Coronary heart disease _ coronary heart disease symptoms, treatment and prevention

Introduction:

Coronary heart diseaseIs a heart disease caused by myocardial ischemia (angina) or myocardial necrosis (myocardial infarction) caused by coronary artery atherosclerosis (atherosclerosis or dynamic vasospasm) stenosis or obstruction, also known as ischemic heart disease.

Cause:

Supplying the atherosclerotic plaque of the coronary artery wall of the heart itself causes a heart disease caused by stenosis of the vascular lumen. The clinical symptoms vary depending on the number and extent of coronary stenosis.

The etiology of this disease has not yet been fully understood, but it is thought to be related to hypertension, hyperlipidemia, hyperviscosity, diabetes, endocrine function and age.

1. Age and gender: The incidence of coronary heart disease is higher after 40 years of age. The premenopausal incidence rate of women is lower than that of men, and it is equal to men after menopause.

2, hyperlipidemia: in addition to age, lipid metabolism disorder is the most important predictor of coronary heart disease. There is a close relationship between total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) levels and the risk of coronary heart disease events. For every 1% increase in LDLC levels, the risk of coronary heart disease increases by 2-3%. Triglyceride (TG) is an independent predictor of coronary heart disease, often accompanied by low HDLC and impaired glucose tolerance, the latter two are also crowns Risk factors for heart disease.

3. Hypertension: Hypertension is closely related to the formation and development of coronary atherosclerosis. Systolic blood pressure is more predictive of coronary heart disease than diastolic blood pressure. The systolic blood pressure of 140-149 mmhg is more likely to increase the risk of death from coronary heart disease than the diastolic blood pressure of 90-94 mmhg.

4. Smoking: Smoking is an important risk factor for coronary heart disease and is the single most avoidable cause of death. There is a significant dose-response relationship between coronary heart disease and smoking.

5. Diabetes: Coronary heart disease is the leading cause of death in underage diabetic patients. Coronary heart disease accounts for nearly 80% of all death causes and hospitalization rates of diabetic patients.

6, obesity: has been identified as the primary risk factor for coronary heart disease, can increase coronary heart disease mortality. Obesity was defined as body mass index (BMI = weight (kg) / height square (m2)) in men >= 27.8, women >= 27.3. BMI was positively correlated with TC, TG, and HDL-C decline.

7, sedentary lifestyle: people who do not love sports, the risk of coronary heart disease and death will double.

8, there are still inheritance, drinking, environmental factors and so on.

symptom:

First, clinical symptoms:

According to its clinical symptoms, coronary heart disease can be divided into 5 types:

1, angina type: manifested as the feeling of crushing behind the sternum, swell feeling, accompanied by obvious anxiety, lasting 3 to 5 minutes, often scattered to the left arm, shoulder, lower jaw, throat, back, can also be radiated Right arm. Sometimes these parts can be affected without affecting the posterior sternal area. Exercising, emotional, cold, full meal, etc., increased the onset of myocardial oxygen consumption called labor angina, rest and nitroglycerin relief. Sometimes angina is not typical, it can be expressed as tightness, syncope, weakness, belching, especially in the elderly. According to the frequency and severity of the attack, it is divided into stable and unstable angina. Stable angina refers to exertional angina pectoris with more than one month of attack. The location, frequency, severity, duration of the attack, the amount of labor that induces the attack, and the amount of nitroglycerin that can relieve pain are basically stable. Unstable angina refers to the frequency, duration, and severity of the original stable angina pectoris, or new onset of exertional angina (within 1 month), or angina at rest. Do notStable anginaIt is a precursor to acute myocardial infarction, so if you find it, you should go to the hospital immediately.

2, myocardial infarction type: a week before the infarction often have prodromal symptoms, such as resting and mild physical activity when the onset of angina, accompanied by obvious discomfort and fatigue. Infarction manifests as persistent intense pressure, suffocation, and even knife-like pain. It is located behind the sternum and often spreads throughout the chest, with the left side as the weight. Some patients can extend the left arm to the ulnar side, causing tingling in the left wrist, palm and fingers. Some patients can radiate to the upper limbs, shoulders, neck, and lower jaw, mainly to the left. The pain site is consistent with the previous angina pectoris, but lasts longer, the pain is heavier, and rest and nitroglycerin do not relieve. Sometimes it manifests as pain in the upper abdomen and is easily confused with abdominal diseases. Accompanied by low fever, irritability, sweating and cold sweat, nausea, vomiting, palpitations, dizziness, extreme fatigue, difficulty breathing, sudden death, lasting more than 30 minutes, often for several hours. If you find this condition, you should see a doctor immediately.

3, asymptomatic myocardial ischemia: Many patients have extensive coronary artery occlusion but did not feel angina, and even some patients did not feel angina in myocardial infarction. Some patients have sudden cardiac death, which was discovered after a myocardial infarction was found during routine physical examination. Some patients have arrhythmia due to an ischemic manifestation of the electrocardiogram, or coronary angiography because of a positive exercise test. This type of patient has the same chance of sudden cardiac death and myocardial infarction as patients with angina, so you should pay attention to your usual heart health.

