The most popular word at present is "depression". When people think that the expression of the word "depressed" is not enough, the word "chest tightness" has become a popular keyword following the fashion trend. Failure, embarrassment, frustration and helplessness are all described as "chest tightness". In fact, patients with real chest tightness will never be so relaxed when talking about this word. The feeling of breathlessness and severe hypoxia will make people feel close to death. The appearance of chest tightness indicates the existence of some organic or functional diseases, which should not be underestimated.
Coronary artery ischemia leads to chest tightness.
Key words: winter, myocardial ischemia, myocardial infarction.
Susceptible population: middle-aged and elderly people, who have a tendency to be younger recently.
Xu Hang (pseudonym) is 50 years old and works in an enterprise staff hospital in Xi. He usually thinks he is as healthy as an ox. However, a few days ago, one day near evening, he felt a little chest tightness and shortness of breath. Because he doesn't have a heart attack at ordinary times, neither his family nor himself cares. They drank some water and went to bed. Unexpectedly, the severe chest pain in the middle of the night made him miserable, and the ambulance sent to the hospital failed to save his life. The final conclusion is acute myocardial infarction.
Professor Zhang told reporters that chest tightness is a symptom, and many diseases can occur, but internal medicine is the main disease, and cardiovascular disease is the most common. In the cold winter, the incidence of sudden cardiac death is high, especially during the period from 65438+February to February of the following year, especially in the continuous low temperature, rainy and windy weather, the incidence of acute myocardial infarction increases obviously, and people aged 40 to 50 should pay more attention to it.
In winter, due to the stimulation of cold to the body, the excitability of the sympathetic nervous system of the body increases, and the secretion of phenolamine in the body increases. The latter can make the blood vessels of human limbs contract, accelerate the heart rate, increase the workload of the heart and increase the oxygen consumption. At this time, myocardial ischemia and hypoxia will cause angina pectoris. Sympathetic nerve excitation and amino acids themselves can also lead to coronary artery spasm and blood concentration, which makes platelets easy to coagulate and form thrombus, which is also an important cause of myocardial infarction. In addition, due to the contraction of blood vessels at low temperature, blood pressure tends to rise, which increases the burden on the heart and may lead to sudden death of myocardial infarction.
As we all know, acute myocardial infarction is often accompanied by severe chest pain. But what about the elderly? Acupoints generally refer to people over 65 years old? Snow is not entirely real. According to data analysis, nearly13 elderly patients with acute myocardial infarction did not have severe chest pain, but chest tightness was the most common symptom. It can be seen that for the elderly, the presence or absence of chest pain is not the main basis for distinguishing acute myocardial infarction.
Most patients with acute myocardial infarction have premonitions before onset. When you feel chest tightness, pain behind the sternum, and sometimes radiation to the left shoulder and back, you must consider whether you have angina pectoris and go to the hospital in time.
How to safely pass the high incidence of cardiovascular and cerebrovascular diseases in winter? First, when the weather is changeable, add and subtract clothes in time. The second is to take medicine on time. You should take some nitroglycerin with you within the validity period. In the case of sudden onset, this drug can effectively relax coronary arteries and relieve symptoms. The third is to strengthen self-care. Keep an appropriate amount of activities, and don't be lazy to go out because of the cold weather, which will reduce the cold resistance. In addition, patients with coronary heart disease should be treated comprehensively, and Chinese medicine and western medicine can't rule it out. What is beneficial to the condition is the best choice.
Myocardial involvement with chest tightness.
Key words: myocardial damage caused by virus infection.
Vulnerable groups: children and young people.
12-year-old Xiaojun's parents are both soldiers and are usually looked after by grandparents. Half a month ago, Xiaojun suddenly had a fever and a sore throat. He rested for a few days and took some cold medicine. Who knows, in recent days, Xiaojun always feels chest tightness and shortness of breath, and breathes every few minutes. The old man thought that the child didn't want to go to school and deliberately made trouble, so he didn't care. I don't want to. Xiaojun's symptoms are getting worse and worse. He has chest tightness, palpitation and dizziness, and he can't insist on going to school, which has attracted the attention of the elderly. After hospital examination, Xiaojun suffered from viral myocarditis, and his chest tightness was caused by myocarditis.
