Fake "myocardial ischemia" makes how many people are anxious!Doctor tells you what is myocardial ischemia!2022-01-28 00:07:01 41 ℃
Author: Dr. Wang cardiovascular
We in the clinic, often encounter some false "myocardial ischemia" of the people. They are often told that there is "myocardial ischemia" coronary heart disease, and even some people have many years of "myocardial ischemia", many years of coronary heart disease. Long-term medication, and experiencing long-term mental stress, their own children someday sudden myocardial infarction. In these so-called patients' myocardial ischemia "coronary heart disease, there are a lot of people are false" myocardial ischemia ", these people, often young women, female menopause, and some old lady said she myocardial ischemia all 50 years; there is mostly false "myocardial ischemia."
Today, cardiovascular Dr. Wang will share with you, which can not be determined, false "myocardial ischemia", if it is false, "myocardial ischemia", must go to a hospital specializing in cardiovascular reassess. Do not take medicine, fear of chaos.
First, the simple judgment of myocardial ischemia by ECG
We met most of the false "myocardial ischemia" in clinical practice, it is simply to determine myocardial ischemia in coronary heart disease by ECG. Including some young men, young women, often say that they have coronary heart disease myocardial ischemia. I asked how they determine they have coronary heart disease myocardial ischemia. They will answer: I did an electrocardiogram, and written on the ECG myocardial ischemia. And later was told that myocardial ischemia in coronary heart disease. Still others done ECG, ECG reads: ST segment changes, T wave changes, T wave inversion, and so the text. Then will be informed of myocardial ischemia is coronary heart disease.
In fact, we have always stressed, not simply based on a change in the ST segment of the electrocardiogram, T wave changes, T wave inversion, it is determined that a person has coronary artery disease or myocardial ischemia. ECG can not appear: myocardial ischemia, the words! Those who do not bind to the specific circumstances of the patient, just looking at an electrocardiogram, to judge a person myocardial ischemia, are not rigorous, or even wrong. 1, some of the electrocardiogram, born the so-called ST-segment depression, or T wave cause, it can not be said to see a little of ST depression or T inversion, said myocardial ischemia is coronary heart disease. That is, these people, from the age of 20 to 40 years old, 60 years old, electrocardiogram are like this. ECG can not see this performance, he said do not ask other information myocardial ischemia of coronary heart disease. 2, writing electrocardiogram report, generally only objective description, can not directly write the name of a disease; diagnosis of the disease is combined with the specific circumstances of the patient's physician, can give a diagnosis after comprehensive judgment, we can not say after reading the ECG, directly write "myocardial ischemia" before. 3, ECG can really help us determine whether a person has no myocardial ischemia, but it must be combined with the patient's symptoms and other information, and finally to judge them, and not simply look ECG.
More importantly, there is no judgment by the ECG myocardial ischemia, to dynamic observation, that under normal circumstances the patient ECG and ECG uncomfortable case is not the same, this is called dynamic change. So that we can assist the diagnosis of myocardial ischemia in coronary heart disease.
Second, by simply uncomfortable determine myocardial ischemia
There are some people, even the electrocardiogram have not done, but there are some uncomfortable performance, he was told that myocardial ischemia. For example, the most common chest pain, chest pain is just a manifestation, hidden behind a variety of diseases, such as angina, aortic dissection, pulmonary embolism, pneumothorax, esophageal disease, lung disease, cancer, costochondritis, chest diseases, herpes zoster , autonomic dysfunction and other diseases. I can not say chest pain is cardiac ischemia. Another example was chest distress were told myocardial ischemia, chest distress there are many possibilities, for example, there may be myocardial ischemia, there may be heart failure, there may be lung disease, there may be pleural disease, there may be anemia and so on. So, can not simply be judged according to the symptoms of myocardial ischemia is not.
Third, cardiologists how to accurately determine myocardial ischemia
1, myocardial ischemia predilection age
Although the age of onset of coronary heart disease in younger, relatively speaking, but still more the proportion of elderly people suffering from coronary heart disease. If we are able to live to the age is large enough, it may be that everyone has coronary heart disease, coronary heart disease because itself is a manifestation of arterial aging, with increasing age, our arteries will harden, and even atherosclerosis hardening, eventually leading to coronary heart disease. So older, relatively speaking, the greater the likelihood of coronary heart disease myocardial ischemia.
2, gender characteristics of myocardial ischemia
Premenopausal women, the risk of myocardial ischemia in coronary heart disease is very low, so the young women to be diagnosed with coronary heart disease myocardial ischemia must be careful. What 20-year-old girl myocardial ischemia, what 66-year-old woman 40 years myocardial ischemia, and so are almost all false myocardial ischemia. The risk of myocardial ischemia young men are 6 times more than young women; but women go through menopause, lose the protection of estrogen, the risk of cardiovascular disease will increase, almost flat with men. So women go through menopause, the risk of myocardial ischemia of coronary heart disease will be significantly increased.
3, who are more prone to myocardial ischemia
Cardiovascular family history, there are three high blood pressure, diabetes, hyperlipidemia and others, the more long-term obesity, smoking, drinking, feasting, do not exercise, stay up late, stress, unhealthy diet, among other factors people more prone to coronary heart disease.
This is our judgment that a person has no one factor for coronary heart disease.
4 However, it must be an experienced doctor to judge according to your symptom, rather than a confusion of a chest pain is a coronary heart disease. If you judge myocardial ischemia through symptoms, it is more scientific, that is, our clinical use is an inspection method, exercise test. Simply put, but if we act, exercise, labor, etc. If there is a similar situation such as chest pain, chest tightness and suffocation, then last a few minutes, after rest, it can be relieved, at this time, it can be initially judged to be myocardial, but also It is to be judged by a coronary angiography or a myocardin, etc.
5, what to check, can judge myocardial ischemia
Symptom is just the feeling of the patient, even if there is an experienced doctor, it cannot be 100% confirmed, and can only be said to be highly suspected. It is necessary to further confirm that there is no myocardial ischemia: coronary CTA or coronary angiography, it can be seen that the cardiovascular is narrow, and how much is narrow, it can confirm coronary heart disease. However, it is not possible to accurately determine whether there is no myocardial ischemia. The exercise test, that is, in the treadmill running with an electrocardiogram, at this time, the changes of the electrocardiogram and the symptoms of the patient's angina, it can be judged that there is no myocardial ischemia. Another test does not need to move, that is, myocardrin, this inspection can help us to judge that there is no myocardial ischemia.
In short, anyone who has only been in this later, I was told that myocardial ischemia, or only a bit of symptoms were told that myocardial ischemia, it is best to find a professional cardiovascular doctor reassessment. Because once confirmed the coronary heart disease, it is a lifetime. Once the hat is not good, it is not only a long-term and even life to take medicine, and even long-term pressure, even long-term anxiety!
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