“Liberty Times” cited Xie Anmin’s post on the Facebook page “Dr. Xie Talks” and pointed out that from the cardiac catheterization to the coronary arteries, the narrowest part that attracts the most attention is the location of atheroma. Plaques are covered by a membrane of varying thickness, with fat and inflammatory cells underneath. When that membrane breaks or cracks, the things in the plaque come into contact with the blood. Those things have a strong ability to attract coagulation components in the blood, and can quickly form thrombi. If the thrombus is large enough and exists long enough, it will It can lead to myocardial ischemia and even myocardial death.
He mentioned that for most patients with coronary heart disease, as long as the atherosclerotic plaques are stable and the membrane surrounding the plaques is intact, their condition will be stable. The size of the plaque will hinder the degree of blood flow. Some will have symptoms such as angina pectoris or exercise-induced dyspnea; some will have no obvious conscious symptoms.
Aspirin (public domain)
Category 1:Unstable angina is called unstable angina when the patient’s symptoms of cardiac ischemia begin to change. The angina becomes more frequent, more intense, lasts longer, is not easily relieved, and even begins to cause different discomforts, or the scope of the discomfort changes or expands.
Category 2:Myocardial infarction has occurred. Regardless of whether the clinical stage of “unstable angina” has passed or not, severe vascular obstruction has taken hold and large-scale myocardial necrosis has begun.
Xie Anmin pointed out that Category 2 is sometimes difficult to distinguish. When myocardial necrosis occurs, the enzymes in the myocardium will flow out into the blood. Test the concentration of various myocardial enzymes in the blood. If it exceeds the standard, it is a condition for diagnosing myocardial infarction. In the first type of acute cases, a small number of myocardial cells often die, and cardiac enzymes also increase slightly. The concentration of the enzymes detected and the sensitivity of the detection method will affect whether it is classified as myocardial infarction.
Xie Anmin reminded that the first type of acuteness is a warning of an emergency. You should seek medical treatment quickly, which may be able to cool down the acute lesions. In many cases, the second type of acute exacerbation does not go through the transition period of “unstable angina” and suddenly occurs like a bolt from the blue, catching the patient off guard. At least 1/3 of myocardial infarction patients are not sent to hospital. He passed away before reaching the hospital.
Myocardial infarction (photoAC)
Xie Anmin said that so far, we do not have an ideal method to predict the possibility of acute coronary heart disease in the short term (within 1 or 2 weeks). Therefore he recommends:
1. Crisis classification:Some epidemiological studies provide formulas that can be used to estimate an individual’s risk of clinical cardiovascular disease (such as coronary artery disease, stroke, peripheral vascular disease, congestive heart failure, etc.) within 10 years. People with high risk are also more likely to have acute coronary heart disease.
2. Medical staff discussion:Think carefully and discuss with medical staff. Among all the discomforts, which ones may be related to cardiovascular disease?
3. Body signals:Listen carefully to see if there are any signals from your body? And the more frequent, intense and persistent it is? If you feel uncomfortable now, it will be accompanied by cold sweats or significant difficulty breathing. These are your body’s way of telling you that no matter what happens, your body may be facing a major crisis and you need to seek medical help as soon as possible.
4. Take 1 aspirin:If you are suffering from myocardial infarction or unstable angina and have aspirin on you, you can chew and swallow 325 grams of aspirin. When I first started researching on hemolytic agents for myocardial infarction, I found that taking an aspirin was almost as effective as taking intravenous heparin in the hospital.
5. Coronary heart disease test:Such as exercise electrocardiogram, computed tomography, MRI scan, ultrasound, etc., although they cannot be used to predict the acute onset of coronary heart disease such as myocardial infarction in the short term, they are useful for predicting death from heart disease in the medium term (1-1.5 years). The probability is very small, but there is a certain degree of reliability. Predicting that a serious accident will not occur is more reliable than predicting that it will occur, and can be helpful in planning treatment options.
6. Reduce inflammatory response in the body:Such as periodontal disease, infection or chronic inflammation, etc., are related to promoting the progression and deterioration of vascular sclerosis lesions, reducing the inflammatory response in the body, and theoretically reducing the acuteness of arteriosclerosis.
Xie Anmin reminded that acute coronary heart disease is an emergency that needs to be correctly identified as early as possible and dealt with immediately. Correct treatment within 3 hours can not only save lives, but sometimes preserve heart function without even seeing signs of infarction.
2024-03-03 10:43:32
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