Director Hao Wei said that myocarditis is mostly caused by cold virus, which usually occurs in children and young adults. At the initial stage of the disease, cold symptoms are often taken as the guide, such as aversion to cold, fever, body aches, sore throat, cough or vomiting. Patients should pay special attention to chest tightness, palpitation, shortness of breath and precordial discomfort in about 2 weeks. Because the onset of viral myocarditis is hidden, it is easy for people to mistakenly think that the cold is not completely cured and mistreated. When myocardial involvement is obvious, children often complain of precordial discomfort, chest tightness, palpitation, dizziness and fatigue. In severe cases, cardiogenic shock may suddenly appear, which is characterized by irritability, pallor, cold limbs and terminal cyanosis, and accidents may occur in a short time.
Treatment? Take 1 and rest for at least 3 ~ 4 weeks in acute phase; 2. hormones; 3, a large dose of vitamin C and energy mixture; 4. Chinese medicine can play an unexpected role in the comprehensive treatment and overall conditioning of this disease; 5. Eat more fruits containing vitamin C (such as oranges and tomatoes) and foods rich in amino acids (such as lean meat, eggs, fish and soybeans); 6. Pay attention to climate change to prevent colds, colds or upper respiratory tract infections; 7, medication should be in accordance with the doctor's advice, especially in patients with arrhythmia, do not arbitrarily increase or decrease the dose; 8. Avoid strenuous activities, pay attention to the laws of life and maintain a good mental state.
Chest tightness in neck and heart is easy to be misdiagnosed.
Key words: cervical spondylosis, chest tightness and chest pain.
Vulnerable people: middle-aged and elderly people.
Sun, a 50-year-old accountant in a government agency, has suffered from chest tightness and precordial pain repeatedly in the past eight years and was diagnosed with coronary heart disease in several hospitals. Long-term use of quick-acting jiuxin pills and nitroglycerin has no effect, and chest tightness and chest pain often occur. When the doctor asked about the medical history, she found that her "angina pectoris" mostly occurred after sitting at the desk for too long, getting up with a high pillow, or suddenly turning or shaking her head. Physical examination found that the cervical spine was slightly restricted, X-ray and CT showed that the physiological curvature of the cervical spine disappeared, and the cervical spine was slightly hyperosteogeny, which was diagnosed as cervicocardiac syndrome caused by cervical spondylosis. After three courses of TCM comprehensive treatment, all the symptoms were eliminated.
Professor Zhang analyzed that patients with cervicocardiac syndrome are older and prone to hyperlipidemia and arteriosclerosis. Some doctors ignore occupation, medical history collection and detailed and comprehensive physical examination, and rely too much on auxiliary examinations such as instruments, especially when imaging examination may not be consistent with clinical symptoms, which is more likely to lead to misdiagnosis or missed diagnosis.
Cervical spondylosis reflexively causes coronary artery spasm and contraction, leads to myocardial ischemia and induces arrhythmia, which is collectively called "cervicocardiac syndrome". In addition to precordial pain, chest tightness, discomfort, palpitation and shortness of breath may also occur. There are ischemic ST segment and T wave changes, ventricular premature beats or atrial premature beats on ECG. But there is a difference between angina pectoris with cervicocardiac syndrome and angina pectoris with coronary heart disease. It has nothing to do with the increase of labor load and emotional excitement, and taking nitroglycerin drugs and calcium antagonists can not alleviate it. However, the increase of cervical spine load is often the inducing factor of this kind of angina pectoris, such as high pillow position, long-term excessive head-up and head-down posture, cold back, sprain and fatigue.
