After the occurrence of coronary atherosclerosis, atherosclerotic plaques will grow on the inner wall of blood vessels, narrowing the lumen of blood vessels and reducing blood flow. At this time, if spasm (narrowing of blood vessels) occurs again, blood flow will be less, which will cause angina pectoris and even myocardial infarction. Generally speaking, the early morning is the high incidence of coronary heart disease. Why is this? This is mainly related to people's sensitivity to pain in the morning and the high excitability of human sympathetic nerves in the morning. The higher the excitability of sympathetic nerve, the easier it is for blood vessels to spasm. In the morning (especially when you just get up), the sympathetic nerve excitability of human body is the highest. Encounter bad stimulation, easy to cause coronary artery spasm, angina pectoris attack. Of course, drinking less water at night, high blood viscosity, long interval between taking medicine at night and low drug concentration in the blood in the morning are also the reasons for frequent angina pectoris and even myocardial infarction at this time.
Coronary heart disease is a multifactorial disease, which is caused by multiple factors acting on different links. These factors are all risk factors, mainly including:
1. age: this disease is more common in middle-aged and elderly people over 40 years old, and it progresses rapidly after 49 years old. However, in recent years, the incidence of coronary heart disease has a younger trend;
2. Gender: In China, the ratio of male to female is about 2 1. However, after menopause, due to the obvious decrease of estrogen level and the increase of LDL (low density lipoprotein) level, the incidence of coronary heart disease in women increased significantly. According to some data, after the age of 60, the incidence of women is greater than that of men.
3. Occupation: There are more mental workers than manual workers, and jobs with a sense of urgency are more likely to get sick;
4. Diet: People who often eat a high-calorie diet and have high animal fat and cholesterol are prone to get this disease. At the same time, eating too much is also easy to get this disease;
5. Blood lipids: People with abnormal blood lipids due to genetic factors, excessive fat intake or disorder of lipid metabolism are prone to this disease;
6. Blood pressure: elevated blood pressure is an independent risk factor for coronary heart disease, and patients with hypertension are four times as high as those with normal blood pressure;
7. Smoking: Smoking is the main risk factor of coronary heart disease. Compared with non-smokers, the incidence and mortality of this disease are 2 6 times higher, which is in direct proportion to the number of smokers every day.
8. Obesity: Obese people are prone to this disease, especially those who gain weight quickly;
9. Diabetes: Some data show that the incidence of diabetes is twice that of non-diabetic people; Among the above factors, hypertension, overweight, high or low cholesterol are the most dangerous factors leading to coronary heart disease.
1. Add clothes to keep warm in time, and don't catch cold. People with coronary heart disease are very sensitive to temperature changes, and whenever a cold wave comes, it often leads to aggravation. Therefore, the patient's clothes should be kept warm, and the room temperature should be kept around 15 18. Patients should pay attention to keep warm when going out and not be attacked by cold air, which is of great significance to prevent blood vessels from contracting due to cold, increase myocardial oxygen consumption and lead to angina pectoris and myocardial infarction.
2. Insist on taking medicine according to the doctor's advice. Coronary heart disease is a chronic disease, which can't be cured by one needle and one medicine. In particular, patients with recurrent symptoms such as chest tightness, breath holding, shortness of breath, palpitation, etc., should take the medicine correctly according to the doctor's advice, and should not stop taking the medicine or use it indiscriminately without authorization.
3. Reasonable adjustment of daily life. Reasonable arrangement of work and life should not only avoid excessive mental and physical labor, but also avoid sitting still for a long time, live a regular life, relax and get enough sleep.
4. The diet should be reasonable. Have a light diet and little salt. Eating too much salt will increase blood volume and increase the burden on the heart. To control the intake of animal fat and cholesterol, eat less fat and animal fat, eat less cholesterol-containing animal viscera and squid, fish eggs and other foods, and the intake of cholesterol should not exceed 300 mg per day, which is equivalent to about 1-2 egg yolks. Eat more fresh vegetables, fruits and bean products, and supplement lean meat and fish appropriately. Drink less or no alcohol, strong tea and coffee.
