In the blink of an eye, the new crown epidemic has lasted for more than two years. The “Omicron” variant of the round came violently, and once again set off a “storm” across the country. According to research, new coronavirus infection has the risk of involving the cardiovascular system, and patients with a history of cardiovascular disease, especially coronary heart disease, may face greater risks in new coronavirus infection. During the epidemic, how should coronary heart disease patients spend safely?
An important pathological outcome of coronary heart disease is myocardial cell damage. Since myocardial cells are non-renewable resources, it should be prevented before it happens. Prevention and control are divided into three levels.
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I.
Primary prevention refers to the prevention of multiple risk factors for coronary heart disease before the onset of the disease. “Li”, such as smoking without leaving hands, eating meat, having alcohol with every meal, being obese but not exercising, being able to lie down and never sitting, being able to sit and never standing, staying up late to watch dramas, playing cards all night, fond of sweets, Such unhealthy lifestyles and habits, such as diet and heavy taste, should be controlled at the source. The focus of coronary heart disease prevention is to intervene in blood sugar, blood lipids, and blood pressure, and change unhealthy lifestyles and habits.
Secondary,
Secondary prevention is the early prevention of coronary heart disease Detection, early diagnosis, and early treatment can control the development of the patient’s disease, improve the prognosis of the patient, reduce the occurrence of adverse cardiovascular events, prevent the recurrence of heart disease, and reduce the mortality rate of the patient. The key is to adhere to the long-term “dual-effective” drug consolidation treatment – effective drugs and effective doses, and we must adhere to long-term scientific secondary prevention of coronary heart disease in order to effectively prevent the recurrence of coronary heart disease.
Third,
Third prevention refers to emergency Rescue of critically ill patients, including prevention of complications, rehabilitation treatment, prolongation of life, etc. The need for special vigilance here is to never ignore the appearance of chest pain, which may be an emergency signal of myocardial infarction.
< strong>How to do it specifically?
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1. Diet
1, “red meat” such as pork, beef, mutton, etc., contains more saturated fatty acids , should eat less, “eat less red meat, health and longevity.”
2. Epidemiological investigation and research results show that tea polyphenols, tea pigments and other substances contained in tea have the functions of lowering blood pressure, lowering lipids, protecting myocardium, and preventing atherosclerosis. Like sclerosis, but you can’t drink strong tea.
3. Eat more fruits rich in vitamin C, such as fresh strawberries, oranges, tangerines, dragon fruits, fresh jujubes, tomatoes, kiwi, etc. It can prevent bleeding, promote wound healing, and enhance the elasticity of blood vessels, especially for patients with coronary heart disease.
4. Eat more yellow vegetables, such as carrots, sweet potatoes, etc., which are rich in carotene and help reduce arteriosclerosis.
5. Dietary fiber is a carbohydrate that cannot be digested by the body, such as whole-grain oatmeal, sweet potatoes, corn and other grains, which increase satiety but cannot be digested by the body. Absorption and metabolism, in layman’s terms, are occupying space without providing heat. In addition, dietary fiber can also reduce fat absorption, play a good role in lowering blood sugar, lowering blood pressure, and preventing cardiovascular and cerebrovascular diseases.
Second, exercise reasonably, prolong life
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1. The exercise method should be based on aerobic exercise as much as possible, which can be supplemented by anaerobic exercise. Such as walking, jogging, swimming, tai chi, yoga, etc., try to avoid simple anaerobic exercise such as high jump, long jump, fast sprint, weightlifting, throwing, push-ups, etc.
2. Choose your favorite aerobic exercise that can be persisted for a long time.
3. The exercise intensity can be based on the individual’s self-feeling during and after exercise, such as sweating slightly after exercise, but no obvious discomfort; The heart rate after exercise is determined. The heart rate after normal exercise does not exceed 100~110 beats/min. After rest, it takes no more than 5 minutes to recover to the heart rate before exercise. No matter which method you choose, as long as you experience palpitation, chest tightness, shortness of breath, dizziness, or any other uncomfortable symptoms during exercise, you should stop immediately and avoid insisting too much.
4. Exercise should be done late rather than early. “Smell the chicken and dance” advocated by the ancients has also become the fitness habit of most modern people, but this method is not advisable for patients with coronary heart disease, and it is very dangerous, because the early morning is the “peak period” of heart attacks, especially every morning. From 6 to 9 o’clock, angina pectoris and sudden death mostly occur during this period. From a physiological point of view, whether it is physical exertion, or the body’s adaptability and sensitivity, afternoon or evening is the best.
Third, physical and mental balance, daily life is regular
Mental stress, emotional agitation, anxiety and other negative emotions will cause the body to release more catecholamines, accelerate the heartbeat, and increase the burden on the heart. Studies have shown that most coronary heartPatients will have psychological problems such as anxiety and depression. Such bad emotions may induce or even aggravate the symptoms of myocardial ischemia. Therefore, it is very important for people to have a peaceful life and maintain an optimistic mood.
