內容目錄
At 4:00 in the morning, I was just staring at me for a while when I was alerted by the ringing of the phone in the duty room!
The phone rings in the middle of the night, and there are only 3 possibilities: emergency rescue, the patient’s condition is unstable and sick, and emergency consultation between departments.
No matter which one it is, it is a critical emergency.
Fortunately, I have been a cardiologist for more than ten years, and I have already practiced the ability to instantly enter the state and immediately wake up.
The call is from the emergency room, me: Hello!
Over there: emergency consultation, heart attack, hurry down!
Me: Got it!
It’s that simple, not a single word, not a second wasted. While wearing white clothes, while running to the emergency room.
The patient is a 38-year-old male. He felt uncomfortable before going to bed at night, with chest tightness and suffocation, but he felt it was too late.
But I didn’t fall asleep when I lay down. It was uncomfortable tossing and turning. By 3 am, I couldn’t take it anymore, so I had to get up and go to the hospital.
Go to the hospital for an electrocardiogram immediately, suggesting acute anterior myocardial infarction. The blood pressure was measured at 98/64mmHg, and the emergency physician contacted the cardiologist for consultation, while following the clinical route, the patient was orally administered 300mg aspirin, 180mg ticagrelor, and 3000u heparin. Establish a liquid channel, inhale oxygen, ask the patient’s family to sign a critical illness notice, etc.
As I ran to the ER, I called the cath lab at the same time, activated the cath lab, and prepared for surgery.
After going to the emergency room, the patient was diagnosed with acute myocardial infarction, and the patient’s family members were informed of the condition and the need for immediate thrombolysis or angiography. The family agreed to angiography, and the patient was sent to the cath lab. Angiography showed that the middle part of the left anterior descending artery of the patient’s heart was completely occluded, and then the guide wire was passed, the balloon was expanded, the stent was implanted, the lumen of the blood vessel was restored, and the blood flow was restored.
The patient is escorted back to the intensive care unit after surgery.
Although the patient came to the hospital in a timely manner, because of the anterior myocardial infarction and more necrotic myocardium, we must continue to observe whether he will suffer from heart failure in the future.
After the patient is settled, he and his family will explain the condition again and inform the operation process.
The family members asked: how could it be a myocardial infarction, and no one in the family had this disease.
Is there any relationship between myocardial infarction and genetics?
The patient’s family members say that no one in the family has the disease, which means that there is no genetics, why would they have myocardial infarction.
Myocardial infarction is genetically related, but not a genetic disease in the traditional sense.
Hereditary diseases in the traditional sense are brought from the womb, that is, at birth, and are destined to occur. However, myocardial infarction only has a certain genetic predisposition, that is to say, heredity will have a certain influence, but it is not a determining factor.
Generally, if the parents had a myocardial infarction or cerebral infarction before the age of 55, the risk of cardiovascular and cerebrovascular diseases in their children is increased. If the parents did not have a myocardial infarction or cerebral infarction before this age, then the myocardial infarction in the child has little to do with genetics.
Second, how does myocardial infarction occur?
Myocardial infarction is actually a blockage of an artery in the heart.
So what’s blocking the arteries in the heart? It’s a blood clot!
How do blood clots come about? The blood vessel is caused by the formation of a thrombus after the plaque ruptures,So the precursor of thrombus is plaque.
So when does a plaque rupture? Plaques in blood vessels are easily ruptured after being stimulated, such as strenuous exercise, staying up late, heavy smoking, alcoholism, cold stimulation, mood swings, etc.
So where did the plaques come from?
Plaque in blood vessels is what people usually call “vascular waste”. This plaque is caused by multiple factors, such as mainly related to hypertension, diabetes, hyperlipidemia, and hyperhomocysteinemia. If a person has these 4 highs, but no 4 highs are found, or 4 highs are found, and there is no active and formal control, then the 4 highs will lead to aggravation of vascular endothelial inflammation, aggravation of vascular sclerosis, small blood vessel cracks, and accumulation of blood vessel walls. Lipid substances, which can become plaques over time.
In addition to 4 highs, our unhealthy life is also the main cause of vascular plaque: smoking and drinking, sedentary, unhealthy diet, obesity, staying up late, stress, etc. Increased risk of vascular plaque.
Third, look at the 38-year-old patient
I have never had a physical examination at ordinary times. After admission, the blood glucose, blood lipids, and homocysteine were all higher than normal values, which is a typical 3-high patient. However, because the patient never went to the physical examination, he did not find it at all, and naturally he never controlled blood sugar, blood lipids, and type cysteine.
Why is the patient so young with dyslipidemia? The patient has been smoking since he was a teenager, and has been overweight and obese since the age of 20. He has never had the habit of exercising, and often stays up late to play. These are the initiators of plaques.
So the family said that the family did not have this disease, why did he get myocardial infarction at such a young age?
That’s because his life determines his outcome. And having a myocardial infarction at such a young age increases the risk of myocardial infarction in his offspring.
Fourth, prevention is the last word
We know the causes of myocardial infarction, and naturally we know how to prevent myocardial infarction. Removing the factors that cause plaque aggravation is the basis for preventing myocardial infarction.
Especially young people, don’t smoke so much, don’t drink so much alcohol, don’t stay up so many nights, don’t eat so much unhealthy food, don’t be too lazy to move, don’t be so fat.
When you reach a certain age, or even if you are not middle-aged, but you have the above-mentioned high-risk factors and usually lead an unhealthy life, then you should monitor your blood pressure, blood sugar, and blood lipids at the age of 20 to see if you have any Three high. If there is a need to actively and formally control, can not be careless!
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