Definition of
coronary heart disease and mechanism of morbidity
.
Coronary heart disease, the full name of coronary atherosclerotic heart disease, is due to coronary atherosclerosis leading to vascular stenosis or occlusion, and then cause myocardial ischemia, hypoxia or necrosis of heart disease.
• morbidity mechanism: The main morbidity mechanism of coronary heart disease is the damage of coronary artery endothelium, and lipid deposition forms atherosclerotic plaque under the endothelium, leading to vascular stenosis. When the plaque ruptures, it can cause acute thrombosis and further aggravate myocardial ischemia.
Epidemiological status
• Morbidity and mortality
Coronary heart disease is one of the most common causes of death worldwide, and its morbidity and mortality increase with age.
• Geographic and gender differences
There are differences in the incidence of coronary heart disease among
different regions and races. The incidence of coronary heart disease in men is higher than that in women, but the incidence of coronary heart disease in postmenopausal women increases rapidly.
Risk factors and prevention
• Main risk factors: hypertension, hyperlipidemia, diabetes, smoking, obesity, lack of exercise, unhealthy eating habits, mental stress, etc. Are the main risk factors for coronary heart disease.
• Prevention strategies: control blood pressure, blood sugar and blood lipids at normal levels, quit smoking and limit alcohol; maintain healthy eating habits, such as low-salt, low-fat, high-fiber diet; moderate exercise to maintain an ideal weight; reduce mental stress and maintain a happy mood.
Typical manifestations and atypical symptoms
• Typical manifestations: Patients with coronary heart disease often have symptoms of myocardial ischemia such as chest distress and chest pain, especially during physical activity or emotional agitation. The pain is mostly located in the back of the sternum, which can radiate to the precordial region and the left upper limb, and can be relieved by rest or sublingual nitroglycerin.
• Atypical symptoms: Some patients may not have obvious chest pain, but only show palpitation, shortness of breath, fatigue and other non-specific symptoms. A few patients even have no symptoms, which is called silent myocardial ischemia.
Diagnostic methods and criteria
• Diagnostic methods: The diagnosis of coronary heart disease mainly includes electrocardiogram, echocardiography, coronary angiography and other examinations. Among them, coronary angiography is the gold standard for the diagnosis of coronary heart disease.
• Diagnostic criteria: According to the patient’s clinical signs, ECG changes and coronary angiography results, doctors can comprehensively determine whether the patient has coronary heart disease. Usually, coronary artery stenosis of more than 50% can be diagnosed as coronary heart disease.
Differential diagnosis and misunderstandings
• Differential diagnosis: Coronary heart disease should be differentiated from other diseases that cause chest pain, such as angina pectoris, myocardial infarction, aortic dissection, etc. The doctor will make a comprehensive judgment according to the patient’s symptoms, signs and examination results.
• Myth: Some patients may think that coronary heart disease occurs only in the elderly, but in fact, coronary heart disease can occur at any age. In addition, some patients may ignore atypical symptoms, resulting in delayed diagnosis and treatment. Therefore, it is very important to raise public awareness and attention to coronary heart disease.
Drug treatment plan and adjustment principle
• Medication plan: Medications for coronary heart disease mainly include antiplatelet drugs, antianginal drugs, lipid-lowering drugs, etc. According to the patient’s condition and the doctor’s advice, choose the appropriate drugs for treatment.
• Principle of drug adjustment: In the course of treatment, the type and dosage of drugs should be adjusted in time according to the changes of the patient’s condition and the side effects of drugs, so as to achieve the best therapeutic effect.
Introduction
of
non-drug therapy
• Lifestyle intervention: by improving diet. Increase exercise, quit smoking and limit alcohol to reduce the risk factors of coronary heart disease.
Less disease attacks.
• Surgical treatment: For patients with multivessel disease or ineffective interventional therapy, surgical treatment such as coronary artery bypass surgery can be considered.
• Interventional therapy: For patients with poor response to drug therapy, interventional therapy, such as coronary balloon dilatation and stent implantation, can be considered to improve myocardial blood supply.
Patient self-management strategy
• Regular follow-up: Patients should go to the hospital regularly for follow-up examination, timely understand the changes in the condition and treatment effect, and adjust the treatment plan.
• Healthy lifestyle: Patients should maintain a healthy lifestyle, including reasonable diet, moderate exercise, smoking cessation and alcohol restriction, to reduce the risk factors of coronary heart disease.
• Self-monitoring: Patients can conduct self-monitoring at home, such as recording the frequency and duration of angina pectoris, so as to detect abnormalities in time and seek medical treatment.
• Psychological adjustment: Patients with coronary heart disease are often accompanied by anxiety, depression and other psychological problems, so they should actively carry out psychological adjustment and maintain an optimistic attitude, which is conducive to disease control.
