Vigilance against psychological disorders combined with organic cardiovascular disease

In addition to the cool cardiovascular disease-like symptoms that can be caused by psychological disorders alone, in many years of clinical work, it is true that many organic cardiovascular diseases have been found to be combined with psychological disorders, and that such psychological disorders can still be symptomatic in terms of the cardiovascular system, or even before the symptoms of organic cardiovascular diseases appear, the cardiovascular symptoms of psychological disorders, as described earlier, should be of great importance to cardiovascular clinicians and patients. physicians and patients. For example, a patient with familial hypertrophic cardiomyopathy presented with panic and chest tightness of relatively long duration unrelated to exertion, and was treated for many years without any effect according to hypertrophic cardiomyopathy. After careful inquiry, it turned out to be a combination of depressive disorder and acute anxiety, and after the application of antidepressant and psychotherapy, the symptoms completely disappeared. Many patients with hypertension combined with acute anxiety, on the basis of the original persistent hypertension, paroxysmal blood pressure rise, the application of antihypertensive drugs alone can not control, with the addition of anti-anxiety drugs to bring blood pressure under satisfactory control. Many patients with coronary artery disease, the symptoms of panic, chest tightness and chest pain, the symptoms are not typical, coronary angiography shows that the coronary artery does have serious stenosis, but stenting has no effect, if carefully questioned, it can be confirmed that the cardiovascular symptoms caused by depression or anxiety disorders. For example, a patient who had episodes of panic attacks and chest tightness for ten years, coronary angiography found that the blood vessels were obviously narrowed, and stents had been placed twice during the five-year period, a total of four stents were placed, but the symptoms did not see any significant improvement, and in 2009 alone, he was hospitalized seven times due to the above-mentioned symptomatic episodes. At the end of 2009, the patient was hospitalized in our hospital, and the follow-up coronary angiography showed that the stent was clear and there was only a slight restenosis in the stent. The patient was asked about his symptoms and found to have obvious agitation, fear, generalized numbness, and sometimes trembling of the limbs during the episodes. The symptoms were treated according to acute anxiety and completely resolved. Patients after cardiac interventions, or after surgical bypass surgery for coronary artery disease are also increasingly presenting with depression or anxiety disorders. Inadequate knowledge about interventional therapy and surgical bypass surgery and excessive worry about possible complications after the procedure have led many patients to develop new cardiac systemic symptoms that cannot be explained by either the original cardiac disease or the procedure itself. If questioned carefully, patients may have developed depression and anxiety disorders. A patient seven years after surgical bypass for coronary artery disease had been experiencing intermittent chest tightness and malaise that had progressively worsened since the surgical bypass. In the year before hospitalization, chest tightness and fatigue persisted and worsened with activity, and he was afraid to answer the phone, afraid to serve the meal when it was ready but only to deliver it to his hand, and afraid to make a sound when he spoke. Hospitalization examination of the heart size is normal, cardiac function is normal, coronary angiography shows that the surgical bypass of the four bridge blood vessels is fluent, there is a bridge blood vessels have been completely occluded. After careful questioning and considering that the symptoms were not related to the heart, the diagnosis was depressive disorder. After psychotherapy and medication, the symptoms basically subsided.