Patient: Suddenly collapsed at home in March 2006 and was rushed to the ICU, where he was diagnosed with myocardial infarction. He was discharged from the hospital and admitted to the hospital in the second half of the year with the diagnosis of emphysema and coronary artery disease. The basic diagnosis was lung infection, pulmonary obstruction and coronary heart disease. In April this year, he was admitted to the hospital again with the same diagnosis of the above symptoms. A week after being discharged from the hospital, he was readmitted, and the diagnosis was still the same. In the past few days, the condition has been recurring, the original admission aminophylline infusion to stop the tightness, but the heart rate is still very high, 100-110, then nitroglycerin infusion to 90, a little movement of small and large sweating, heart rate accelerated to 110-120, now stop the tightness, but the heart rate is still very high. Laboratory tests, test results, x-rays, etc. are all at the doctor’s. After being discharged from the hospital, he had to be sent to the hospital again for treatment in less than three months at most. No significant effect was seen. The hospital doctor contacted the respiratory department of the provincial hospital several times for transfer treatment, but there was no bed available so far. I hope to communicate with Dr. Huang here to see if he can give me a guideline on how my father should be treated next. Thank you! The patient: My father’s condition recurred during his hospitalization last week, and the doctor also recommended transferring him to another hospital for treatment, and he originally wanted to go to the outpatient clinic of the provincial hospital last week, but he has been delayed due to the lack of beds for medical treatment. Huang Guohua, Department of Respiratory Medicine, Guangdong Provincial People’s Hospital: Thank you for your trust in our hospital. A few days ago, a hospital contacted our department for referral, but it was indeed unable to do so because of the tight bed space, I wonder if it was your family. The patient’s situation you describe is not very clear, from the medical history and symptoms, it seems that in addition to bronchitis emphysema, but also pay attention to the possibility of cardiac insufficiency, therefore, the chest X-ray, blood gas analysis, blood routine and other information are very important, in the absence of these treatments I am sorry I can not give more advice, so as not to make a wrong judgment and delay the disease. A reminder: If you come to our clinic, make sure to bring all kinds of test sheets and films and previous hospitalization data, otherwise it is difficult to give proper treatment immediately with just a verbal description of your condition! Patient: Thank you, Dr. Huang, for your attention to us in your busy schedule. We have been worried about our father’s treatment since his recurrent illness. Thank you for your reply! Patient: I just saw that Dr. Huang will have an additional consultation on Tuesday afternoon at the 308 clinic of the Huifu West Branch. But I’m not sure about the appointment number, thank you for your reply! Please forgive me for the long journey! Patient: I have made an appointment, thank you Dr. Huang for reminding me to bring the information! Huang Guohua, Department of Respiratory Medicine, Guangdong Provincial People’s Hospital: The appointment number for Guangdong Provincial People’s Hospital Huifu West Branch is 020-81882222, but you can usually register on the spot; if you go to the main hospital on Dongchuan Road, it is recommended to make an appointment in advance (020-83882222) to avoid spending too much time in the queue. There is free transportation from the main hospital to the Huifu West Branch, so pay attention to the signs at the gate to avoid detours. Huang Guohua, Department of Respiratory Medicine, Guangdong Provincial People’s Hospital: I saw the patient and the information you brought in the outpatient clinic today, and explained to you and the patient generally at that time, but due to the limited time, and also considering the prevalence of these problems, so I bowed the woman here again from the information you brought and the examination of the patient, the diagnosis of the patient is basically clear and can be diagnosed as chronic obstructive pulmonary disease (COPD in English). The patient has been treated in the local hospital and the symptoms have been improved, but the lung function is poor, at the same time combined with old myocardial infarction, the heart function is also not very good, so there is still shortness of breath after activity and fast heart rate, these are in line with the patient’s pathophysiology. (To be continued later) Huang Guohua, Department of Respiratory Medicine, Guangdong Provincial People’s Hospital: It was noted that the patient had the application of beta-blockers (i.e., betaxolol, medrolol, etc.) after the infarction, and the patient’s COPD episodes had worsened in recent years, and there was an association between the two. However, this does not mean that the original use of beta-blockers was wrong, as beta-blockers play an important role in the secondary prevention of coronary heart disease, only that there is now a therapeutic contradiction and it is not appropriate to continue using beta-blockers under the current circumstances. According to the patient’s condition, the current treatment goal should be set to reduce the number of acute exacerbations and improve the quality of life, that is, the treatment of COPD in the stable phase, with drugs mainly based on inhaled hormones and long-acting bronchodilators. The original model of sulforaphane is 50250, which is also effective, but the existing research confirms that it is more certain that 50500, two inhalations a day, can improve the symptoms and reduce acute exacerbations after a period of application. In addition, the Ventolin you brought is a short-acting mixture that can be used during shortness of breath episodes, but if you need to use it too many times in a day and for too long, you need to seek medical attention to adjust the medication. Other measures to be considered are flu vaccination (at the vaccination station) and respiratory exercises (at the rehabilitation unit). Patient: Thank you very much for Dr. Huang’s patient diagnosis and explanation today, I am not too worried about my father’s condition now, and I bought an oxygen absorber for him today, and because of his poor health and resistance, I am now considering having him receive a flu vaccination in a couple of days, as suggested by Dr. Huang. I hope to get more advice and guidance from Dr. Huang on his progress and other changes in the future. Guangdong Provincial People’s Hospital Respiratory Department Huang Guohua: Thank you also for your trust in me!