The "Hong" Heart of Medical Sciences 丨 Talking about the myocardial infarction by the "59 -year -old bus driver accident"

Editor's note: At present, with the continuous improvement of science and technology, people are enjoying the superior modern life such as clothes, food, housing, travel, and entertainment, but also suffer from various adverse diseases. A variety of bad lifestyles and work pressure have greatly increased the risk of cardiovascular and cerebrovascular diseases, diabetes, cancer, etc. In order to pay attention to your life and health, Zhou Hong, a professor of Wuhan Yaxin Hospital, the largest Wuhan Yaxin Hospital in the Central South China, opened the column of "Medical" Heart Hospital in Central South China. My life is healthy.

Recently, a 59 -year -old bus driver in Shanghai allowed passengers to get out of the car in time before fainting, ensuring that the safety of passengers' safety caused widespread attention.

According to a passenger who got off the car ahead, the driver said the only two passengers on the car told you to get out of the car quickly and get out of the car. I will not be in their bodies. After the passenger gets off, the driver will faint. Lost control, the vehicle slid into the river after wipe the two battery cars. After passers -by rescue, the two cyclists were sent to the hospital for treatment. The driver who fainted was quickly diagnosed because of myocardial infarction. After treatment, patients have recovered.

There are more diseases that cause syncope

There are many diseases that cause syncope. In medical, syncope is a state of excessive broad brain blood supply that leads to short -term consciousness loss. During the attack, the patient fell to the ground because the muscle tone disappeared and could not maintain a normal posture. Generally, it was a sudden attack and a rapid recovery. There were few sequelae. However, suddenly fainting and falling are not necessarily syncope. Because syncope may cause accidental damage, and a common and challenging emergencies, the causes are complicated and diverse, which can easily lead to misdiagnosis.

Silation is roughly divided into three categories: reflexive (neurological media) syncope, hypotension (OH) syncope, and heartogenic syncope, which leads to dizziness and even fainting. , Drugs, hypoglycemia, heat stroke, electrolyte disorders and other causes.

Entering summer, chest pain centers often receive coronary heart disease patients of all ages, and their first symptoms are different. Coronary coronary arteries are "oil pipes" that supply blood to the heart of the heart. If the blood vessels are stenosis and "insufficient oil supply" will cause patients with myocardial ischemia and hypoxia, chest tightness, chest pain, fatigue, and dyspnea. And there is the characteristics of worsening after activity. If there are induced factors, there are severe and lasting sternum back pain, rest and nitrate drugs (nitroglycerin) cannot be fully relieved, accompanied by increased serum myocardial enzyme activity and changes in electrocardiogram of electrocardiography, which can be slow and fast heart rate, heart rate is fast, heart rate Frequent fascination, shock, or heart failure such as premature beats may cause syncope. If you do not get effective medical treatment in 120 minutes, you can often endanger life. Therefore, the chest pain center often reminds that once symptoms occur, 120 calls should be dialed in time within 120 minutes to stop all activities.

This scene is common in clinical practice: some patients are fainting at the door of the emergency room while driving to the hospital on their own. The chest pain center of Changsha Taihe Hospital recently received a patient with vomiting and fainting discomfort. After an accurate judgment of the emergency department, the patient quickly entered the process of chest pain treatment, bypassing the CCU, and directly sent the patient to the intervention catheter. Due to the timely and accurate diagnosis, the patient was three lesions of coronary heart disease, with a narrow stenosis of the anterior downside, and the narrowing of the right coronary artery was 95%. Sifferential stenosis caused severe myocardial ischemia, a decrease in autonomous heart rate, and the "tombstone" change of the electrocardiogram ST section. High, myocardial enzymes are elevated. After the cooperation of emergency and cardiac teams, the emergency intervention in PCI treatment was quickly completed, and patients were effectively treated.

Patients with coronary heart disease should pay attention to in winter and summer

Data show that my country's coronary heart disease has exceeded 11 million people. The main complications of coronary heart disease include sudden cardiac death, arrhythmia, heart failure, cardiological shock, ischemic myocardial disease, and two -polyetric prolapse. When these complications are severe, they will cause sudden syncope in the patient, and some may even be the first symptom of coronary heart disease. Usually, patients may only cause discomfort or fatigue and fatigue.

