OVERVIEW
Overview
Coronary artery stenosis is the narrowing of the coronary vessels caused by coronary atherosclerosis. It occurs mostly in the elderly, or in young and middle-aged people with high risk factors (high blood sugar, high blood pressure, high blood lipids, etc.). Patients usually have a history of coronary artery disease, the main clinical manifestations of chest tightness, panic, shortness of breath and other symptoms, severe coronary artery stenosis can lead to myocardial infarction and cerebrovascular crisis, coronary angiography can confirm the diagnosis and understand the degree of stenosis, the need for timely treatment.
Whether medical insurance
yes
Department
Cardiology, Vascular Surgery, Cardiac Surgery, Geriatrics.
Clinical symptoms
Palpitation, chest tightness, shortness of breath, dyspnea, etc. In severe cases, chest pain, cyanosis, nausea, vomiting, and even dizziness and coma.
Harms
Causes insufficient blood supply to the myocardium, which can seriously lead to acute complications such as acute myocardial infarction and insufficient cerebrovascular blood supply, which are life-threatening.
Complications
Myocardial infarction, cerebrovascular blood supply insufficiency.
Examination
Physical examination, electrocardiogram, cardiac ultrasound, coronary angiography, etc.
Diagnosis
History of coronary heart disease, hypertension, etc., usually less exercise, more meat-based food, accompanied by clinical symptoms such as chest tightness, panic, shortness of breath, etc., combined with coronary angiography can make a clear diagnosis.
Treatment principle
Treatment of underlying diseases, interventional therapy to relieve stenosis, and coronary stenting or bypass surgery if necessary.
Curability
By actively treating the underlying disease and choosing the appropriate treatment to relieve the stenosis, the symptoms can be improved and the therapeutic effect can be achieved, and the prognosis is still favorable.
Dietary advice
Eat a sensible diet, control the intake of high cholesterol and high fat foods, and eat more fresh vegetables and fruits. Control total calorie intake and limit weight gain.
Etiology
Epidemiology
Most often occurs in the elderly, or young and middle-aged with high risk factors such as hyperglycemia, hypertension, and hyperlipidemia, often with a history of coronary heart disease.
Etiology
There is usually a history of coronary artery disease, hypertension and other underlying medical conditions, which are related to dietary habits, exercise, smoking, alcohol consumption and other factors.
Symptoms and Diagnosis
Typical symptoms
1. Mild stenosis: the degree of stenosis of the lumen is less than 25%, usually there is no obvious clinical symptom, but may be accompanied by panic, chest tightness, shortness of breath, dyspnea, etc. after activity or exertion.
2. Moderate stenosis: the degree of stenosis of the lumen is 25%-75%, usually there is chest tightness, shortness of breath, dyspnea and so on when there is a little activity, and even cyanosis, dizziness, nausea and so on.
3. Severe stenosis: the degree of stenosis of the lumen is more than 75%, and symptoms such as cyanosis, chills, sweating, nausea, vomiting, fainting, etc. can occur, and even cause angina pectoris, acute infarction, and “near-death” sensation.
Diagnostic basis
1. History of coronary heart disease and hypertension.
2. Clinical manifestations such as palpitation, chest tightness, chest pain, shortness of breath, dyspnea, etc., profuse sweating, cyanosis of lips and mouth, fainting, etc. may occur after strenuous activities.
3. Electrocardiogram (ECG) with ischemic changes and cardiac ultrasound with abnormal blood flow can assist in the diagnosis, and coronary angiography can confirm the diagnosis and understand the degree of coronary artery stenosis.
Treatment
Treatment guidelines
Active treatment of underlying diseases, interventional therapy to relieve stenosis, and coronary artery bypass grafting if necessary.
Drug therapy
Anticoagulant therapy can use aspirin, clopidogrel. Statins can be used for lipid-lowering and plaque-fixing. Beitlerock, Kangke and other drugs can be used to ease the heart rate and reduce oxygen consumption. Ginkgo biloba, hemosiderin capsule, shuxueining injection can be used to activate blood circulation and remove blood stasis.
Surgery
Stenting or coronary artery bypass surgery.
Other treatments
Coronary intervention.
Prognosis
Medication for the underlying disease, interventional therapy to improve stenosis, and coronary artery bypass grafting surgery if necessary can correct coronary stenosis and improve the condition with a fair prognosis.
Questions you may be concerned about
What to do if coronary artery stenosis is more than 50%?