4, heart failure and arrhythmia type: some patients have angina pectoris, after the extensive lesions, extensive myocardial fibrosis, angina gradually reduced to disappear, but the appearance of heart failure, such as tightness, edema, fatigue, etc. A variety of arrhythmia, manifested as palpitations. Some patients have never had angina, but directly manifested as heart failure and arrhythmia.

5, sudden death type: refers to the unpredictable sudden death caused by coronary heart disease, caused by cardiac arrest within 6 hours after the onset of acute symptoms. Mainly due to ischemia caused myocardial cell electrophysiological activity abnormalities, resulting in severe arrhythmia.

Second, the signs:

Generally, there is no clear positive sign in the early stage. In the heavier ones, the heart can be enlarged to the left, the first heart sound is weakened, and the arrhythmia can be heard when the heart beats, the atrial fibrillation, etc. Sound, apex can be heard and galloping.

diagnosis:

Coronary heart disease is a common and frequently-occurring disease in middle-aged and elderly people. In daily life, if you have any of the following conditions, you should seek medical advice promptly and find coronary heart disease as soon as possible.

(1) When tired or mentally stressed, there is pain in the back of the sternum or in the anterior region, or contraction-like pain, and radiate to the left shoulder and left upper arm for 3-5 minutes.

(2) Chest tightness, palpitations, shortness of breath, and self-relief during rest.

(3) There are headaches, toothaches, and leg pains related to exercise.

(4) Chest pain and heart palpitations when eating a meal, being cold, or watching a thriller.

(5) When the sleep pillow is low at night, feel chest tightness and suffocation, need to be comfortable in the high lying position; when sleeping, or when lying down in the daytime, suddenly chest pain, palpitations, difficulty breathing, need to sit up or stand immediately to relieve.

(6) Pain, chest tightness, shortness of breath or chest pain discomfort during sexual life or forced bowel movements.

(7) Hearing noise can cause palpitation and chest tightness.

(8) Repeated pulse irregularities, unexplained tachycardia or slow.

Should be differentiated from myocarditis, hypertrophic obstructive cardiomyopathy, pericarditis, pleurisy, etc.:

1, myocarditis

Myocarditis refers to a localized or diffuse acute, subacute or chronic inflammatory lesion in the myocardium. The relative incidence of viral myocarditis has increased in recent years. The severity of the disease is different, the performance is very different, the infants and young children are more severe, the adults are lighter, the lighter can have no obvious symptoms, and the severe ones can be complicated by severe arrhythmia, cardiac insufficiency or even sudden death.

For the prodromal symptoms of acute or subacute myocarditis, the patient may have fever, fatigue, sweating, palpitation, shortness of breath, and pain in the precordial area. Check for arrhythmias such as contraction and conduction block before the visible period. Aspartate aminotransferase, creatine phosphokinase increased, and erythrocyte sedimentation rate increased. Electrocardiogram and X-ray examination are helpful for diagnosis. Treatment includes rest, improving myocardial nutrition, controlling cardiac insufficiency and correcting arrhythmia, and preventing secondary infections.

2, pericarditis

Pericarditis can be divided into acute pericarditis, chronic pericarditis, constrictive pericarditis, patients may have fever, night sweats, cough, sore throat, or vomiting, diarrhea. Acute heart tamponade can occur when the pericardium quickly exudes a large amount of fluid. The patient has chest pain, difficulty breathing, cyanosis, pale complexion, and even shock. There may also be ascites, hepatomegaly and other symptoms.

3, pleurisy

Pleuritis, also known as "pleural inflammation", is inflammation of the pleura. After the inflammation subsides, the pleura can return to normal, or two layers of pleura adhere to each other. Caused by a variety of causes, such as infections, malignant tumors, connective tissue disease, pulmonary embolism. Tuberculous pleurisy is the most common type. In dry pleurisy, a small amount of fiber exudation appears on the surface of the pleura, which is characterized by severe chest pain, which is like a needle-like shape. Examination can reveal changes in pleural friction. In exudative pleurisy, with the increase of exudate in the pleural cavity, chest pain is weakened or disappeared, and patients often have cough and may have difficulty breathing. In addition, there are often systemic symptoms such as fever, weight loss, fatigue, and loss of appetite. Examination can reveal the performance of heart and lung compression. In the case of a large amount of pleural fluid, it can be found by chest examination and X-ray examination. The treatment of tuberculous pleurisy mainly includes tuberculosis drug treatment; accelerate the absorption of pleural fluid, and if necessary, pumping treatment; prevent and reduce pleural thickening and adhesion, and use adrenal cortex hormone. Pleuritis is inflammation of the pleural wall and visceral layers caused by various causes. Most of them are lesions secondary to the lungs and chest, and can also be local manifestations of systemic diseases. There are many types of clinical pleurisy, most common with tuberculous pleurisy.

