Twenty-eight days ago, we rescued a patient with acute myocardial infarction, Zhou Da S, male, 54 years old; it has been almost a month in the past two days, and we should come for a review soon.
Last night, a myocardial infarction patient we rescued, Zhou Xiao S, male, 52 years old, has a name that differs from the patient we rescued 28 days ago. I thought it was very interesting at the time, but it is also not possible to casually ask about the personal privacy of other patients.
It was a coincidence that the 54-year-old Zhou Da S came for a re-examination this morning, and he had not waited for my consultation when he entered the door. Mr. Zhou spoke first: Dr. Wang, if you don’t say it back, my brother also had a heart attack last night and was also in your hospital.
I said: Is it Zhou Xiao S?
Mr. Zhou said: Yes, yes.
I said: I felt you and I were relatives yesterday, but I didn’t expect that they were actually brothers.
Mr. Zhou said: My brothers have a heart attack, is it hereditary?
I said: Did your parents have a definite disease in this area?
Mr. Zhou: My parents and my mother both have heart disease and have been taking medicine.
I said: What heart disease, how was it diagnosed, and what medicines were you taking?
Mr. Zhou: Myocardial ischemia, electrocardiogram, what to eat to protect the heart, to unclog blood vessels, etc., every day.
I said: So, their coronary heart disease is not necessarily true coronary heart disease, what’s more, coronary heart disease is related to heredity. But generally, parents who have had myocardial infarction and cerebral infarction before the age of 55, have had stents, had bridges, etc., will increase the risk of cardiovascular disease in their children. They are all cardiovascular diseases that occur after old age, and it cannot be said that your myocardial infarction is inherited from your parents.
Mr. Zhou: Then why did both of our brothers have a heart attack?
First, let’s take a look at the underlying diseases of Mr. Zhou and his brothers
Mr. Da Zhou never had a physical examination before he suffered a myocardial infarction a month ago. I don’t usually feel uncomfortable, so I always think I’m healthy. The result was a sudden myocardial infarction to the hospital, and later found that the blood pressure was also high, and the blood lipids were also high. But blood pressure 160/114mmHg, triglyceride 5.4mmol/L, low density lipoprotein cholesterol 4.7mmol/L, this is a typical hypertension and hyperlipidemia.
At the same time, the blood test for homocysteine was 49umol/L, which was also much higher than the normal value.
Whether it is hypertension, hyperlipidemia, or hyperhomocysteinemia; each independent factor increases the risk of atherosclerosis, Mr. Da Zhou3 There are all items, and I didn’t find it, and I don’t know when it happened. Eventually, long-term high blood pressure, high blood lipids, and high homocysteine led to the aggravation of Mr. Da Zhou’s vascular plaque, which eventually developed into myocardial infarction.
Mr. Zhou’s blood pressure has been low since he was admitted to the hospital yesterday, but he said that he has occasionally measured blood pressure several times, and they are all between 160-170. The reason for the low blood pressure yesterday was because of a myocardial infarction. Later, blood sugar and blood lipids were checked. It is a typical three high. Mr. Zhou has three highs, but he is not uncomfortable at ordinary times, and he never takes medicine to control it.
The cause of myocardial infarction is thrombus. The predecessor of thrombus is plaque. The main causes of plaque are hypertension, diabetes, hyperlipidemia, and hyperhomocysteinemia.
This is the main reason for the myocardial infarction between the Zhou brothers.
Second, let’s look at the living habits of Mr. Zhou and his brothers
The Zhou brothers’ parents do not have three highs, why do both brothers have three highs now?
Lifestyle is the bane:
We don’t need to ask a doctor, just by looking at the figures of the two brothers, we know that they are overweight and they are belly fat. Central obesity is abdominal obesity. Generally speaking, the waist circumference of men is more than 90cm and that of women is more than 85cm, and abdominal obesity is diagnosed.
Abdominal obesity is an independent risk factor for cardiovascular disease. Abdominal fat cells secrete a large number of pro-inflammatory factors, which can directly or indirectly participate in the inflammatory response, leading to insulin resistance and metabolic syndrome. , Elevated blood pressure, elevated blood lipids, elevated blood sugar, accelerated the formation of atherosclerosis, and increased the risk of cardiovascular disease.
The dude’s stomach, if you can joke about it, it’s polite to say that it’s a beer belly, or even a pregnant woman.
Why are they both so fat and their stomachs are so big, on the one hand they eat, on the other hand they don’t move. The brothers must have eaten the same thing at home when they were children, and this formed their eating habits later on. I like to eat flatbread, fried dough sticks, and a little pickles. This is breakfast. Look at the staple foods high in carbohydrates, fried foods, and high-salt foods. This diet will lead to a significantly increased risk of high blood pressure, diabetes, hyperlipidemia, and obesity. At noon, I have a bowl of braised beef stewed with potatoes, or a large bowl of noodles. I rarely eat vegetables. Here I want to tell you that potatoes are not vegetables. Potatoes are actually a staple food because they contain a lot of starch. This diet is also the basis for obesity and three highs. I still like these things in the evening, do I still go out to eat some so-called “delicious food”, eat less vegetables, never eat fruit, even if I eat fish and shrimp, I like to make seafood with oil and salt.
The long-term result of this diet is obesity and three highs. I didn’t have the habit of exercising since I was a child, so I never exercised when I grew up.
Finally, I forgot to mention that both of my brothers have been smoking since they were 20 years old, and they also like to drink two glasses at ordinary times.
These unhealthy lifestyles, smoking and drinking, unhealthy diet, inactivity, obesity, etc. are the basis of the three highs, which will eventually increase the risk of atherosclerosis. Over time, it will lead to Vascular stenosis, causing myocardial ischemia, induced plaque rupture, thrombosis, and myocardial infarction.
It is not a coincidence that the two brothers suffered myocardial infarction at the same time within one month. Look at their living habits and their attitude towards the three highs. I think this is the case. With such an attitude, the occurrence of cardiovascular and cerebrovascular diseases is almost certain.
We also ask people who have the same living habits as the Zhou brothers to pay attention and change.
The Zhou brothers were lucky because they were rescued, but not everyone who lives like them with a sudden myocardial infarction is so lucky!