Text/Wang Qian
Grandpa Zhuang is 70 years old and still maintains a good posture. What he is most proud of is that he has kept the habit of exercising for many years. Every morning he goes to Neihu Sports Park to exercise, but he doesn't know how to do it recently. In the middle of the exercise, he occasionally feels chest pain and tightness, just like being pinned down by a stone, which is very uncomfortable.
Yin Weixian, director of the Cardiovascular Department of Zhenxing Hospital, said that these are self-reports that patients can easily hear in clinic. When they are exercising or emotional, they will have symptoms of chest tightness or breathlessness, and even sleep until midnight at night and feel breathless. You must sit up or get out of bed to get some fresh air. If this happens, beware of cardiovascular disease may have quietly knocked on the door!
Cardiovascular disease is a general term for heart diseases and vascular diseases, not just the number one killer in developed countries. According to the statistics of China people 10 every year, the second, third and fifth places of 20 10 are heart disease, cerebrovascular disease and diabetes respectively. Coupled with the ninth hypertension and 10 kidney disease, the combined mortality rate of cardiovascular diseases has surpassed that of malignant tumors, which also shows that cardiovascular diseases should not be underestimated.
Younger cardiovascular and cerebrovascular diseases
The occurrence of cardiovascular diseases is closely related to age. Yin Weixian said that the older you get, the higher the probability of occurrence, especially when the weather gets cold, many elderly people have no time to adapt, and cardiovascular diseases are prone to attack. However, in recent years, cardiovascular diseases tend to be younger. Outpatients will find that some people in their early thirties are diagnosed with cardiovascular diseases. The reasons are as follows: first, the westernization of diet, everyone likes to eat high-fat and high-calorie food; Moreover, lifestyle changes, work depends on computers, the labor force decreases, and the amount of exercise on weekdays also decreases. Weeks and holidays are often full of video games and movies, which is even worse.
Yin Weixian said that the National Institutes of Health once conducted an analysis, showing that after the age of 45, both men and women need to be alert to cardiovascular diseases, because women have female hormones to protect the cardiovascular system, so it is easy to cause cardiovascular diseases after menopause. However, if men have a family history of cardiovascular diseases before the age of 55 and women before the age of 65, special attention should be paid to the prevention of early cardiovascular diseases. Therefore, the medical community at home and abroad has been proposing the importance of screening cardiovascular diseases for many years.
Establish the body's first line of defense
Screening diseases through various examinations is definitely the first line of defense to establish health protection. Yin Weixian emphasized that from the perspective of preventive medicine, the doctor's main job is to see if this person can get sick, and the examination is to scientifically help people evaluate the possibility of getting sick or whether there are signs of cardiovascular disease through instrument testing. It is the first-level prevention to do preventive screening when you are not sick and develop healthy living habits. According to statistics, during the period from1980 to 2000, more than 40% of the mortality rate of cardiovascular diseases in the United States was due to the successful implementation of primary prevention.
Generally speaking, stroke is related to blood pressure, while angina pectoris and myocardial infarction are closely related to cholesterol. But before the onset, even if blood pressure or cholesterol exceeds the standard, people may not have obvious feelings in their lives, so they often ignore preventive measures. Often wait until cardiovascular obstruction leads to organ function loss, such as myocardial infarction, stroke, peripheral artery occlusion, etc., and then regret it! At this time, if we actively make up for it, even if it is secondary prevention, it will still have a considerable effect if it succeeds, which can greatly reduce the recurrence of the disease.
Because arteriosclerosis, which represents the initial symptoms of cardiovascular diseases, began as early as the twenties and thirties, fortunately, with the progress of medical examination technology, many diseases can be detected and prevented with precision instruments first. The following methods can help people to screen cardiovascular diseases at an early stage:
Find the three high test
Echocardiography
Echocardiography is mainly used to check the structure and overall function of the heart and great vessels, but it can't directly see whether the coronary artery vessels that deliver blood to the myocardium are blocked. This examination can help doctors understand the subjects' myocardial function, including contraction and relaxation, blood flow direction and speed, and can also detect the activity of heart valves and whether there are defects.
Because it is non-radioactive, painless and non-invasive, it is a rapid and accurate examination, which can be carried out in outpatient department, and the cost is about 3000~4000 yuan. After the inspection, normal activities can be resumed without any restrictions.