There is a special quantitative differential diagnosis method for hyperthyroidism, rheumatic heart disease and coronary heart disease: hyperthyroidism (referred to as hyperthyroidism), rheumatic heart disease (referred to as rheumatic heart disease), coronary atherosclerotic heart disease (referred to as coronary heart disease) is Three different types of heart disease, but in a certain period of disease, their performance is quite similar, which is easy to cause misdiagnosis and mistreatment.

complication:

1. The nipple muscle dysfunction rate of 50% c on the onset of 5dJ scoop, apical area heard contraction of small late clicks and loud hairy systolic murmur, severe disorders leading to left heart failure.

2. The incidence of papillary muscle rupture is 1%, multiple within 3 days, and the mortality rate is high. The apical area hears a loud squeezing murmur, the first heart sounds weakened, severe heart failure and/or cardiogenic shock, and pulmonary edema can occur rapidly.

3. Cardiac rupture is rare, and most of them are ruptured free wall of the ventricle. Causes acute pericardial hemorrhage, acute pericardial tamponade and quenching, often occurs about 1 week after onset.

4. Congestion is a very important complication of myocardial infarction. Found in the first 1-2 weeks after onset, most of the conjunctival wall thrombus shedding caused by brain, kidney, spleen, limbs and other arterial embolism: lower extremity venous thrombosis caused by pulmonary artery congestion.

5. Ventricular wall tumors are mainly found in the left heart space, the rate of cattle is 5% - 20%: ECG due to right pathological Q wave. The sT segment was picked up for more than 1 month. X-ray, echocardiogram and radionuclide examination showed ventricular epilepsy.

treatment:

Calcium channel blockers, nitrate drugs, and enzyme-converting inhibitors can be used for treatment. For patients with faster heart rate, β-blockers can be used, and sustained release agents are preferred. Can be added with enteric-coated aspirin 100-325mg 1 / d, pay attention to the treatment of risk factors for coronary heart disease such as antihypertensive treatment, lipid-lowering treatment, treatment of diabetes, smoking cessation, alcohol prohibition. It is also possible to use static liquid and nitrate lipid intravenous drip. In combination with heart failure and arrhythmia, correction of heart failure and antiarrhythmia should be added (see heart failure and arrhythmia). If necessary, interventional therapy for coronary heart disease (PTCA+ stenting) may be considered. Bypass surgery.

In people who are middle-aged or 60-year-old, people with coronary heart disease are not uncommon. Because some people have no symptoms, the ECG is normal. This is a recessive coronary heart disease, which is noticed until there are intermittent symptoms of heart disease. Patients who have been diagnosed with coronary heart disease should learn to correctly master several drugs, such as nitroglycerin, heartburn, diazepam, and Chinese medicine Baoxin pills. When the heart attack occurs, the patient has aura symptoms of self-perception. For example, the pain in the precordial area, the sense of twist, the feeling of fear, etc., can be taken according to his own experience, rest on the spot, oxygen in the condition, Can get good results, do not have to wait for a doctor to prevent serious attacks. Pay special attention to avoid sticking to the various activities that are carried out. The danger often occurs in “sticking to it”! Traveling, business activities, you should carry your medicine. Special emphasis is placed on smoking cessation, and smoking is prohibited when angina pectoris occurs frequently.

Treatment of acute exacerbation of coronary heart disease

1, angina: should immediately stop physical activity, rest on the ground, try to eliminate the cold, emotional and other incentives; immediately sublingual nitroglycerin or Xiaoxin pain 1 piece, if not relieved, re-infested every 5 to 10 minutes, If the infusion is ineffective for 3 consecutive times, and the chest pain lasts for 15 minutes or more, there is a possibility of myocardial infarction. It should be immediately sent to the hospital for emergency treatment; it can be orally administered with 3 mg, and those who have the condition should take oxygen for 10 to 30 minutes. Patients with coronary heart disease should carry nitroglycerin and other drugs with them. Once they have chest pain, they should be taken immediately, and be careful not to use the drugs that are ineffective. Stable angina relieves angina after rest and nitroglycerin. Unstable angina is a serious and potentially dangerous disease that should be immediately sent to hospital for treatment and close observation.

2, myocardial infarction: acute myocardial infarction mortality is high, more than half of the patients died before hospitalization, most of the death occurred within 1 hour after the onset, usually caused by ventricular fibrillation. Therefore, first aid measures and rapid transfer to the hospital are essential. In high-risk patients (hypertension, diabetes, previous angina patients), the following conditions occur: chest discomfort, extreme fatigue, difficulty breathing, especially accompanied by sweating, dizziness, palpitations, sudden death, high degree of suspicion Myocardial infarction should be immediately sent to the nearest medical institution with conditions for ECG, ECG monitoring, DC defibrillation, and intravenous thrombolysis. At the same time keep calm, do not cause panic and fear of the patient, and contain nitroglycerin, or quick-acting heart-saving pills, Guanxin Shuhe pills, etc., conditions can be intramuscular injection of papaverine, or dulidine, and stability, and maintain ventilation and suction Oxygen, if no contraindications, immediately take oral aspirin 300 mg. If ventricular tachycardia occurs, malignant arrhythmia such as ventricular fibrillation is immediately defibrillated by DC. In the event of a cardiac arrest, cardiopulmonary resuscitation should be performed immediately by artificial respiration and chest compressions.

