Mr. Zhang, 63 years old, suffered a sudden myocardial infarction. During the process of being sent to the cath lab by the emergency department, he suffered from ventricular fibrillation.
Thanks to a doctor and a defibrillator in the hospital, the patient’s heart started beating immediately. Actually, Mr. Zhang could have dismantled this heart bomb a month ago, but because he didn’t want the stent and didn’t believe in the stent, it was dragged on until now, and he almost died.
More than a month ago, Mr. Zhang developed episodic chest pain. Sometimes it happens when you go upstairs, walk fast, and exert force. It also happens during breaks. And there were more attacks at that time, and later I went to the hospital emergency room.
At first glance, the cardiologist confirmed that Mr. Zhang had unstable angina pectoris, and he should be hospitalized and angiography should be done. Otherwise, there is a risk of myocardial infarction, but Mr. Zhang is very resistant to hospitalization, angiography, and stents.
Finally, he was reluctant to be hospitalized and asked the doctor to give him some medicine to eat first. He was then prescribed aspirin and statins to prevent myocardial infarction, as well as diltiazem and other drugs to control angina.
The patient went home after taking the medicine and took the medicine after returning home, but the attacks continued. Later, I heard people say that drinking decoction can cure me, so I found an expert and prescribed 21 decoctions.
During this month, Mr. Zhang still suffered from angina pectoris. He basically did not dare to go downstairs, but stayed at home. Sometimes he did not dare to eat too much, otherwise he would have chest pains. I finished taking the soup, but there seems to be no obvious improvement. I plan to go to a master to see if I need to adjust the medicine.
Unexpectedly, at 10 am, the chest pain recurred, which was significantly worse than before, accompanied by profuse sweating, and continued to not relieve. Because a month ago, the cardiovascular doctor said that if you don’t stay in the hospital, you may have myocardial infarction. If you have persistent chest pain, you must call 120, otherwise there is a risk of sudden death.
So after 15 minutes of chest pain, Mr. Zhang asked his family to call 120 immediately, and then he was sent to the hospital in time. If 5 minutes late and ventricular fibrillation occurs outside the hospital, if there is no defibrillator, Mr. Zhang will be gone today.
After defibrillation, the patient was sent to the cath lab, and angiography revealed 99% stenosis at the proximal end of the right blood vessel, which is called subtotal occlusion. The blood vessels were then opened and the patient returned to the intensive care unit.
It doesn’t sound good, I knew it earlier, why bother? After tossing for a month and risking his life, he was finally treated with a stent.
When is cardiac imaging required?
1. Patients with myocardial infarction
Like this patient today, it has happened Acute myocardial infarction, then we have to open the blood vessels. If the blood vessels are to be opened by means of balloons and stents, an angiography must be done first to see which blood vessel is blocked and where it is blocked. Therefore, patients with acute myocardial infarction need to do angiography to prepare for the opening of blood vessels.
2. Patients with uncontrolled angina pectoris
The same patient,1 A few months ago, it was actually unstable angina pectoris. At that time, the patient also took a lot of drugs, whether it was aspirin, statin, or drugs to control angina pectoris, as well as the decoction he took later. In fact, are using, but still have angina. So what should I do in this situation?
Can anyone tell you what to do?
In addition to angiography to see how narrow the blood vessels are, there are other ways, obviously there is no, At this time, angiography is the only way.
If angiography was performed a month ago, the stenotic blood vessel was found, and the severe stenosis was also solved by stenting. There will be myocardial infarction, no ventricular fibrillation today, and no danger to life. There will be no myocardial necrosis, and there will be no risk of heart failure in the future.
But it is because He did not listen to the advice of the cardiologist, but thought that he could control it with medication, but he suffered a myocardial infarction, which almost killed him.
3. Evidence of coronary heart disease: Positive exercise test, severe stenosis on coronary CT, arterial STT changes on electrocardiogram, myocardial ischemia, new complete left bundle branch block on electrocardiogram, and unexplained Cardiomyopathy, unexplained left heart failure, unexplained arrhythmias, unexplained chest pain, etc. require cardiac angiography.
Angina is a bomb , we dismantled it, we can be safe, we did not dismantle this bomb, it will explode at any time, that is myocardial infarction, it will be life-threatening.
The sign of myocardial infarction is angina pectoris. What kind of pain is angina pectoris?
1. Location of pain: mainly chest pain, or pain in the precordial area, but also Toothache, headache, shoulder pain, back pain, abdominal pain.
2. The nature of the pain is mostly dull, squeezing pain, like a stone pressing on it. On the chest.
3. There are also painless angina pectoris. Because some angina pectoris are painless, many people ignore them. Some angina pectoris are only manifested as chest tightness and suffocation, profuse sweating, nausea and vomiting, throat tightness and other symptoms.
4. Duration: generally about 3-5 minutes, rarely less than 2 minutes, almost impossible for a few seconds. Angina pectoris generally does not exceed 15 minutes.
5. Accompanying symptoms, in addition to the symptoms mentioned above, angina pectoris is often accompanied by chest tightness, suffocation, and profuse sweating.
A lot has been said, and it is difficult for everyone to remember, so is there a simpler way to make a preliminary judgment?
A simple judgment is that the above-mentioned discomfort is not usually present, but the above-mentioned discomfort will appear recently during activities, labor, fatigue, running, sports, etc. It lasts for a few minutes at a time, you need to stop and rest for a while, and rest for a few minutes to relieve. It is precisely because angina pectoris will be relieved in a few minutes, so it will be ignored by many people, thinking that it is all right.
However, every time angina pectoris is a myocardial infarction alarm, once angina pectoris occurs, you must seek medical attention in time, otherwise the next angina pectoris may develop into myocardial infarction! Some people also asked, what if the symptoms mentioned above continue for 15 minutes and do not relieve? Our old classmates (old fans) all know that it means that there may be a myocardial infarction!
Mr. Zhang had typical angina pectoris a month ago. After going upstairs and brisk walking, he would have chest pain. It also occurs when he is resting. That is unstable angina pectoris. It is very easy for myocardial infarction. Willing to further treatment, but chose conservative drug treatment.
Some diseases have developed to a certain stage and cannot rely solely on conservative treatment.
I missed the opportunity of conservative treatment, and then missed the opportunity of stent for angina pectoris. Do I have to wait until myocardial infarction to get stent?
But many people are not as lucky as Mr. Zhang, and can’t come to the hospital at all!