Why is he still uncomfortable after the stent surgery for coronary heart disease?
Last month, Lao Xu suddenly felt chest tightness and sometimes chest pain, and could not work hard, and was afraid of being anxious and angry. The doctor said that the stenosis was too serious and a stent had to be placed to support the stenosis, but the doctor also said that the other blood vessels with less serious stenosis did not need to be stented. The doctor also said that other blood vessels with less severe stenosis did not need stents, and that conservative treatment with medicine would be sufficient. Then the doctor made two stents in the narrowest part of the blood vessel, the operation was done very smoothly, and he was discharged after being hospitalized for 2 days for observation, and after being discharged, he has been eating a large amount of western medicine every day according to the doctor’s requirements, but for some reason, after being discharged, Lao Xu felt weak and afraid of being tired, and sometimes he felt tightness in his chest and breath-holding. He does not understand what is going on here?
Here, let’s talk about this disease from him.
With the development of social economy, people’s living conditions have been greatly improved, but then brought about by the unhealthy lifestyle almost filled the whole society: large fish and meat eating habits, nervous and anxious mood pressure, less and less physical activity, etc., so that more and more people suffer from a variety of rich diseases: hypertension, diabetes, hyperlipidemia, which is often referred to as The “three highs”, but the “three highs” is the “vanguard” of many diseases, with the “three highs” will soon With the “three highs” will soon bring a lot of incurable diseases, the most common of which is – coronary heart disease.
What exactly is coronary heart disease?
Above we saw the case of old Xu, his heart blood vessels in some places appear narrow, we say this is to have coronary heart disease. Coronary heart disease is to supply blood to the heart of the blood vessels – “coronary arteries” due to the “three high” long-term stimulation caused by atherosclerosis, resulting in grease on the walls of the blood vessels, if If the “three highs” are not well controlled, the more lipids will be attached, causing the lumen inside the blood vessels to become thinner and thinner, thus causing the heart to need insufficient blood and oxygen, making the patient feel tightness in the chest, breathlessness, and in severe cases, chest pain. When a patient with coronary heart disease is active and tired or emotionally agitated, the oxygen and blood needed by the heart will increase, which will cause a contradiction between the oxygen supplied by the blood vessels and the oxygen needed by the heart. When the narrowing of the heart vessels becomes more and more severe, the symptoms become more and more obvious. If the heart vessel is suddenly blocked by a blood clot, it can lead to acute myocardial infarction when 100% occlusion occurs, which can be life-threatening.
Now that we know what coronary heart disease is all about, it is easy to understand why stents can be used to treat it. When the doctor supports the severely narrowed blood vessel with a stent, the lumen of the vessel will be spacious again, the blood flowing inside will be unobstructed again, and the symptoms of heart ischemia will be improved.
Why do many patients with coronary heart disease who have had stents put in often experience various kinds of discomfort?
There are several main possibilities.
Firstly, in general, heart stenting can only solve the stenosis of the main blood vessel, that is, the large blood vessel, while the small blood vessel with diameter less than 2 mm cannot be put into stent, so when both the large blood vessel and the small blood vessel have problems, only the problem of the large blood vessel can be solved by stenting, but the stenosis of the small blood vessel will also cause symptoms of heart ischemia such as chest tightness and chest pain.
Secondly, sometimes normal or less narrowed blood vessels may spasm due to various reasons, which may also cause transient narrowing of the blood vessels and also make the blood flow poorly, thus causing symptoms of heart ischemia.
In addition, there is another possibility that when stents are placed inside the main blood vessels, the stents will squeeze the openings of the branches when they are propped up, just like when cleaning the silt of the main river, the silt will block the small rivers, and the stents put in may cause the narrowing of the side branches, which will also cause the symptoms of heart ischemia.
How does TCM recognize coronary heart disease?
