Cardous vascular disease and psychological disorders, which is the so-called " comorbid ".
In recent years, it has been found that the incidence rate in outpatients is 15% to 30%, and the incidence rate among hospitalized patients has been further increased, especially for patients hospitalized for cardiac emergency, the incidence rate of "co-diseases" can reach 60% to 75%. Among patients with psychological disorders, the relative risk of initial and recurrent cardiovascular events is significantly increased, which is comparable to the already identified risk factors for coronary heart disease. In addition to the common clinical typical depression and anxiety disorders, many psychological diseases-related symptoms that occur in cardiology patients are not typical, but will significantly increase the incidence of cardiovascular events.
In our clinical practice, we often receive patients with depression and anxiety after cardiac stent surgery. For some patients who need surgery, if they can intervene in time when problems are found or potential tendencies before the operation, it will be better than only diagnosed and treated when serious symptoms appear after the operation. It will avoid the recurrence of multiple postoperative symptoms and undergoing 2 or 3 consecutive surgeries. Many stents are placed, and finally the symptoms are repeatedly reflected.
Today's society attaches more and more importance to "cardiac rehabilitation management" .
Co-morbidity is coming, and cardiovascular rehabilitation cannot be exempted from
For example, a 72-year-old teacher Zhao had a sudden illness in clinical practice. clinically diagnosed as "myocardial infarction". Fortunately, he had a heart stent surgery in time and saved his life. Two months after the operation, she developed dull back pain again, and each time the pain lasted for a long time. However, all indicators were normal during the review. Through communication, the doctor found that she was always worried about problems with stent , such as whether the stent would fall off when the movement was large, whether it would calcify for a long time, whether the magnetic magnetic examination would affect it, whether there would be metal detection alarms in airport security checks, etc., and how long it would take to start daily life. After psychological scale evaluation, it was found that Teacher Zhao was in a severe state of anxiety. She was treated with psychological assistance, patiently explained her condition and common sense issues related to stent surgery, and added anti-anxiety drugs. She came to follow up a week later, and there was a significant improvement.
Analysis: Patients with sudden myocardial infarction like Teacher Zhao have severe invasion on the body while also causing huge mental and psychological trauma. Statistics show that more than 60% of heart disease patients have had psychological disorders of varying degrees, and anxiety and depression disorders are the most common, especially for some patients with cardiac vascular stenosis. Repeated anxiety will lead to vasoconstriction, affecting the disease examination and later recovery.
data show that the incidence of anxiety disorder in cardiovascular patients is about 40%, which is much higher than the incidence of depression. 24.5% of arrhythmia patients, 23.75% of stent implantation of coronary heart disease, 6% of myocardial infarction, and 3.25% of heart failure patients all experienced anxiety disorders.
~~Recognition of anxiety disorder~~
However, the identification of anxiety disorders, common symptoms of anxiety disorders are chest pain . Chest pain is mostly acupuncture-like, which occurs in silence and has nothing to do with fatigue. Some are relieved after activity, nitrate drugs are not significantly relieved, there is no obvious ischemic change in the electrocardiogram examination, or non-specific ST-T changes, and there is excessive worry, tension and anxiety, which are often accompanied by sleep disorders, hyperactivity of autonomic nervous system such as sweating, blushing, palpitations, shortness of breath and dizziness, hand shaking, nausea, intestinal rumbling, frequent urination, pain and other anxiety symptoms in various systems. The patient complains a lot, involving multiple systems and multiple organs, and the complaints are unclear.
Psychological classification: Two types of
generalized anxiety : The patient has been nervous and irritable for a long time, but there is no actual objective threat, he is worried, restless, trembling, and thrilling. The symptoms are at least 6 months;
Panic attack: There is no cause of sudden intense irritability and anxiety, and he is full of fear, as if death is coming, there are no obvious symptoms during the gap period, and there are at least 3 attacks within a month.Patients with panic attacks may have cardiopulmonary, digestive, nervous system symptoms, accompanied by disintegration, loss of reality, and near-death experience. They can be spontaneous or induced in special scenarios. More women than men are, and tachycardia is accompanied by attacks. Patients often seek emergency treatment in cardiovascular disease, which is prone to misdiagnosis as acute coronary syndrome or acute left heart failure .
Experts believe that the diagnosis and treatment of cardiovascular disease anxiety disorders are very challenging because anxiety is very common in people. Normal anxiety can improve the ability to cope with difficulties, which is often short-term. The tension and depression of pathological anxiety exceeds the ability to bear is continuous and will affect daily life. We can use professional psychological scales to identify the anxiety level of heart disease patients and conduct targeted treatment.
Warm reminder
Regarding the rehabilitation problems of cardiovascular diseases, it is effective to reduce the risk of recurrence of cardiovascular events and myocardial infarction, thereby reducing repeated hospitalizations and unnecessary revascularization, thereby effectively regaining the best physical strength, mental state and social functions of the patient.
The above content is excerpted from the new health and new life. I would like to express my gratitude to the original author!