3, acute heart failure and cardiogenic shock: acute myocardial infarction and ischemic cardiomyopathy may occur acute heart failure, due to large area of myocardial necrosis. Mostly acute left heart failure, patients with severe breathing difficulties, accompanied by irritability, suffocation, complexion gray, cyanosis, sweating, coughing, a lot of white or pink foam sputum, this situation must be immediately sent to hospital for rescue.

Drug, intervention, and bypass therapy for coronary heart disease

The drug only controls the symptoms and stabilizes the plaque in the coronary arteries. The drug is the foundation. The intervention has been developed in the last 20 years. It has matured since 2000, not only to control the symptoms, but also to completely cure the narrow blood vessels. Simple intervention, non-invasive, no need to open the chest, and immediate, technically high-risk, requires a certain amount of training, there are certain conditions to do, but also the patient's cooperation. Once the stent forms a thrombus, it will be a problem, with a 1% incidence. Generally speaking, people now pursue the quality of life in addition to their pursuit of life. A 40-year-old man goes out to run every day, wants to play golf, climbs the mountain, and although he does not die every day, he feels that living is not very interesting, so he has to intervene. If you can't do the intervention or the economic conditions are relatively poor, you can solve it by getting into the seven or eight brackets. Then simply give up and consider the bridge.

In fact, intervention and bypass surgery is one thing. The intervention is to open the clogging inside. The bridge is to open the chest and get a pipe from the upstream to the downstream to reopen a passage. In theory, drugs, interventions, and surgery have the same effect on low-risk stable patients. It is also good to do interventions, to do bridges, to take medicine, and not to die. This is a recognized research result. However, in the middle of the intervention process, the surgical injury to the patient is much smaller than that of the surgery. The recovery time is much shorter. Generally speaking, surgery and intervention have different surgical indications, and the patient's economic adaptability and physical illness are generally considered. The specific situation. A hundred 40-year-olds have as many medicines as they can, or who intervene, or who have died at the end of the bridge. People who are involved in intervention can climb Xiangshan, but people who take medicine can never climb mountains, and those who take bridges can climb. However, there are fewer recurrences in the bypass, more recurrences in the intervention, and less chance of restenosis in the bypass. Now there are drug stents that can prevent recurrence, and the recurrence rate of drug stents and bypass is estimated to be similar.

Chinese medicine treatment or prescription medication

In terms of treatment, it is appropriate to use emergency treatment, palliative treatment, first attack and then supplement, first supplement and after attack, attack and compensation, etc. according to the different clinical manifestations of the patient, and it is not possible to attack the end or only to repair the deficiency. Ignore the dredging.

1. Xinyang deficiency: Xinyang is not a serious illness with insufficient heart. The ancients said: "The heart and the fire are attached to the life gate." The root cause of the lack of heart yang is the death of the life gate, the cube is aconite (the dosage is about 10g, this product is poisonous, can not be used), Guizhi Yishen Zhongzheng fire. "The famous doctor's theory" said: "The fire is less angry, the fire is strong, the gas is strong", so the use of cassia twig without cinnamon, and the amount of collateral and collateral is not large, the meaning is to slightly fire, in order to prevent excessive dryness and yin. Red ginseng (preferably Korean ginseng or Jilin ginseng) is used for qi products. Patients with coronary heart disease have different degrees of heart and pulse resistance, so they are often accompanied by safflower, peach kernel, salvia miltiorrhiza and other blood stasis drugs. At the same time of promoting blood circulation and removing blood stasis, we should also pay attention to qi and qi, and intend to adjust the viscera cutting machine to regulate blood and sputum. Blood stasis in patients with coronary heart disease can be caused by cold or by heat. Cold coagulation for a long time and can be heated. Those who are hot and simmering or simmering for a long time, if they still use Wentong's products, will certainly help the heat to hurt the yin. It should be cooled and bloody, which means yin. In addition, patients with coronary heart disease also have varying degrees of turbidity block, so the use of aromatic turbid, warming sipping method of Pinellia, Chenpi, Tiannanxing, Coix seed, spring Amomum. However, if the heat of the long-term heat is still used, it will help the heat and yin, and it must be cleaned at this time.

