[World Heart Day] Yang Jingang: How to get back the lost ~ Heart

September 29, 2022 is the 23rd World Heart Day. The theme of this year is "One Men's Heart", which is intended to advocate the public's more initiative to pay more attention, spread, and practice heart health concepts.

The greatest sorrow of modern medicine is to treat the heart as a mechanical pump. Half a number of coronary heart disease is not dead from hypertension, diabetes, and hyperlipidemia, but the hostility of our death. The heart is wise. It can communicate with the organs of our whole body. The best medicine for the treatment of heart disease is not his, not aspirin, but ...

Yang Jingang:

Deputy Chief Physician of Fuwai Hospital of the Chinese Academy of Medical Sciences

China Health Information and Health Medical Big Data Society Society of Children's Big Data Application Development Alliance Vice Chairman

Director of the Editorial Department of "China Cycling Magazine"

More than ten years ago, I was also an ordinary doctor. I was busy on the first clinical line every day and rescued many patients. Our cardiovascular doctor is educating others every day, how to practice our lifestyle, but in fact I am also very sad. In the past two years, many doctors have also had sudden death, and one of my good friends, he suddenly died suddenly when he was 48 years old. So why?

Thinking caused by fisherman saving fish

Everyone knows that the doctor is also very busy. In 2017, half of the doctors in China actually worked 60 hours a week. Twelve years ago, when I was hospitalized, I had to work at least 72 hours a week. Later, I thought that as a doctor, if we regarded every patient as a fish that rushed to the beach, we actually did not have so many manpower to save these fish one by one.

So since then I think, how to use a means or what work to do to avoid letting more fish rush to the beach, and avoid exhausting each of our fishermen? So how to save more people is a question I have been thinking at that time. I also wrote an article at the time. Lu Xun was actually a doctor at that time. Later, he gave up his doctor and engaged in literature. So I think Lu Xun is a good model? But at the time, I couldn't let go of the identity of a doctor. I think scientific research must be an important direction.

In the past 12 years, I participated in two very important studies, one was the construction of the Beijing emergency rescue system project, and the other was a registered research on myocardial infarction in China. So what did we find?

The "four thresholds" of myocardial infarction treatment

First of all, we need to emphasize why people die suddenly? Our heart is like an electrical organs, and every jump of the heart is driven by current. Where is the wires of these currents buried? Buried in our myocardial muscle. Every time the heart beating is the passing of a complete current. When we were in myocardial infarction, a blood vessels were completely blocked, causing a heart muscle necrosis of the heart. The cumulative wires may be completely broken and the heart will not be beat. Of course, it is also possible that the heart of the heart can be leakage and the spark is a ventricular fibrillation. When we rescue the patient, we will use the electrode to shock the patient to the patient, which can restore the heart to the jump.

In recent years, myocardial infarction technology has developed rapidly, and global myocardial infarction treatment has died from 100 people in the 1960s, and only 5 of each 100 people have died every 100 people. This is a very important progress. However, from our hospital studies, the hospitalization of myocardial infarction has not declined in 10 years, and it still stays at the level of the 1980s in Europe and the United States. An article published by Professor of China Anzhen Hospital statistics that even if all hospitals can implement high -quality treatment, they can only save patients with less than 10 % of myocardial infarction. This is a very sad fact. Why is this?

First of all, it is necessary to clarify a concept. Myocardial infarction is a disease that treats time dependence. It is the golden time we treat within 3 hours. About 50%will die within 3 hours. Rate will be reduced. So how do I want to reduce this mortality? How to get the most effective treatment in the shortest time?

In fact, 2/3 patients in China died outside the hospital. There is a data survey in Beijing found that among all residents who died in acute coronary heart disease, if you are less than 35 years old when you are suffering from coronary heart disease, 90%are dead in the hospital; ; The elderly died 70%of the hospital. So the younger, the more you have acute coronary heart disease, the more likely it is to die outside the hospital! What is the problem? It is sudden death. So I still have to emphasize that there are four thresholds for the treatment of myocardial infarction. What is the most important threshold? When you have acute chest pain and suspect it is myocardial infarction, do you know that you are myocardial infarction? This is the simplest, most common and effective knowledge. If you don't know, you can't take a correct way;

Second, how do you deal with it? Are you taking some medicine for a while, or take some medicine? Still going to call?

The most important thing is calling ambulance! The ambulance is the third level;

Fourth, whether the ambulance knows which hospital to transfer you to is blindly transferred, or it is very quickly transferred to a very good hospital. Can you take the most effective treatment when you arrive at the hospital?

Don't think that after the second or third level, we can survive, and there are many obstacles: First, let's talk about a scene first. At the time of the onset, half of myocardial infarction patients did not know that we were Myocardial infarction. You don't know how you can start treatment. Can you enjoy so effective technical means now? You miss time, and you don't know if you are myocardial infarction when you die suddenly. Only 15%of Chinese myocardial infarction patients call ambulance. When I reported at the U.S. conference last year, Americans couldn't believe it. He said how could you China be like this?