In Chinese medicine, coronary heart disease is generally known as “chest paralysis and heart pain”, which is caused by various pathogenic factors, including weather changes, mood swings, poor dietary habits, old age and physical deterioration, resulting in paralysis of the heart arteries by phlegm, blood stasis, qi stagnation, cold condensation and other pathological factors, manifesting as episodes of suffocation and pain in the danzhong or left chest. In mild cases, there is occasional transient dullness or vague pain in the chest, or episodes of indistinct discomfort in the danzhong or left chest; in severe cases, the pain is severe, or it is crushing-like colic. It is often accompanied by palpitations, shortness of breath, dyspnea, even shortness of breath, panic, pallor, and cold sweat. It is often triggered by exertion, a full meal, cold and emotional excitement, and can also occur without obvious triggers or when it is quiet.
According to Chinese medicine, “paralysis of the heart chakra” is the fundamental pathogenesis of chest paralysis and heart pain, which is consistent with the coronary artery stenosis found in modern medicine. With the advancement of technology, the invention of cardiac stenting in the 1970s applied a large number of modern scientific and technological achievements to solve the problem of coronary artery stenosis in the most intuitive way. From the perspective of Chinese medicine, stenting is also a means of unblocking blood flow, improving blood circulation, and activating blood stasis. Can stenting completely solve the problem of “paralysis of the heart”?
According to traditional Chinese medicine, the pathology of chest paralysis and cardiac pain has two aspects: deficiency and real, and often mixed with deficiency and real, with deficiency of qi, yang, yin, and blood, especially qi and yang deficiency; and real, with qi stagnation, cold condensation, phlegm, and blood stasis, and can interact with each other, with blood stasis and phlegm being the most common.
As a means to activate blood stasis, stenting can activate blood stasis, but it can only partially solve the local problem, while the patient’s overall physique and the whole body’s cold and heat deficiency status do not change. Moreover, as a “foreign body”, the “stent” will cause new blood stasis and other pathological conditions in the body, so that some people have no symptoms before the stent is put in, but many symptoms appear after the stent is put in.
In addition, for patients with deficiency of positive energy, the deficiency of positive energy will be more serious after applying “stenting” which is similar to activating blood stasis or even breaking blood stasis, and then the patients will be weak and tired after the surgery, which is the manifestation of deficiency. There are also some patients who are not only tired and easily tired, but also afraid of cold, with cold hands and feet, and feet like in ice water, which is called “Yang deficiency” and “Yang Qi deficiency” in Chinese medicine. In Western medicine, these conditions are not major problems because they find that the blood vessels are open through examination, but they ignore that these are problems that seriously affect the patient’s quality of life.
Therefore, I think that for the treatment of coronary heart disease, no matter before or after stenting, especially after stenting, the patient’s constitution should be adjusted according to Chinese medicine, and for the characteristics of the patient’s original deficiency and mixed deficiency, the treatment should be to supplement its deficiency and to exacerbate its surplus. For the original deficiency, it is appropriate to supplement, weighing the deficiency of the heart’s qi, blood, yin and yang, and the deficiency of the liver, spleen and kidney, to adjust the yin and yang, replenish the qi and blood, and adjust the internal organs of the decline, especially should pay attention to replenish the heart’s qi and warm the heart’s yang; for the standard deficiency, it should be diarrhea, for the qi stagnation, blood stasis, cold condensation, phlegm and the use of qi, blood, warming and phlegm, especially should pay attention to activate the blood and remove the phlegm. The ultimate goal of both tonifying deficiency and dispelling evil is to make the heart and blood flow, and to make it pass without pain.
In addition, patients with coronary heart disease must improve their lifestyle, which has a theoretical basis in the traditional Chinese medicine theory of health regimen, such as fat people more phlegm, weight loss or weight loss, can reduce phlegm internal production; quit smoking, limit alcohol, reduce fire toxicity, damp heat intake from the outside; advocate physical exercise, reduce social tension psychological state, regulate the mind and body, so that the liver qi to strip, prevent liver qi stagnation; reduce salt intake, because salt into the kidney, the kidney is the main water, the kidney Injury caused by the kidney water drink within the stop; increase the intake of fruits and vegetables, reduce the intake of saturated fatty acids, total fat, Chinese medicine believes that most of the fruits and vegetables are clear fire and heat, moderate fat, sweet and thick taste, to avoid the internal production of phlegm and dampness, blocking the veins, thus causing blood stasis paralysis heart veins.