2. Heart yin deficiency: Coronary heart disease is more common in the elderly, while the elderly are common yin deficiency. In the course of the disease, it is easy to have yin deficiency, especially the symptoms of kidney yin deficiency. For a long time, the yin and qi deficiency, or the deficiency of qi deficiency and fluid production, can have symptoms of qi and yin deficiency. Therefore, it is suitable to use the method of supplementing qi and nourishing yin. Schisandra, Radix Pseudostellariae, Radix Paeoniae Alba, Ophiopogon japonicus, and Dendrobium are commonly used in Yiqi Yangyin. Although the medicinal taste is not much, it has the four methods of qi, heat, nourishing yin and yang. Nourishing Yin can increase the source of Qi and blood, and Qi can carry blood. Therefore, it can promote the role of promoting blood circulation and removing blood stasis. Radix Pseudostellariae, Schisandra, and Ophiopogon japonicus are Shengmaisan. According to modern pharmacological studies, Shengmaisan has a stable and long-lasting cardiotonic effect, which has a repairing effect on the damaged inner wall of the coronary artery and stabilizes normal blood pressure.

The above content is for reference only, please consult the relevant physician or relevant medical institution if necessary.

prevention:

Control prevention

Prevention is divided into three levels. Primary prevention refers to prevention when there is no disease, secondary prevention refers to prevention after onset, and tertiary prevention refers to prevention of complications after onset, of which secondary prevention is of the most significant significance in the past 30 years. External secondary prevention has increased the average life expectancy of 4.6 years. The main drug prevention drugs include aspirin, Tianxintai, Guanmaining and other drugs. China's clinical treatment of light prevention, leading to the high recurrence rate of cardiovascular and cerebrovascular diseases in China.

That is, reduce the risk of coronary heart disease in people without evidence of coronary heart disease. It is mainly aimed at susceptible populations, controlling predisposing factors and preventing the formation of atherosclerosis. Actively and effectively prevent the occurrence of risk factors from children, adolescents and young people.

1. No smoking;

2, keep the blood pressure normal and stable, the ideal blood pressure is 120/80mmHg. Prevention and treatment of high blood pressure includes maintaining normal weight, limiting alcohol, salt intake, maintaining proper potassium, calcium and magnesium intake, and taking antihypertensive drugs under the guidance of a doctor.

3, to maintain normal blood lipids, prevention and treatment of hyperlipidemia, high-risk groups should be regularly checked, low-fat diet, exercise, and taking lipid-lowering drugs.

4. Avoid mental stress.

5, too little exercise is an important risk factor for coronary heart disease, regular exercise helps maintain weight, reduce high blood lipids and high blood pressure, coronary heart disease.

6, maintain normal blood sugar, prevent diabetes.

7. For high-risk patients with risk factors for coronary heart disease (hypertension, diabetes, hyperlipidemia, etc.), it is recommended to take long-term care to prevent coronary heart disease.

First, what is the key to controlling coronary heart disease?

The key to controlling coronary heart disease is prevention. Although coronary heart disease is a common and frequently-occurring disease in middle-aged and elderly people, the pathological basis of atherosclerosis originates in childhood, and decades of this have provided an extremely valuable opportunity for prevention work. Primary prevention, prevention of coronary atherosclerosis, elimination of coronary heart disease in germination; secondary prevention, improve the early detection rate of coronary heart disease in the whole community, strengthen treatment, prevent the development of lesions and strive for its reversal; Control complications in a timely manner, improve the quality of life of patients, and prolong the life of patients.

Primary prevention of coronary heart disease, ie intervention of risk factors. Prevention of coronary heart disease can adopt two prevention strategies for the whole population and high-risk groups. The former is to change the life behavior habits, social structure and economic factors related to coronary heart disease risk factors in a certain population, region or country, in order to reduce the mean value of risk factors in the population; the latter is aimed at having one or more recognized (such as high blood pressure, smoking, etc.) and coronary heart disease have a clear causal relationship with the reduction of the level of risk factors, in order to effectively reduce the incidence of coronary heart disease. Currently recognized risk factors for coronary heart disease include men, middle-aged and elderly people over 40 years old, family history of premature coronary heart disease, smoking (current smoking > 10 / day), hypertension, hyperlipidemia, severe obesity (overweight > 30) %), a clear history of cerebrovascular or peripheral vascular obstruction. Among them, high blood pressure, high cholesterol and smoking are considered to be the three most important risk factors for coronary heart disease. In addition to gender, age and family history, other risk factors can be prevented and treated.

In children with coronary heart disease, the formation of atherosclerotic lesions is a long process. Therefore, we must develop good living habits and healthy lifestyles from an early age. The dietary structure should be reasonable, avoid excessive intake of fat and a large number of sweets, strengthen physical exercise, prevent obesity, hyperlipidemia, hypertension and diabetes. People who are overweight and obese should take the initiative to reduce calorie intake and increase exercise. In patients with hypertension, hyperlipidemia and diabetes, in addition to risk factors intervention, it is necessary to actively control blood pressure, blood sugar and blood lipids. Vigorously promote smoking cessation activities, especially to prevent children from becoming a new generation of smokers.

Second, measures to prevent coronary heart disease

do not smoke.

Eat only a small amount of butter, cream and all kinds of greasy food.

Reduce the amount of meat you are used to, remove the fat from the meat you eat, eat the cooked meat, and don't eat fried meat. Eat up to three eggs a week.

Eat plenty of fruits and vegetables, but keep your diet balanced.

Reduce salt intake. Low salt intake can lower blood pressure and reduce the risk of developing coronary artery disease.

