The symptoms and examination of coronary heart disease, a little professional!

The symptoms and examination of coronary heart disease, a little professional!

In the cardiovascular patients who died, more than half of patients with coronary heart disease died of asymptomatic myocardial ischemia, sudden death, angina pectoris, and acute myocardial infarction; and good lifestyle and eating habits, Reduce the overall incidence by half.

[What are the symptoms of coronary heart disease that should be vigilant in the early stage? 】

The degree of coronary artery stenosis is not consistent with the severity of the patient’s symptoms. Early coronary heart disease can be completely asymptomatic, or only some atypical symptoms, such as chest tightness, chest tightness, and reduced activity endurance.

If the elderly often have these symptoms, especially if the symptoms are obvious when the activity increases, and you should get better after stopping the activity, you should be alert to the presence or absence of coronary heart disease.

[What are the types of coronary heart disease in clinical practice? 】

Clinical classification of coronary heart disease, the current application method is the World Health Organization standard:

(1), asymptomatic coronary heart disease, also known as occult Coronary heart disease often does not show symptoms.

(2), angina pectoris coronary heart disease

labor angina pectoris: heart rate increases during exercise and emotional agitation, myocardial oxygen consumption increases, causing myocardial ischemia and hypoxia and chest pain, Rest or take nitroglycerin to relieve.

Spontaneous angina pectoris: When angina occurs in a quiet state, it is not related to whether the myocardial oxygen consumption increases. The degree of chest pain is heavier and it is not easy to relieve nitroglycerin. This type of angina is often associated with coronary artery spasm.

Combined angina: angina can occur in both labor and quiet.

(3), myocardial infarction coronary heart disease

is a serious type of coronary heart disease, based on coronary atherosclerosis, atherosclerotic plaque rupture, thrombosis or blood vessels The coronary artery is completely blocked, resulting in myocardial necrosis.

(4), myocardial sclerosis coronary heart disease

Due to long-term myocardial ischemia, fibrous tissue hyperplasia, enlarged heart, heart failure or arrhythmia.

(5), dying

refers to a person who seems to be healthy, or who has a heart attack but has a stable condition, suddenly dying from the onset to death within 6 hours.

[60If a person of many years old has heart palpitations and palpitation, is it coronary heart disease? 】

Heart palpitations and palpitation are symptoms that can occur in a variety of heart conditions. Non-heart disease people, such as hyperthyroidism, autonomic dysfunction, anemia, etc. can also appear palpitations. Because coronary heart disease occurs in middle-aged and elderly people, and 60 years old or older is the prevalence of coronary heart disease, but can not rely on these symptoms alone, they think they have developed coronary heart disease, should go to the hospital for detailed examination.

[People who do not have symptoms of coronary heart disease, why do they suddenly die due to illness? 】

Asymptomatic coronary heart disease is also called occult coronary heart disease, and the incidence is still unclear.

Although these patients are asymptomatic, myocardial ischemia may occur during an electrocardiogram or continuous 24-hour ambulatory electrocardiogram, and some active treadmill exercise tests are positive.

Therefore, it is important to have regular physical examinations for middle-aged and elderly people (preferably once a year).

Several people may have sudden death, regardless of symptomatic or asymptomatic coronary heart disease. Sudden death refers to a person who looks healthy or a patient with stable disease (mostly heart, lung or nervous system diseases) and dies within 6 hours of acute symptoms.

More than half of the sudden death is caused by coronary heart disease. The reason for this is that on the basis of coronary arteriosclerosis, acute myocardial ischemia occurs due to coronary artery spasm or thrombus obstruction, causing local ECG instability. Severe arrhythmia and death.

[The electrocardiogram has myocardial ischemia, what is the problem? 】

The electrocardiogram reported myocardial ischemia (myocardial strain) refers to ST-segment depression, T wave low or inverted, indicating coronary insufficiency. If it is middle-aged and elderly, the most common is coronary heart disease. It should be noted, however, that these changes in ST and T waves can also occur in other heart or autonomic dysfunctions.

In addition, the above-mentioned electrocardiogram abnormalities accounted for about half of the patients with coronary heart disease. That is to say, the ECG report is normal, and the existence of coronary heart disease cannot be denied.

The symptoms and examination of coronary heart disease, a little professional!

Typical ECG: consists of P, Q, R, S, T, U waves.

[ECG “Pulmonary Pwave”, what is the problem? ]

There is a “pulmonary P wave” in the electrocardiogram, which refers to a high-point P wave in the ECG II, III, and AVF leads with an amplitude of ≥0.25 mV ( MV), indicating right atrial hypertrophy. In the elderly, it is often caused by chronic pulmonary heart disease (pulmonary heart disease); in adolescents, congenital heart disease should be considered.

The symptoms and examination of coronary heart disease, a little professional!

[What are the characteristics of a typical angina attack? 】

Typical angina is a sudden onset of chest pain that occurs during physical activity. After stopping the activity, the pain can be relieved. The pain is located behind the sternum, but also in the anterior region of the heart, radiating to the neck, upper left arm and even the upper abdomen. The nature of pain is crushing, tightness, and suffocation. The pain lasts for 1 to 5 minutes. If only a few seconds of acupuncture-like pain occurs, it is often not angina.

The symptoms and examination of coronary heart disease, a little professional!

If it is spontaneous angina, when there is no physical activity, even chest pain occurs during sleep, the pain is more severe and the duration is longer. If you have an electrocardiogram during an angina attack, you may have a ST-segment depression (a few are elevated), and a low-wave or inverted T-wave will help diagnose.

If middle-aged and elderly people often have chest tightness or chest pain, especially chest pain associated with increased activity, although not typical symptoms as mentioned above, they should be further examined to diagnose coronary heart disease.

[What is the meaning of the diagnosis of “beta receptor allergy syndrome”?

Some young people or middle-aged women have symptoms of palpitation, rapid heart rate, and chest tightness, sometimes accompanied by anxiety, upset, and a few seconds of stinging in the chest. . The electrocardiogram shows that the ST segment is falling and the T wave is inverted. The propranolol test, that is, the oral electrocardiogram returned to normal after 0.5 to 1 hour after oral administration of 20 mg. This condition is an autonomic dysfunction, called “beta adrenergic receptor allergy syndrome”, not coronary heart disease. This syndrome can be treated with oral propranolol or betaloc (Metoprolol) and works well.

The symptoms and examination of coronary heart disease, a little professional!

It should be reminded that before the diagnosis of beta-receptor allergy syndrome, it should be examined in detail to rule out diseases such as hyperthyroidism and myocarditis.

[ECG “Bundle branch block”, is it related to coronary heart disease? 】

Bundle branch block is more common in heart disease (common coronary heart disease in the elderly), but can also be seen in normal people (especially right bundle branch block is often seen in no People with heart disease).

Therefore, it was discovered that bundle branch block should be combined with clinical symptoms and other tests to determine whether there is a disease.

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