new blood vessels through cell differentiation is called gene or stem cell therapy. This research has shown initial results and has brought hope to patients with end-stage coronary artery disease.