OVERVIEW
Overview of Coronary Artery Embolism
Coronary embolism is a pathological process in which an embolus enters a coronary artery by dislodging from the heart or the proximal artery wall, blocking arterial blood flow and causing myocardial ischemia or even necrosis. Any embolus that enters the root of the aorta may enter the coronary artery and cause coronary embolism.
Whether medical insurance
Yes
Department
Cardiovascular Medicine, Cardiac Surgery
Clinical symptoms
Pain, fever, tachycardia, arrhythmia, nausea, vomiting and epigastric distension.
Hazards
It may cause narrowing of the lumen and insufficient blood supply to the myocardium, leading to myocardial infarction and thus life-threatening.
Complications
Arrhythmia, acute myocardial infarction, coronary artery spasm, etc.
Tests
Electrocardiogram, cardiac enzymes, coronary angiography, ultrasound, X-ray examination, etc.
Diagnosis
Sudden chest pain, the nature of the pain is similar to angina pectoris, nitroglycerin treatment is ineffective, combined with the results of coronary arteriography can be diagnosed.
Treatment principle
Sedation and analgesia are given, and thrombolytic or interventional therapy is chosen according to the results of coronary angiography.
Curability
It can relieve the symptoms and improve the prognosis.
Dietary recommendations
Low-salt and low-fat diet, more fiber-rich, easy-to-digest, light diet, small meals, should not be too full. Avoid fried, spicy and other stimulating foods.
Causes
Causes
The most common cause is dislodgment of the mitral valve or aortic valve, followed by dislodgment of thrombus in the coronary artery or dislodgment of atherosclerotic plaque in the coronary artery causing embolism.
Symptoms and Diagnosis
Typical symptoms
1. Pain is the first to appear, mostly in the early morning, the pain site and nature of the same as angina pectoris, but the degree of heavy, long duration, rest or nitroglycerin treatment is ineffective, may be accompanied by a sense of imminent death, a small number of patients can be the beginning of the shock or acute cardiac failure. 2. There may be fever, tachycardia, arrhythmia, etc., the fever appears 24 to 48 hours after the onset of pain, and the temperature is mostly around 38 ° C. 3. Sometimes there may be nausea, vomiting and epigastric distension, and in severe cases there may be eructation.
Diagnostic basis
1. Previous valve surgery or prosthetic valve, or recent infective endocarditis. 2. Severe chest pain without obvious cause, rest or nitroglycerin treatment is ineffective, may be accompanied by a sense of imminent death. 3. Coronary angiography to see the thrombus shadow can help diagnosis. 4.
Treatment
Treatment guidelines
Remove the thrombus and relieve the obstruction of coronary blood flow caused by the thrombus.
Medication
Drug sedation, analgesia, anticoagulation and antiplatelet therapy if necessary.
Other treatments
Interventional therapy.
Prognosis
The prognosis depends mainly on two factors: the size of the embolus and the size of the lumen of the involved coronary artery. The smaller the embolus, the lower the likelihood of myocardial infarction or fatal arrhythmia; if the embolus is extremely small, it may be clinically asymptomatic. If the coronary artery is normal before embolization, only focal myocardial infarction may occur; embolization of the diseased coronary artery is very likely to affect the proximal coronary artery, and embolization of the left main stem is rare but usually fatal.
Nursing care
Daily care
1. Appropriate exercise, weight reduction for obese people. 2. Maintain good mood, avoid agitation. 3. Prevent respiratory infections.
Dietary management
1. Eat small and frequent meals, should not be overfilled. 2. Eat more fiber-rich, easy to digest, light diet. 3. Eat less high cholesterol, high calorie, high fat food. 4. Prohibit fried, spicy and other stimulating foods. 5. Avoid smoking and alcohol.