Exercise regularly. There is evidence that two or three vigorous exercises a week can reduce the risk of heart disease. But because it is dangerous to do strenuous exercise suddenly, you must start your exercise plan in a gradual way.

Respond to mental stress and seek ways to mediate stress in life. You can cultivate your hobbies or exercise to relax the tension in your daily life.

Controls high blood pressure, hypercholesterolemia and diabetes.

Check your body regularly and follow your doctor's advice.

3. What is the relationship between eating habits and coronary heart disease?

Bad eating habits and unreasonable dietary patterns are closely related to the occurrence of “modern diseases”. According to large-scale population surveys, unreasonable dietary structure and secondary apolipoprotein abnormalities are important factors in causing atherosclerosis.

In 1912, Russian scholars fed rabbits with high-cholesterol foods, resulting in an experimental atherosclerosis animal model. It was found that during the establishment of the model, the abnormal increase of blood lipids followed by atherosclerotic lesions indicated that poor dietary habits can lead to disorder of lipid metabolism, resulting in atherosclerosis, leading to coronary heart disease. .

40 years ago, the incidence and mortality of coronary heart disease in the United States once rose rapidly. Since the 1960s, the incidence and disability rate of coronary heart disease have dropped significantly. The reason is that most scholars believe that the improvement of lifestyle is mainly to reduce cholesterol intake and control smoking, thus reducing the risk factors for coronary heart disease. However, in China, with the improvement of living standards, the incidence and disability rate of coronary heart disease are increasing year by year due to the unreasonable dietary structure and the prevalence of smoking. A large number of epidemiological survey data show that there is a close relationship between eating habits and coronary heart disease. The incidence of coronary heart disease is significantly higher in people with vegetarian diet and high cholesterol.

Fourth, smoking cessation and eating less fatty foods can reduce the incidence of heart disease

The results of a survey conducted by the United Nations in 21 countries show that reducing smoking and eating less fatty foods have paid off and reduced the incidence of heart disease. Published in the British medical weekly "Lancet" in the research report, there are several reasons for the decline in heart failure and coronary heart disease mortality in developed countries.

The program is implemented by the World Health Organization under the UN. The goal was to compare the incidence and mortality of heart attacks between the mid-1980s and the mid-1990s, with men and women between the ages of 35 and 64 as subjects. The conclusions of the first part of the plan were published last May, which shows that the incidence of heart disease has declined significantly in developed countries, especially in Northern Europe, the United States and Australia. China, the former Yugoslavia and some parts of Russia have risen in the opposite direction.

The second part of the report pointed out that the reason for the decline in morbidity is that in countries with reduced morbidity, male smoking is reduced and women's blood pressure is decreasing. Although the weight has increased a little during this period, the blood cholesterol level has dropped by half due to the emphasis on diet. However, the main reason is that the treatment of heart disease patients in Western Europe is better. In addition to drugs that have thrombolytic drugs, drugs that prevent vascular occlusion are also readily available. In addition, surgeons have adopted a greatly improved surgical approach to coronary heart disease.

5. What is the relationship between climate change and coronary heart disease?

The incidence of coronary heart disease angina and myocardial infarction increases in cold weather or in winter and spring. The three optimal factors associated with coronary heart disease are: temperature, daily variation (the difference between the average daily temperature between two adjacent days) and average wind speed. Continued low temperature, rainy and windy weather is prone to disease. In addition, there are significant differences in the annual average pressure and high pressure, and the incidence is high when the air pressure is low.

In cold, humid and windy weather, the incidence of coronary heart disease is high because of cold stimulation, especially in the wind, easy to make the sympathetic nerves excited, speed up the heart rate, blood pressure, systemic vasoconstriction, peripheral resistance increased, myocardial oxygen consumption increased At the same time, it can also induce coronary artery spasm, so that the lumen is continuously occluded, or the plaque is squeezed to damage the intima, platelet aggregation, thrombosis and acute blockage of the lumen, can also lead to acute myocardial infarction.

Therefore, in the high season, patients with coronary heart disease should pay attention to keep warm and reduce outdoor activities to prevent disease.

6. What should be paid attention to in patients with coronary heart disease during the winter and spring seasons?

After extensive epidemiological investigations, climate change can induce acute myocardial infarction in patients with coronary heart disease. According to West Germany's "Medical World" report, in the Alps in the spring and autumn, the number of patients with myocardial infarction increased significantly. The incidence of myocardial infarction is highest in China's Shandong region from March to May; in Beijing, April and November each year is the peak incidence of myocardial infarction in coronary heart disease. At the end of autumn and early winter and early spring, the atmospheric pressure, wind speed and temperature difference in most parts of China are extremely unbalanced, and the changing climate may cause the angiogenesis of the heart to directly affect the blood supply of the heart itself; in the cold season, often It is prone to colds and bronchitis, which is very unfavorable for patients with coronary heart disease, and is often the main cause of angina pectoris and myocardial infarction. Therefore, patients with coronary heart disease should pay attention to the following problems in winter and spring:

(1) In addition to adhering to the commonly used drugs for coronary heart disease, we must also prepare health care kits, oxygen and other emergency medicines.