5. Keep a good and stable mood. Try to avoid excessive excitement, avoid ecstasy, watch less intense games and thrilling movies, which can prevent vasospasm caused by excessive excitement of sympathetic nerves and prevent the increase of myocardial oxygen consumption.
6. combination of static and dynamic. In addition to patients with frequent angina pectoris, heart failure, acute myocardial infarction and severe arrhythmia, ordinary patients can do some physical activities within their power, such as walking, doing exercises and jogging. It is beneficial to enhance heart function and increase coronary blood flow. Take part in sports activities step by step. Don't breathe too fast, and there is no obvious discomfort.
7. Take emergency medicine with you. People with coronary heart disease should carry some first-aid drugs with them, such as nitroglycerin and quick-acting jiuxin pills. So that you can use it quickly when you are sick.
8. For patients with weak constitution, traditional Chinese medicines with functions of invigorating qi and consolidating exterior, strengthening body resistance and promoting blood circulation and removing blood stasis can be taken appropriately to improve immunity and enhance disease resistance, so as to reduce the possibility of disease recurrence or aggravation.
The purpose of coronary heart disease treatment is to increase myocardial blood supply, thereby alleviating or relieving symptoms, restoring heart function, prolonging patients' lives and improving their quality of life. There are three methods to treat coronary heart disease: drug therapy, interventional therapy and surgical treatment.
1. drug therapy: drug therapy includes western medicine and Chinese medicine, and western medicine is better during the attack. At present, the treatment of traditional Chinese medicine has achieved great success, greatly reducing the pain of patients, reducing the mortality rate, improving the quality of life of patients and prolonging their life. Chinese medicine can be used reasonably in mild period. Western medicine mainly includes: nitrates: such as nitroglycerin, isosorbide dinitrate, Xinkang and so on. Statins lipid-lowering drugs: such as Lipitor, Shujiangzhi, lovastatin, can delay or prevent the progress of arteriosclerosis. Antiplatelet drugs such as aspirin and plavix. Beta blockers such as betaloc and bisoprolol are commonly used. Calcium channel blockers are the first choice drugs for patients with coronary artery spasm, such as "Happy Heart" and "Love Heart".
2. Interventional therapy: Percutaneous transluminal coronary angioplasty and coronary stent implantation are commonly used. The catheter with balloon dilates blood vessels and squeezes the plaque on the blood vessel wall, thus increasing blood flow. After operation, stents were placed in blood vessels to keep the blood vessels unobstructed. This method has a certain therapeutic effect, but it is easy to relapse and may cause thrombosis.
3. Surgical treatment: refers to coronary artery bypass grafting, which is commonly referred to as coronary artery bypass grafting. Bypass surgery is suitable for patients with diffuse and calcified diseased blood vessels, especially for patients with three coronary arteries or left main artery lesions.
Now most of China has entered autumn and winter, especially in the northeast. In recent days, the temperature has gradually decreased, the temperature difference between day and night has increased, and the number of patients with cardiovascular diseases, especially coronary heart disease, will increase significantly. Therefore, it is extremely important to do a good job in prevention. At ordinary times, we should increase publicity to reduce the risk factors and incidence of coronary heart disease. For patients who have been diagnosed, active treatment and regular follow-up are needed to effectively prevent and treat coronary heart disease.
Zhang Yanhong, Director of the Second Department of Dry Diagnosis, Affiliated Hospital of Shenyang Medical College, Chief Physician, Master of Medicine, Professor. He is a member of Northeast Geriatrics Alliance, an expert in evaluation of Shenyang Science and Technology Bureau, and an expert in evaluation of senior professional and technical qualifications of Shenyang Health and Wellness Committee. He has rich experience and high attainments in the diagnosis and treatment of cardiovascular diseases such as coronary heart disease, hypertension, arrhythmia and heart failure.