Coronary artery stenosis more than 50% should receive coronary heart disease drug treatment, including: improve myocardial ischemia, reduce the symptoms of drugs, such as metoprolol, etc.; prevention of myocardial infarction, improve the prognosis of drugs, such as aspirin.
1. Improve myocardial ischemia drugs: β-receptor antagonists: can reduce myocardial oxygen consumption to relieve angina. Commonly used metoprolol, bisoprolol. Nitrates: reduce myocardial oxygen consumption, improve myocardial perfusion. Commonly used isosorbide dinitrate and isosorbide mononitrate. Calcium channel blockers: reduce myocardial oxygen consumption, dilate coronary artery. Commonly used verapamil, diltiazem and so on.
2. Prevention of myocardial infarction drugs: antiplatelet drugs: to prevent plaque rupture platelet aggregation blockage of blood vessels, commonly used aspirin, clopidogrel or tegretol, or indobufen. Statin lipid-lowering drugs: the first choice of lipid-lowering drugs for coronary heart disease, can effectively lower lipid and stabilize plaque. Commonly used atorvastatin, resuvastatin and so on.
Coronary heart disease patients are recommended to hospitals, follow the doctor’s instructions standardized diagnosis and treatment.
How to treat coronary artery stenosis
Coronary artery stenosis can be treated with lifestyle changes, medication (e.g. aspirin, fluvastatin) and surgery (e.g. coronary artery bypass graft surgery).
Coronary artery stenosis generally refers to the narrowing of coronary arteries caused by coronary atherosclerosis.
1. Change of life habits: We should insist on reasonable exercise in daily life, and at the same time, we should avoid overfeeding in diet, eat vegetables and fruits appropriately, eat less desserts and fried foods, and quit smoking and limit alcohol.
2. Drug treatment: this is the most fundamental treatment, the commonly used drugs are anticoagulant drugs (such as aspirin) and statin drugs (such as fluvastatin).
3. Surgery: It is mainly suitable for some serious coronary atherosclerotic stenosis, and stent implantation or coronary artery bypass grafting surgery is often adopted.
In conclusion, the treatment of coronary artery stenosis, need to be under the guidance of the doctor in conjunction with their own examination to choose a reasonable program of treatment. Drugs need to be used in accordance with the doctor’s instructions.
What kind of Chinese medicine for coronary artery stenosis
Coronary artery stenosis belongs to the category of “chest paralysis and heart pain” in traditional Chinese medicine, and can be treated with proprietary Chinese medicines such as Compound Danshen Drops Pills, Coronary Heart Suho Pills, and Musk Cardioprotection Pills.
1. Compound Danshen Drop Pills: It has the functions of activating blood circulation and removing blood stasis (promoting blood circulation and eliminating blood stasis in the body), regulating qi and relieving pain (relieving pain by unblocking qi), and is suitable for chest paralysis (chest tightness and pain) caused by qi stagnation and blood stasis (blood stagnation due to lack of smooth flow of qi). Occasionally, gastrointestinal discomfort may occur, and pregnant women should be cautious.
2. Guanxin Suhe Pill: It has the function of regulating qi, relieving pain and relieving chest pain, and is suitable for chest paralysis caused by cold condensation and stagnation of qi, and impassability of heart veins. Pregnant women are prohibited, avoid spicy, cold, greasy food, adverse reactions are not clear.
3. Musk Cardioprotective Pill: It has the functions of aromatic and warming (using aromatic and pungent dispersal, warming the meridians to dispel cold in the body), benefiting qi and strengthening the heart (enhancing heart function by replenishing qi), and is also suitable for chest paralysis caused by stagnation of qi and blood stasis (stuffy pain in the chest). Pregnant women and those who are allergic to this product are prohibited, athletes should use with caution, take note of the occasional numbness of the tongue when taken sublingually.
All of the above medications should be used under the guidance of a doctor. Coronary artery stenosis is a critical condition, and when symptoms of heart pain occur, you should seek prompt medical attention from a professional doctor.
Nursing care
Daily care
Live a regular life, avoid excessive stress, and maintain emotional stability.
Don’t smoke or drink heavily, and exercise properly.
3. Follow the doctor’s instructions to take medication regularly and review regularly.
Diet regulation
Low-salt, low-fat, high-quality protein diet and weight control. Regular intake of food that is beneficial to vasodilatation and adequate intake of vitamins and trace elements. Strictly prohibit smoking and alcohol, avoid spicy food, strong tea and coffee.