Fourth, adhere to medication and review regularly< /p>
It is of great significance to strengthen the compliance of patients with taking medication, implement effective medication guidance for patients with coronary heart disease, and let them understand and be familiar with the usage, function, and adverse reactions of drugs.
1. Antiplatelet drugs
This is a very important drug after stenting to prevent stent thrombosis. It mainly includes two categories: one is the cornerstone of the treatment of coronary heart disease – aspirin, which needs to be taken for a long time and should not be discontinued without special reasons; the other is ADP inhibitors, in fact, there are two drugs, clopidogrel or ticagrelor, which are It is required to take the stent for at least 12 months after the operation, and review it after 12 months. If the stent is smooth, most patients can stop it, or in other cases, they need to follow the doctor’s advice. These two drugs are very critical drugs and must not be discontinued at will, otherwise the consequences are often catastrophic. When taking antiplatelet drugs, you should pay attention to whether you have a tendency to bleed in your daily life. For example, when you brush your teeth, your gums always bleed, your skin has bleeding spots and petechiae, and your stools turn black when you don’t eat green leafy vegetables. Reaction, but in most cases will not cause serious consequences, patients should not be arbitrarily discontinued.
2. Statins
mainly include pravastatin, atorvastatin, rosuvastatin, simvastatin, etc. For patients with coronary heart disease, the main effect of taking such drugs is not to lower blood lipids, but to stabilize arterial plaques and play a role in slowing or even reversing the progression of plaques. Regardless of whether the blood lipids of patients with coronary heart disease are at normal levels, long-term use of statins is recommended. However, these drugs may increase transaminases, and they can continue to be used if they do not exceed 3 times the upper limit of normal. It is important to note that when fatigue, muscle weakness, and myalgia occur, even if the creatine kinase level does not increase, you should go to the hospital for treatment, and don’t delay.
3. Drugs for heart rate control
mainly include metoprolol, bisoprolol and so on. The main role of lorol drugs is to slow down the heart rate, reduce myocardial oxygen consumption, improve the long-term efficacy of patients, prevent the recurrence of myocardial ischemia, and need to be taken for a long time. The heart rate should not be lower than 50 beats/min during taking the medicine. Too slow heart rate may cause fatigue or even cerebral ischemia.
4, ACEI (angiotensin-converting enzyme inhibitor) or ABR (angiotensin receptor blocker) drugs, such as pril and sartan These are antihypertensive drugs in people’s impression, but for patients with coronary heart disease, these drugs can promote vasodilation, improve myocardial function, and have anti-myocardial ischemia effects, so they also need to be taken for a long time. The biggest adverse reaction of ACEI drugs is dry cough. In severe cases, you can consult your doctor whether to change the drug.
5. Chinese patent medicines
Traditional Chinese medicine believes that angina pectoris and myocardial infarction are equivalent to “chest paralysis, heartache, real Heartache, envelope pain”, etc., are caused by “qi stagnation and blood stasis”. Shexiang Baoxin Pill has the effect of “aromatic warming, nourishing qi and strengthening heart”, which can dilate coronary artery, improve vascular endothelial function, inhibit inflammation of vascular wall, promote therapeutic angiogenesis, and thus quickly relieve various types of coronary heart disease angina pectoris and myocardial infarction It can relieve the pain caused by myocardial ischemia, and the effect lasts for a long time. It is also a good drug for coronary heart disease.
In addition, regular review every year is required, especially for patients after stenting of myocardial infarction, coronary angiography needs to be reviewed half a year after stenting, because at this time, myocardial infarction recurs. or a peak time for stent restenosis.
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References:
[1] Gao F, Rahman F. DOACs and Atherosclerotic Cardiovascular Disease Management: Can We Find the Right Balance Between Efficacy and Harm [published online ahead of print, 2022 Apr 7]. Curr Atheroscler Rep. 2022;10.1007/s11883-022-01022-w. p>
[2] Shi W, Ghisi GLM, Zhang L, et al. A systematic review, meta-analysis, and meta-regression of patient education for secondary prevention in patients with coronary heart disease: impact on psychological outcomes [published online ahead of print, 2022 Feb 4]. Eur J Cardiovasc Nurs. 2022;zvac001.
[3] Zhou Xunjie, Shen Rong, Fu Deyu, etc. Comprehensive Traditional Chinese Medicine Clinical observation of preventive health care intervention in risk groups of coronary heart disease[J].Journal of Cardiovascular and Cerebrovascular Diseases of Integrated Traditional Chinese and Western Medicine,2017,15(11):1345-134.
[4 ] Wang Gaotong, Liu Guoluan, Yang Xuejia, et al. Follow-up study on the effect of standardized treatment for secondary prevention in patients with coronary heart disease [J]. Chinese General Medicine, 2012, 15(08): 831-833.
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