The young teacher’s chest pain finally found the truth in four years, and the inexplicable angina is no longer a “neuropathy”!2019-08-07 00:34:05 1282 ℃
Chest pressure in the chest, increased after exertion, lasting more than three minutes, the patient is 38 years old, male. Isn't this typical angina?
However, for this disease for four years, I can't find any problems. Some doctors even recommend to see neurology. What do patients feel?
Today’s uncle is not going to tell a story. Li Dong, the protagonist of the story, almost jumped off the operating table at the moment of the truth.
Because of these years, he has been too hard to toss. The heart disease that he eventually diagnosed is now getting higher and higher. Many patients who have inexplicable pain but can't find the cause can finally know the truth.
Li Dong is from Wuhan, teacher, father of the second child.
One evening in 2015, Li Dong, who was full of food and drink, was bending, and suddenly there was a pain in the chest, crushing cramps, but not three minutes. It is.
Although Xiao Li was a little worried, he never went to the hospital because he had never committed it.
A month later, Li Dong sentenced his homework in the office, and suddenly his chest hurt again. Same time as March, the same position, the same degree, or even the same duration. Li Dong was a little nervous now and went to the hospital immediately.
In the large hospital in Wuhan, the cardiology doctor arranged for Li Dong to check: ECG, heart color ultrasound, plate test, coronary CT... a series of checks Li Dong one by one. When the results of the examination came out, the doctor said that the blood lipids were a little high; ct showed normal blood vessels, no stenosis or blockage. Not sick! Take some medicine to go home.
Why is it painful? Not easy to explain. So by the end of 2015, Li Dong still had the same symptoms. He also checked the information himself. Is it unstable angina? He went to Wuhan again.
The same check was repeated and all items were normal.
Although the number and duration of heartaches have increased, no problems have been detected.
So two years have passed. Symptoms continue to worsen. Li Dong went to the hospital in Wuhan for the third time. This time, coronary angiography was performed without any stenosis. Going home.
2018In the year, I went to Wuhan for the fourth time, but I still didn't find out. The doctor who is already familiar with him tells him that he can't see a neurology department?
Hmm? I have a psychological problem? It shouldn't be.
Li Dong was not willing to go to another large hospital. Coincidentally, he heard the doctor call before he entered the door and said his hometown! Xiao Li was very excited and sat down with the doctor for a few words. The doctor came to see the fellow villagers, saw the previous inspection report of the fellow villagers, and listened to the bumps of the villagers’ medical treatment in recent years. They thought about it and said to Xiao Li: "You should not do these checks, waste money, you are not sick. You are a mental illness." Then I wrote a hospital name to Xiao Li. "You can go to this hospital to see."
Xiao Li thanked the fellow doctor and went straight to the hospital. When I arrived at the hospital, I saw the "neurology department" on the brand. Xiao Li’s heart was completely cold.
"I was sinking in my heart. I want to say that this is still not treating me as a neuropathy? I left, and I didn't go." Xiao Li said here, and sighed again. "I still go to Shanghai to see." After all, I went to the big hospital, but the doctor said that the blood vessels were not narrow or blocked. I prescribed medicine and left."
This is the way until mid-July 2019. Occasionally heard a friend mentioned the heart center of Beijing Chest Hospital, he found a thousand miles. This time he did not have any hope, he took a day off.
It is also a coincidence that Li Dong brought all the inspections this time, but did not bring the contrast CD. Maybe he doesn't think it's useful. However, Zhang Jian, director of the Heart Center, asked him to be hospitalized for angiography.
On the operating table, the truth appeared.
Slow blood flow dynamics under contrast agent
contrast agent injection, Xiao Li's blood vessels appear on the screen. One, two, three, four, five, six. The heart jumped six times and the contrast agent went from the head of the blood vessel to the tail of the blood vessel.
Slow blood flow! Most patients, even those with severe cardiovascular stenosis, do not have more than two heartbeats from the beginning to the end of the contrast when they are doing angiography, and will disappear quickly, that is, the screen is black. The developing part disappears quickly. Because the contrast agent is absorbed by small blood vessels in the myocardium.
But the injection of Li Dong cardiovascular contrast agent, slowly, the most need 6 cardiac cycles, that is, the heartbeat 6 is only past. According to the diagnostic criteria, more than three cardiac cycles are slow blood flow. Moreover, the contrast agent in his blood vessels is also very slow to absorb. That is the black part, it only disappeared for a long time.
Obviously, there was a problem with the microvessels in his heart. To supply blood to the myocardium, we can see the large blood vessels, only bear 5%, 95% are invisible microvascular bears. Li Dong happens to be a problem with microvessels!
This explains why Li Dong has symptoms of angina. Because the blood is not delivered efficiently, the nutrients needed for the myocardium are not acquired in time. It is also the result of vascular stenosis or vasospasm, as well as myocardial ischemia. The reason for his chest pain in four years is myocardial ischemia!
This is like pouring a basin of water on the ground. The ground is loose, and a basin of water is quickly absorbed. If the floor panel is knotted, the water will not go down for a long time.
In order to further prove the problem of microvessels, surgeon Wu Hangyu injected Li Dong into the coronary artery to expand the microvascular drug nicorandil. After doing the angiography, it will be different soon!
"Slow blood flow" after the blood flow increased instantly
It can be seen that the blood flow is almost fast, and black The contrast agent disappeared very quickly, and even disappeared even after it was apparent. This shows that after the expansion of the microvessels, the rate of absorption of blood by the myocardium is immediately increased!
At this time, Li Dong's myocardial ischemia was immediately improved.
clarified the diagnosis, knowing the cause, Li Dong is the most happy, but instead proves that he has no mental illness... The stone in Li Dong’s heart is falling on the ground.
Why is there a slow blood flow? This is also a difficult problem in the current international cardiovascular community, and related research results are few. It is only speculated that it is related to platelet activation, diabetes, hyperlipidemia, vasospasm, etc., but the cause is still not clear. This also caused slow blood to be hidden in the deep public, and many professionals lack understanding.
Last time Uncle Uncle specifically said a slow blood flow in the article, many readers are particularly concerned about what kind of medicine to treat with slow blood flow. Today, I will focus on explaining it again.. At present, for slow blood flow or drug treatment, doctors will use anti-inflammatory, anti-platelet and lipid-lowering drugs, and drugs that dilate microvessels according to the specific examination of patients, and require patients to control the three high. The name of the specific drug, because it is a prescription drug, the uncle will not mention it. Because prescription drugs must be prescribed by doctors, we must not prescribe medicine for ourselves.
- In the previous：36-year-old woman, no pain, no diagnosis of lung cancer, a sign on her hand, or has reached the middle and late stages
- The next article：Returns list
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