After a myocardial septic patients with coronary heart disease, the most common is ventricular arrhythmia. Clinically, ventricular premature beats and ventricular heart tachycardia are particularly much. Data show that 60%to 100%of patients will have ventricular premature beats. The duration of ventricular premature beats or ventricular heartbeat speed may cause ventricular fibrillation and cause the risk of sudden death to increase significantly. Patients received by some hospital chest pain centers are mainly middle -aged and elderly men. Most of them have basic diseases such as hypertension and diabetes. Some patients have long -term smoking and drinking habits. Those who have long -term work, stay up late, and have tight and noisy working environment, these factors are more likely to induce and aggravate coronary heart disease.

Most people think that coronary heart disease is frequent in winter, because the general blood pressure will rise in winter, and the burden of heart or corresponding increase. In fact, coronary heart disease may be high all year round. In particular, it is related to the patient's own potential basic diseases, including coronary heart disease, diabetes, and "three highs". It is easy to sweat in summer, and the imbalance of body moisture will cause blood viscosity. If the patient itself has cardiovascular disease and insufficient water intake, it may also cause myocardial infarction. Sweating can cause electrolyte disorders. ) It is easier to attack.

It is difficult to be hot in summer. Some people depend on cold drinks, shower or air conditioners to cool down. In the air -conditioned rooms with a temperature difference above 10 ° C, people will be cold. Driving the emotional undulation, it is easy to make people irritable and anxious, the emotional fluctuations are too large, the night is not good, and even staying up late to stay up late, it is easier to cause heart discomfort and even cause myocardial infarction. For people with high -risk crowds, that is, people who have serious weight index and have the above risk factors, how should they usually avoid serious complications caused by coronary heart disease?

Generally, more than half of patients will have clues during the 1-2 weeks before myocardial infarction. For example, the number of angina pectoris occur than before, and taking the same dose nitroglycerin tablets do not relieve symptoms as in the past; patients under the sternum under the sternum Either the severe and lasting pain in the front area of ​​the heart, or the swelling and discomfort in the front area, the radiation of the arms and neck during pain, and the symptoms such as pale, panic, shortness of breath, cold sweat; these symptoms may be due to the activity. Or if you climb the building, you should pay more attention. There are many symptoms of acute myocardial infarction, and even some people will go to the doctor because of headache, nausea and vomiting, and toothache. Because these symptoms are also the manifestation of digestive tract diseases that are prone to summer, we must actively investigate whether there are pathological changes in the corresponding organs. And attract attention, you can check the heart while doubting the digestive system disease.

What should I do after faint?

After syncope, people around them should help patients lie on their heads to prevent vomiting and suffocation. If there are airway foreign bodies, they should be removed in time to ensure that the respiratory tract is smooth. At the same time, pay attention to observing the basic life signs, blood sugar is also important, and water must be supplemented to observe whether the patient's consciousness recovers. Dial 120 emergency calls in time.

At present, the state is actively building a chest pain center network. The emergency vehicles are equipped with defibrillations that can handle severe ventricular arrhythmia. Some public places also have AED devices. After these treatment, they can often perform effective treatment of patients as soon as possible. If the consciousness is restored, you should ask the patient if there are other discomforts. If necessary, you should send it to the hospital's emergency center in time for the next examination and treatment.

Summer is approaching, "Medicine Hongxin" reminds people to pay more attention to good health, usually maintain healthy living habits, do not stay up late, less overeating in the night market, quit smoking and drink less; Miscellaneous grains, beans and olive oil are mainly, eat less animal oils, red meat, and eat less foods containing a large amount of saturated fatty acids or fried barbecue foods. Good personal protection, sun protection, heatstroke prevention, once you are unwell, rest in time. Do n’t think of chest pain, do n’t think of “tolerance and endure”, and do n’t just think that it ’s unclean or stomach disease. When you seek medical treatment, you must do an electrocardiogram and other examinations.

The "Medical Hongxin" column also reminds personnel who are engaged in high -risk work drivers, construction workers, dangerous positions, etc., and even ordinary people should pay more attention to check their bodies in a timely manner and eliminate hidden dangers.

Source: Wuhan Science and Technology News

Invited guests: Zhou Hong

Edit: Xu Lu

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