I think the issue of consciousness must be the first. 10%of people went to the hospital, but he did not choose an ambulance instead, but drove himself, or asked his family to drive. What was wrong? 10%of people died on the way to the hospital.

I used to have a patient. He arrived at the door of the hospital. Our hospital had a street bridge at that time. He was lying on the flyover during the process of walking in the hospital to the hospital. Fortunately, we had a doctor passing him to treat him urgently.

After arriving at the hospital, the doctor has told you that it is acute myocardial infarction. Making a bracket is the most effective way of treatment, but our patients take an hour on average to sign this word. I also reported this result at the World Cardiology Conference, and foreigners couldn't believe it. In fact, the reason is very simple: a family member in China may come, maybe the third child, I have to call my second brother after seeing it, the second brother said no, I have to call the eldest sister, the older sister said no, the old lady wants to want it, the old lady wants Come, one hour passed.

The current research we do is also the only investigation in community residents in China. If you have a myocardial infarction, do you know what you should do? Only 30%know.

When the doctor explains the condition, it takes a lot of time to tell the patient what is myocardial infarction and what is the most effective treatment. Many patients don't know. In this hour, I have seen two patients lost the opportunity to rescue during the conversation and signing.

We are popular. The most important feature of 75%of myocardial infarction patients is severe chest pain or chest tightness, accompanied by sweat, 3-5 minutes of excessiveness. If this is the symptoms, although it is already good and I have to be vigilant, I will use this principle to treat a good friend of me.

Nitrate glycerin and quick -acting savior pills can relieve symptoms and can be used, but it cannot save life. It can only relieve symptoms. Don't be lucky, even in the middle of the night, you have to go to the hospital to see it. Many people lose the best time to treat the treatment because they don't want to trouble others.

I feel that it is not enough to do these problems. It is not enough to educate everyone how to prevent and treat cardiovascular disease. So I later made the deputy editor of the two newspapers, the director of the editorial department of a magazine, and I had a blog that had more than one billion readings.

International problems: sudden heart death prevention

We haven't asked a question clearly. Many celebrities and doctors look good. Why do they die suddenly? Is it difficult to see a doctor? Is it difficult to see a doctor? Is celebrities expensive? It's not difficult or expensive, what is the reason?

I want to correct a very important concept. Many people think that the blood vessels in the heart are blocked little by little. wrong! This is a completely wrong concept. What does heart disease look like?

It is a vascular that looks not very narrow, and suddenly a volcanic eruption. Where is the volcano? It is growing on our blood vessel wall. We are called plaques in medicine, and it is popular as garbage, which is rusty in our blood vessels and is unpredictable. Therefore, the prevention of our sudden death is very difficult, and there is no way internationally.

Then a healthy person developed coronary heart disease for the first time, and each ten people died suddenly and four myocardial infarction. Why? It is when your blood vessels don't look so narrow, and the volcanic eruption suddenly erupted, so don't wait until there is angina pectoris before you want to go to the hospital to see a doctor, then it is too late, because the life of life was not treated when there was a first crown heart disease on the ten people. It's time.

This is actually a compensation mechanism of the body, because the plaques are first to the foreign minister during the process of atherosclerosis. It really doesn't work to walk into the blood vessels. Don't be nervous, there is no probability of sudden death, but it is also a common situation in our crowd. Prevention should start with children

How many people in our normal crowd have atherosclerosis? Our hospital did a very great job. In the 1970s, Dean Wu Yingkai led the patients who collected death in the country of the Fouwai Hospital in the country, including car accidents, trauma, pneumonia, appendicitis and other diseases. the most important reason.

First, atherosclerosis originated from children. It does not mean that atherosclerosis when we go to the young and middle -aged people, they originated from children, so prevention should start from children;

Secondly, in the middle and young people, the progress of atherosclerosis is very fast. At the age of 40 to 50, 70 % of people may have atherosclerosis;

Third, as long as your age is increased, everyone will have atherosclerosis. As long as you live long enough, 100 % people have atherosclerosis.

But many high -life people have atherosclerosis and narrow, but in fact he is very healthy. So people can get along with atherosclerosis harmonious.

Recover the "lost" heart with ancient wisdom

Let's look at why many young and middle -aged blood vessels have no serious vascular stenosis, but sudden death has occurred. The elderly 70s, eighty, and 80 -year -old people have severe atherosclerosis but are still alive. How can this problem explain?

We talked about a case. An old gentleman was on the bus. Because a young man did not let the seat, he slapped the guy's four, but he died suddenly. Why?

I think this study is a cross -era study. This is an international study involved in a research group: 90 % of myocardial infarction can be predicted, but which three reasons are the most important reason for everyone to know? The first one that everyone may be able to guess is hyperlipidemia; the second is smoking, 50%of Chinese men smoke; what is the third place? Tastest and stressful, many people ignore this problem.

As for hypertension, diabetes, including insufficient exercise, and less fruits and vegetables, it also goes back.

There is also a study in the United States that there are seven rules to prevent heart disease. In fact, it is very simple: exercise, diet, weight, no smoking, blood lipids, blood pressure, blood sugar, but he has no pressure to increase pressure.

