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Review of this article: Li Jiehui, Fuwai Hospital, Chinese Academy of Medical Sciences, Deputy Chief Physician
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The most common phrase that cardiovascular doctors hear in outpatient clinics is “chest pain”. This symptom is common and complex, because many diseases may cause chest pain, but the treatment methods are not All the same, and some even the exact opposite.
Tear pain in chest and back –
Aortic dissection
Ma Liang, Director of Cardiac and Great Vascular Surgery, First Hospital of Zhejiang University: The aorta is the largest artery in the human body. After that, the high-speed, high-pressure blood flow passes through the rupture and enters the space between the inner and outer membranes, forming aortic dissection. Once dissection occurs, the weak outer membrane will be difficult to withstand high-pressure blood flow for a long time, and it will be easily ruptured, which is life-threatening. Winter is a high incidence period for aortic dissection. The temperature is low, the blood vessels constrict, the blood pressure rises, and the blood flow is more likely to break through the intima to form a dissection. In recent years, patients with aortic dissection are getting younger and younger. One thing that young patients have in common is that their blood pressure is not well controlled. Young people, who like to eat late-night snacks, are tired and have poor rest, and more and more people have high blood pressure.
Gallery copyright pictures, do not authorize reprintspecial reminder If you have severe pain such as tear-like back pain, chest pain, and abdominal pain, you should go to the hospital in time. Myocardial infarction is generally thought of when chest pain occurs. The treatment of myocardial infarction and aortic dissection are two completely opposite ways. Aspirin for myocardial infarction is an anticoagulant drug, and dissection surgery requires slower blood flow. it is good.
recurrent anginapain —
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coronary spasm
There is a type of recurrent angina pectoris that troubles many people, especially middle-aged women. Because there are “symptoms but no evidence”, all the examinations have been done, and the blood vessels are smooth without stenosis, but there is no abnormality. Zhang Jian, Chief Physician of the Heart Center of Beijing Chest Hospital: Some patients in the heart center, especially middle-aged women, will experience similar myocardial infarction or It is a manifestation of severe myocardial ischemia, and some of them hit 120 because of angina pectoris. As a result, they went to the hospital and found that the blood vessels were quite smooth. It is very common in clinical and belongs to unstable states such as coronary artery contraction and spasm. The contraction causes the lumen of the coronary artery and the area of blood supply to decrease, and coronary spasm results in the interruption of blood supply. These are two different degrees. The vast majority occur in diseased coronary arteries. Under the action of external force, such as sympathovagal excitement and other factors, contraction or spasm occurs. It does also occur in some perfectly normal coronary arteries, which is the result of changes in the internal environment of the body. Special reminderTo distinguish whether myocardial ischemia caused by coronary stenosis or myocardial ischemia caused by vasospasm can be checked, CT scan , coronary angiography, intraluminal imaging, such as OCT, etc. Young women with no genetic background do not have coronary artery disease, possibly from temporary changes in the internal environment.
chest painweaknessdifficulty breathing –
Pulmonary embolism
End of year cleaning, family gatherings and playing mahjong, if you have leg pain and always feel chest tightness and can’t breathe, Pain on both sides of the back, this unexplained “tiredness” and chest pain may be due to pulmonary embolism. People who usually sit for a long time and like to rest need special attention. Song Bin, Chief Physician of Vascular Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University: The main cause of pulmonary embolism is the formation of lower extremity deep vein thrombosis, although many Middle-aged and elderly people like to maintain health, but they usually focus on moxibustion and scraping. In addition, when they are older, they like to play mobile phones and mahjong. If they maintain one movement for a long time, the blood circulation of the lower limbs will slow down and form venous thrombosis. The symptoms of pulmonary embolism are also very typical. The onset is sudden, and the patient suddenly develops symptoms such as unexplained collapse, pale complexion, cold sweats, difficulty breathing, tingling in the chest cavity, cough, and syncope. The patient becomes extremely agitated, nauseated, convulsed, etc.
Gallery copyright pictures, do not authorize reprint Sedentarypeople, when looking at computers, playing mobile phones, or playing mahjong, do more to step on the brakes Movements can enhance blood circulation in the legs. Usually, you must exercise more, maintain a normal amount of water, and let the blood flow, so that it is not easy to form blood clots.
chestcrushing pain—
Acute Coronary Syndrome
Acute Coronary Syndrome is a syndrome caused by acute myocardial ischemia, which is the most common fatal clinical chest pain. Typical angina pectoris is crushing or oppressive, and the pain site is often behind the sternum. Wang Xiangrui, Chief Physician of the Department of Pain at Shanghai Oriental Hospital: The common symptom is chest squeezingThe pain can radiate to the shoulder, left forearm, and neck. Chest pain lasts 2 to 10 minutes and can be relieved within 3 to 5 minutes after rest or nitroglycerin. Fatigue, full meal, cold, emotional agitation, etc. can be induced. When myocardial infarction occurs, the duration of chest pain in patients is usually more than 30 minutes, which may be accompanied by nausea, vomiting and other manifestations, which cannot be effectively relieved by nitroglycerin. Special reminderThe symptoms of elderly patients, diabetes and other patients may be atypical and need to be carefully identify. The timing of rescue for acute coronary syndrome is the key, and patients with suspected symptoms should be sent to the hospital immediately.
Chest Pain with Heartburn –
Gastroesophageal Reflux
A bad stomach can also cause chest pain. The most typical symptoms of gastroesophageal reflux disease are chest pain and acid reflux and heartburn. Smoking and drinking, Helicobacter pylori infection, mood swings, irregular work and rest, lack of exercise… Each of these is a heavy pressure on the “gastroesophagus”, and gastroesophageal reflux disease has become a common disease.
Gallery copyright image without authorization > Zhou Dongsheng, Chief Physician, Department of Gastroenterology, Xiamen Fifth Hospital, Fujian: The typical symptoms of gastroesophageal reflux disease are heartburn, regurgitation, and chest pain. Reflux can cause esophageal damage, manifested as erosion esophagitis; it can also cause tissue damage other than the esophagus, such as the throat and airway. When gastroesophageal reflux occurs, the first step is to make lifestyle changes. Eat 80% full, take a walk after meals, etc. Avoid lying on your back or lying on your stomach. People with abdominal obesity need to lose weight. On this basis, drug therapy or minimally invasive surgery can also be performed. Special reminderpeople with gastroesophageal reflux Don’t drink too much porridge. Porridge will produce a lot of stomach acid, and liquid food is more likely to reflux. Don’t eat anything 2 hours before bedtime at night. Severe symptoms can raise the head of the bed.
Source: Health Times
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