(2) If angina occurs frequently, you should stay in bed in time and go to the hospital for examination and treatment.

(3) Persist in participating in physical exercise such as outdoor walking, Tai Chi, Qigong, etc. However, in the event of weather changes such as sudden cooling, blizzard, and strong winds, it is necessary to stay indoors. According to the temperature change, the clothes should be replaced in time to keep warm.

(4) Avoid fatigue, nervousness, emotional excitement, and participate in social activities and long-distance travel as little as possible, and moderately control sexual life.

(5) Advocate bathing with warm water to improve the cold resistance of the skin, and actively prevent upper respiratory tract infections such as colds and bronchitis.

Seven, rehabilitation exercise for elderly patients with coronary heart disease

Older people should follow the doctor's advice and appropriate activities.

The amount of exercise should start from lightweight, such as rotation of active limbs, knee flexion, swinging arms, movable neck, shoulder joints, sitting up, then getting out of bed, lying on the chair, eating, washing, going to the toilet, gradually increasing the amount of activity , to achieve or close to the activity before the infarction.

Walking is the most convenient way to exercise, more friends, for recreational activities. Try to avoid running and jumping, because sometimes it will cause adverse reactions such as orthostatic hypotension.

Tai Chi is also a good exercise method for patients with coronary heart disease

Older patients have poor sweating response, so the heat dissipation is slow, so they are not heat-resistant. Therefore, when the temperature is high or the humidity is high, exercise should be suspended.

Risk factors for the onset of coronary heart disease

6, obesity: has been identified as the primary risk factor for coronary heart disease, can increase coronary heart disease mortality. Obesity was defined as body mass index (BMI = weight (kg) / height squared (m2)) in men >; = 27.8, female >; = 27.3. BMI and TC, TG increased, and HDL-C decreased positively.

7, sedentary lifestyle: people who do not love sports, the risk of coronary heart disease and death will double.

8, there are still inheritance, drinking, environmental factors and so on.

Prevention common sense:

In middle-aged or 60-year-old social groups, people with coronary heart disease are not uncommon. Because some people have no symptoms, the ECG is normal. This is a recessive coronary heart disease, which is noticed until there are intermittent symptoms of heart disease. Patients who have been diagnosed with coronary heart disease should learn to correctly master several drugs, such as nitroglycerin, heartburn, diazepam, and Chinese medicine Baoxin pills. When the heart attack occurs, the patient has aura symptoms of self-perception. For example, the pain in the precordial area, the sense of twist, the feeling of fear, etc., can be taken according to his own experience, rest on the spot, oxygen in the condition, Can get good results, do not have to wait for a doctor to prevent serious attacks. Pay special attention to avoid sticking to the various activities that are carried out. The danger often occurs in “sticking to it”! Traveling, business activities, you should carry your medicine. Special emphasis is placed on smoking cessation, and smoking is prohibited when angina pectoris occurs frequently.

1. Patients with coronary heart disease should be open-minded and regularly checked to pay attention to changes in the condition. Such as acute exacerbation of angina, should rest, take medication. Such as Guanxin Suhexiang Pill, Shexiang Baoxin Pill, Suxiao Jiuxin Pill; or containing Xiaoxintong, Xintongding, nitroglycerin tablets; if necessary, oxygen, those with nervous mood to take stability and adjuvant treatment.

2. It is necessary to have a regular life. Proper physical exercise not only prevents obesity, improves cardiopulmonary function, enhances resilience, but also reduces the incidence of hyperlipidemia, diabetes, hypertension, hyperviscosity and thrombosis. The way of exercising varies from person to person, and it is generally appropriate to use Tai Chi, walking, and Qigong.

3. A reasonable diet and good health habits play an important role in preventing the occurrence and progression of coronary heart disease. Taking vegetarian food, vegetables and fruits as the main diet will reduce the rise of blood cholesterol and lipoprotein; vegetable oil, peanut oil and corn oil will help lower blood cholesterol and should be increased. Develop a good bowel habit, keep the stool smooth; bath water should not be hot, not big pool.

In addition, to avoid excessive mental stress and emotional excitement, early smoking cessation, daily drinking should not exceed 25ml.

4. If the angina pectoris is still not relieved, and there is palpitations, suffocation, and excessive sweating in the anterior region, ECG and echocardiography should be recorded. If it is confirmed to be acute myocardial infarction, first aid should be taken to prevent ventricular fibrillation. , the occurrence of cardiogenic shock.

Cardiopulmonary endurance training guide for coronary heart disease

Training intensity: The heart rate during exercise should be between 40% and 85% of the reserve heart rate (HRR); the calculation method is (220 one age-a static heart rate), then multiply by 40% plus the static heart rate. The first heart rate number; the second number is also {220 one age-one static heart rate), multiplied by 85% plus static heart rate. In addition, the exercise intensity can also be monitored by "RPE" (conscious exercise intensity).