What should I do if China faces cardiovascular disease? China has its own traditional wisdom. What is this wisdom?

Several celebrities in China were arguing about "getting angry" more than ten years ago. They believe that the fire is unique to China. There is no evidence of a folk statement. There is no scientific basis, and there is no foreign abroad. Later, I turned the information. I think there are foreign countries. What is it? INFLAME-setting fire, inflammation --- inflammation. In fact, it is inflammation, red swelling and pain, as long as there is inflammation, it is red, so this is a consensus in the world. Our inflammatory blood vessels are red.

So what are the hazards of inflammation? There are three major hazards in inflammation: first, we can increase our atherosclerotic hardening; the second endometrium is more likely to rupture. There is a fiber hat in the blood vessels. Fiber caps are the most important membranes. Essence People often talk about our arteriosclerosis? Drinking vinegar, drinking vinegar, drinking vinegar can only burn stomach. If the inflammation is more obvious, this fiber hat is particularly prone to long thrombosis after the rupture of the fiber hat, which promotes thrombosis.

So what factors can we get angry in our lives? It is actually very simple. From the perspective of diet, the salty things, too sweet things, too greasy things, and less fruits and vegetables are these. Sleeping actually allows us to restore immunity. If your immunity cannot be recovered, it is old and inflammation. It promotes the development of atherosclerosis. The pressure is actually in this category.

Let's see what is the harm of the urgency to get angry? The first anger can increase the risk of our heart disease within 2 hours.

I have a patient who has a serious and severe quarrel with his girl while eating, and then I went to the hospital to diagnose myocardial infarction. I immediately came up and found that the blood vessels were good, but the patient was still in the heart. Intersection It was because his excessive behavior caused the blood vessels to shrink seriously. Although it was not narrow, it also caused a large area of ​​heart necrosis.

There is also an executive, because he was afraid that he would take some anticoagulant drugs for a long time. We gave him the valve repair and did not replace him with metal flaps. As a result, he went back to work. It was broken, and it took more than 100,000 to suffer. Do it in vain.

If your stock trading is so in the stock market, whether it is up or falling, your risk of coronary heart disease is increased. Why? Whether you are happy or disappointed, it causes your emotional fluctuations.

We have studies that can see the harm of loneliness, which is the same as smoking 15 cigarettes every day; the risk of heart disease increases by 19%; the risk of death of the heart is doubled, so be good and good deeds; It affects health; in addition, the risk of death of kind lady is reduced, the mortality rate of people with a living goal, the gratitude has obviously improved physical and mental health, and the health of optimism has doubled. These are actually what we should implement. Health care, this is the wisdom of our lives. Therefore, some people in the United States wrote a book "Good Mood and Good Heart". He said that the biggest sorrow of modern medicine is to treat the heart as a mechanical pump. Half of the coronary heart disease is not dying from hypertension, diabetes, and hyperlipidemia, but the hostility of our death. The heart is wise. It can communicate with the organs of our body. The best drug for the treatment of heart disease is not his, not aspirin, but optimism and love.

I don't say that we want to use our ancient wisdom to confirm our modern knowledge. These wisdoms were created by our ancient Chinese, but the wisdom of China was proven by our modern science.

The heart and body disease we are talking about is that psychological diseases can affect the body. Of course, body disease can also affect psychology, including hypertension, coronary heart disease, myocardial infarction. In fact, it is the heart and body disease we are talking about.

Confucius said: Benevolence, Dade must have a longevity; Chinese medicine is full of illness, and the heart is still sick, but look at our current people's hearts, the whole person's emotions are buried by the impetuous mood;

"The Tao Te Ching" said: The five colors are blind, the five tones are deaf, and the five flavors are refreshing, but is it good for your body?

So we speak in China: Internal and outer kings. What is righteousness, removing uneasy emotions, not being blinded by material desires, keeping our hearts quiet, and self -cultivation to improve our moral cultivation. Internal and outer kings are our greatest health wisdom in China. The heart of our Chinese medicine, the heart of China, is not the heart, it is the spirit of the heart. It not only includes the heart, but also affects our emotions, which is of great significance to our life happiness.

It can also reflect our life value, so we talk about medical treatment, if you are a doctor, you talk about brackets, pills, and surgery knives every day, you are the medicine; if you are a middle doctor, you want Pay attention to the behavior of patients, pay attention to the patient's thoughts, and pay attention to people rather than disease, nor medicine; if you can do medical treatment, then whether you create a harmonious and healthy environment, or you can benefit the people of one side, all of which are all the people, that are all the people. It is a great doctor.

It has also published a study and lecture on the secrets of Gao Shou includes: diet and valuable living, meaningful, communicating with the society, likes to exercise, spiritual life, compassion, responsibility, belonging, care, and maintain health. Only this one is a physiological indicator. Therefore, our ancestor believes that as a person must establish a life for heaven and earth, the general origin of China's cultural origin "Book of Changes" said: Heaven and Heaven, gentlemen are constantly improving;

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