Inspection process: You must unbutton your coat and lie flat on the inspection table. Therefore, it is recommended to wear light and comfortable clothes when accepting cardiac ultrasound examination, so as to untie or take off the coat during the examination. During the examination, there will be electrode pads on the chest, wrists and ankles, because there will be ECG records during the echocardiography examination. During the examination, the technician will move the ultrasonic probe on the chest, and usually ask the subject to adjust his posture or maintain a certain breathing mode and speed. The whole process takes about 20 minutes (depending on the complexity of the patient's condition).
◎ Static electrocardiogram
When the heart is beating, there will be current inside and outside the myocardial cells due to the change of potential. It is the electrocardiogram that records the change of this current as a picture, so as to know whether the heart is working normally. From the change of ECG, we can first know whether the heart beats regularly, that is, whether there is arrhythmia. When the shape or blood flow state of the heart changes for various reasons, the ECG will also change. Therefore, from the changes of different ECG images, doctors can know which part of the conduction system or heart may have a problem.
Examination process: supine, with the upper body, connect the electrodes to the chest, hands and feet. During the examination, you must lie flat, hold your breath, and stay still for about 10 seconds to prevent interference or ECG recording leads from falling off, which will affect the ECG results. The whole inspection time is about 10 minute, and the cost is around 300 yuan. However, doctors also specially reminded that some sudden or active heart disease symptoms, such as angina pectoris caused by insufficient coronary blood flow, are limited by the time and place of ECG examination, and it is difficult to explain them by ECG measured under static conditions.
◎ Exercise electrocardiogram
Because static electrocardiogram has its limitations, a certain proportion of patients with cardiovascular diseases have normal electrocardiogram at rest and abnormal electrocardiogram after exercise. Therefore, when necessary, people will be required to do ECG examination while doing exercise. This test is called "exercise electrocardiogram". The principle of examination is to increase the burden on the heart and the demand for oxygen through exercise. In this case, we can evaluate whether the heart has myocardial hypoxia, and then understand whether the coronary artery is blocked.
Inspection process: exercise electrocardiogram has no radiation and the inspection time is short. During the examination, an ECG patch will be attached to the chest and a lead will be connected. At the same time, a pulse pressure belt will be tied to the arm to measure blood pressure. The test machine is like an electric treadmill seen in a general gym. According to the standard procedure, the amount of exercise is gradually increased, from the first stage to the maximum amount of exercise according to the patient's acceptability. At the same time, the changes of ECG, heartbeat and blood pressure are monitored, and the examinee can complete the examination smoothly only by cooperating with the guiding action. It takes about 1 hour, and the cost is about 2000 yuan. After the blood pressure and heartbeat are relieved, the subjects can go home to work and rest normally as long as they have no discomfort symptoms.
24-hour electrocardiogram
Because the symptoms of cardiovascular disease may not appear at any time, in order to grasp the ECG changes in the heart at any time, the instrument is installed on the body 24 hours a day. This kind of examination is called "24-hour electrocardiogram examination" and "portable electrocardiogram examination".
Examination process: The main method is to accurately and continuously record the electrocardiogram produced by each heartbeat of the patient for 24 hours through a computer recorder, and show the heart of the examinee and how to adapt to various activities and situations in daily life. Normal activities during the installation, except that the instrument can't be taken down and you can't take a shower that day. The doctor said that the 24-hour electrocardiogram examination is a further examination, and the cost is about 4000 yuan. I didn't do my usual health check.
Remote electrocardiogram
In addition, for patients who are too busy to see a doctor or inconvenient to see a doctor, or whose heart symptoms appear at too long a frequency interval, in order to grasp the unpredictable and temporary heart condition, there is another examination method, namely "remote electrocardiogram". Yin Weixian said that even if the patient has no symptoms, about 30% may have abnormal ECG at some time. Remote electrocardiogram can be more accurate. At the first moment when the patient is uncomfortable, it can capture ECG data and make a diagnosis in time. At present, several hospitals in Taiwan Province Province provide remote electrocardiogram examination, but the service hours and contents of each medical institution are different. According to the long-term monthly rent of the instrument, the cost is about 4000 to 7000 yuan per month.
Examination process: Yin Weixian further explained that remote ECG measurement is through a heart monitor. As long as the patient feels uncomfortable symptoms such as palpitation, chest tightness and chest pain at any time, he can record his ECG for about 30 seconds, and then transmit the ECG to the professional cardiologist in the hospital by phone or mobile phone, so that he can get the diagnosis and advice from the professional doctor.
Evaluate the three high risks through inspection.
Usually, adults should have at least one simple cardiovascular health examination, including basic examinations such as blood drawing and electrocardiogram, and then follow up according to the results of basic examinations. Good health, recommended every 234064.