At 3 a.m., 120 sent a middle-aged man from 1981!
Acute extensive anterior wall large-area myocardial infarction, the patient's heart rate is 120 beats per minute, blood pressure is 80/40mmHg, the whole body is wet and cold, and the consciousness is indifferent. The mortality rate of this myocardial infarction is extremely high. Rescue immediately, send the patient into the catheter chamber, open the blood vessels, and imaging found that the patient's anterior branch lowering opening was completely blocked. Open the vascular implant stent and send the patient back to the monitoring room.
In the case of dopamine maintaining blood pressure and IABP assists heart circulation, the patient's heart rate is 130 beats/min and the blood pressure is 90/54mmHg. Then we communicated with the family again. On the one hand, we showed the patient's family the process of the angiography. The operation was relatively smooth and the blood vessels were opened. On the other hand, we informed the family that the patient was in too serious condition and was still in shock and was not out of danger of life.
The family said that the patient went to the hospital once 3 days ago. The doctor suggested that the patient be hospitalized, but the patient heard that the stent might be needed after hospitalization, so the patient refused. Because the patient said that he had seen it online that angina pectoris does not necessarily require a stent, and it is enough to take medicine for angina pectoris, so when the doctor told him that it was angina pectoris, he was very disgusted and refused to be hospitalized, so he just prescribed medicine and went home to take it.
But I didn’t expect that 3 days later, my heart and blood vessels became blocked, and myocardial infarction occurred, and it was so critical.
So is it angina pectoris, so don’t use a stent?
is of course not, this needs to be viewed specifically. Simply put, angina pectoris is divided into stable angina pectoris and unstable angina pectoris. The risk of instable angina is almost the same as myocardial infarction.
1. Angina
Angina is a discomfort caused by the stenosis of the heart artery blood vessels to a certain extent, causing insufficient blood supply to the blood vessels, which leads to myocardial ischemia , thus causing an uncomfortable manifestation. Generally speaking, when the cardiovascular stenosis exceeds 75%, angina pectoris may occur.
We have said many times that angina pectoris is not only pain in the precordial area, but may also include chest pain , shoulder pain, back pain, abdominal pain, toothache, headache, and even some angina pectoris may not be painful, but it is manifested as chest tightness, breathing, sweating and other discomfort.
The occurrence of angina pectoris indicates severe cardiovascular stenosis. If the next step of severe stenosis is not subject to regular treatment, it may develop into myocardial infarction, or even sudden death.
So angina pectoris can be simply understood as a sign of myocardial infarction!
2. Stable angina pectoris
Stable angina pectoris is also called labor angina pectoris. Simply put, the patient has severe cardiovascular stenosis, but angina pectoris will not occur during rest. Only when the heart rate increases when the heart rate increases, the heart's oxygen demand increases. At this time, the narrow blood vessels cannot meet their own blood supply and oxygen supply, which will lead to ischemia and hypoxia, which will manifest as angina pectoris.
This kind of angina pectoris has a relatively low risk, and the risk of myocardial infarction is relatively low, so it is called stable angina pectoris.
This stable angina pectoris is prevented by regular aspirin + statin drugs, and some drugs to control angina pectoris can be effectively controlled. If the angina pectoris does not occur after taking the medicine, then further stent treatment can be avoided.
and studies have shown that stent treatment does not bring more benefits for this stable angina pectoris. So it is not that angina does not require stents, but that this stable angina does not require stents.
Of course, stability is only relative. If this stable angina gradually worsens, the drug cannot control it, or develops into unstable angina, it is as dangerous as myocardial infarction.
3. Unstable angina pectoris
Compared with stable angina pectoris, unstable angina pectoris is much more dangerous.
unstable angina and acute myocardial infarction , these two diseases are collectively called "acute coronary syndrome", so they themselves belong to the same class of diseases at the same level.
Instable Angina simply means that the cardiovascular vessels are severely stenosis and will be blocked immediately, and blood clots may block blood vessels at any time; acute myocardial infarction means that the blood vessels have thrombosis and the blood vessels have been blocked.
If you have to say the severity, then myocardial infarction is more dangerous than unstable angina, but unstable angina is one step away from myocardial infarction. Unstable angina may develop into myocardial infarction at any time, so they are all called "acute coronary syndrome".
The simple understanding of unstable angina pectoris is that patients will experience angina pectoris when they are resting, and if they exercise a little, they will suffer from angina pectoris. The above mentioned stability angina pectoris usually does not occur during rest, but only after activity.
In short, whether it is stable angina or unstable angina, it should be treated regularly and actively; especially unstable angina, it should be treated according to acute myocardial infarction, which requires angiography or even a stent.
Don’t have a single understanding of it, just use it to judge your life by hearing it!
Professional matters must be listened to by professionals!