The personal trainer must let the customer know that the form is used to determine the intensity, fatigue and discomfort felt by the body during exercise. The intensity of 12-15 is enough for most athletes. If you feel shortness of breath, chest tightness and pain, you should reduce your exercise intensity to 8-9.

2. Training frequency: 3-5 times a week.

3. Duration of training: 20-60 minutes. In addition, you must add 5-10 minutes to warm up and relax.

4. Types of training: walking, jogging, fixed bicycles. Aerobics or water sports are all available.

The investigation found that long-term night work is prone to coronary heart disease

Experts from the Danish National Institute of Occupational Health conducted a large-scale survey across the country, which showed that night workers are susceptible to coronary heart disease. The experts used 1293888 men aged 20-59 years as subjects to conduct a one-year follow-up survey between the two groups during the day and night. The results showed that the nighttime working group was 1.15 times more likely to be admitted to the hospital due to coronary heart disease than the daytime working group. Experts believe that the main reason is that the 24-hour normal biological rhythm of the night worker's body is broken, which may lead to dysfunction of various organs in the body, poor sleep, affecting body recovery and rest; changes in diet, increased smoking, reduced physical activity; social activities Reduced, easily lead to increased mental stress. All of the above factors may increase the risk of coronary heart disease.

Diet therapy for coronary heart disease

The diet should be light and low in salt. It is especially important for people with high blood pressure. The intake of salt is controlled below 5 grams per day. It can be increased or decreased as the amount of activity in the season. For example, there are more sweating in summer and more outdoor activities, which can increase the salt intake. In winter, sweating is less and the amount of activity is reduced accordingly. Salt intake should be controlled.

Coronary heart disease one day recipe example

Breakfast: milk (vitamin AD 250 ml, white sugar 5 g) ham sausage (50 g ham), mixed with side dishes (75 grams of carrots, 25 grams of celery)

Meal: 1 fruit (200 grams of pear) {coronary heart disease diet, coronary heart disease diet}

Lunch: braised fish (100 grams of grass carp), mushroom rapeseed (50 grams of mushrooms, 150 grams of rape), taro (standard powder 125 grams)

Dinner: casserole (100 grams of tofu, 50 grams of lean pork, 10 grams of seaweed, 200 grams of cabbage, 15 grams of fans), rice (100 grams of rice)

30 grams of oil for all-day cooking and 6 grams of salt.

The above recipe contains 2060  2 kcal (8600 kJ)

Three famous prescriptions for the treatment of coronary heart disease

One: ginseng drink: 10 grams of raw sun ginseng.

The raw ginseng is steamed with stewed oysters and served with ginseng.

Two: Ginseng Sanqi Drink:

Raw sun ginseng 5-10 grams, 3-7 grams. The raw ginseng is steamed with steamed pork, and the juice is taken to the end of the Sanqi.

Three: Ginseng stewed chicken: 30 grams of raw sun ginseng, 5 grams of notoginseng, 100 grams of chicken. A total of three and a half hours of stewing in a stew pot. Eat chicken and drink soup.

Appropriate people: lack of heart, chest tightness and dull pain, shortness of heart, shortness of breath, fatigue, fatigue, face white, or easy to sweat out, pale red tongue, thin fur, pulse and so on.

What should be paid attention to in patients with coronary heart disease during exercise?

Although exercise is good for patients with coronary heart disease, but the exercise is not appropriate, the damage brought to patients with coronary heart disease is also not obvious. Therefore, patients with coronary heart disease must pay attention to the following issues when participating in sports:

(1) Avoid emotional excitement before and after exercise. Stress and emotional agitation can increase catecholamines in the blood and lower the threshold of ventricular fibrillation. Plus exercise may have the risk of inducing ventricular fibrillation. Therefore, within 3 days of the onset of angina pectoris, patients within half a year after myocardial infarction should not be subjected to more vigorous exercise.

(2) It is not advisable to have a full meal before exercise. Because the blood supply in the human body needs to be redistributed after eating, the amount of blood flowing to the gastrointestinal tract to help digestion increases, and the blood supply to the heart is relatively reduced, which may cause insufficient blood supply to the coronary artery, thereby causing angina pectoris.

(3) The movement should be gradual, persevere, and usually not active, do not suddenly engage in intense sports.

(4) Avoid wearing too thick during exercise, affecting heat dissipation and increasing heart rate. Increased heart rate will increase myocardial oxygen consumption.

(5) Avoid taking a hot bath immediately after exercise. Because the whole body is immersed in hot water, it will inevitably cause extensive vasodilation, and the blood supply to the heart will be relatively reduced.

(6) Avoid smoking after exercise. Some people often use smoking as a rest after exercise, which is very harmful. Because the heart has a post-exercise vulnerability period after exercise, smoking tends to raise free fatty acids in the blood and release catecholamines, and the effect of nicotine easily induces heart accidents.

Introduction to coronary heart disease

Published by on January 30, 2019January 30, 2019