The root of "cervicocardiac syndrome" is cervical spondylosis, so it is mainly used to treat cervical spondylosis. In daily life, it is necessary to correct the high pillow position, avoid excessive head-up and head-down, and pay attention to keeping the neck warm; Local physical therapy and hot compress; Proper neck gymnastics can relieve or alleviate various symptoms of "cervical heart syndrome".
Anxiety, chest tightness and shortness of breath
Keywords: nervousness, anxiety, chest tightness and palpitation.
Popular population: young adults, with more women than men.
Zhan Jiang is a 40-year-old political cadre of an enterprise in Xi 'an. I flew to Beijing for a meeting last July. Suddenly I felt nervous, chest tightness, flustered and trembling on the plane. After I arrived in Beijing, my condition eased. I went to Beijing by train again two months ago and had another attack on the way. At that time, I thought it was a "heart attack". I asked to get off the bus halfway and was admitted to the hospital. Since then, chest tightness, palpitation, nervousness, anxiety, irritability and trembling have always existed, and they have attacks almost every day. Doctors plan to diagnose "recessive coronary heart disease". Taking Danshen tablets, adenosine triphosphate, oryzanol and brain Le Jing is ineffective. Later, I went to the mental health center for consultation, and the doctor gave the patient ECG, EEG, EEG topographic map, blood lipid and other tests, and found no abnormalities. However, the total score of his Hamilton Anxiety Scale was 2 1, and the doctor made a diagnosis of "anxiety neurosis".
Director Jia Rui of Xi 'an Mental Health Center said that the incidence of anxiety disorder in the general population is 5%, which usually has three aspects: 1, inner experience: fidgeting, fidgeting; 2, autonomic nervous system changes: chest tightness, rapid heartbeat, palpitation, weakened gastrointestinal peristalsis, loss of appetite, etc. ; 3. The motor system is characterized by weakness, weakness of hands and feet, slight tremor, trembling, blinking, grinding teeth, facial muscle tension, fidgeting and other unnecessary actions.
After the symptoms of anxiety disorder appear, patients should not blindly use drugs, and should consult relevant medical institutions to find out whether they have anxiety disorder. The focus of psychotherapy is 1, the reason of relieving mental stress (that is, changing cognition). Give them appropriate support, let them relieve their worries and give up unreasonable demands. 2. A correct understanding of the disease. With the help of a doctor, you should have a correct and clear understanding of your symptoms and physical condition.
Director Jia Rui said that there is another kind of person who has no organic heart disease, but often feels oppressed in the chest, flustered and short of breath, nervous and afraid, and has a feeling of dying frequently, as if he must be rescued immediately. This is actually a "cardiac neurosis" patient. One of the characteristics of this kind of patients is that they love to think, think too much, and get to the bottom of everything, that is, the advantages of being good at thinking are a bit overdone.
Mental health experts point out that people's psychology and physiology are inseparable. For example, when you are stimulated by external stimuli or psychological factors, your physiological reaction will be very strong, and you may have chest tightness, palpitation and cold sweat, which are normal physiological defense functions of people. But if this phenomenon lasts for too long and there is no specific reason, then you may suffer from cardiac neurosis. Even so, don't panic, as long as through systematic treatment, cardiac neurosis can be completely cured.
Sorrow and chest tightness.
Key words: biliary tract diseases, palpitation, chest tightness.
Popular population: obese middle-aged women.
Zhao Yanhua (pseudonym) is 45 years old and works as a teacher in a middle school in Xi 'an. In recent months, I feel chest tightness, palpitation, rapid heartbeat and pain in my right upper abdomen. The doctor diagnosed me as angina pectoris. After a period of treatment, the symptoms did not improve. A few days ago, after her severe pain in the upper abdomen, her symptoms such as discomfort in the precordial area disappeared after her gallbladder was removed due to acute cholecystitis.
Director Zhao Kun thinks that the root of Miss Zhao's illness is not the heart but the gallbladder, and she suffers from gallbladder-heart syndrome. Cholecardiopathy syndrome is a disease that is easily confused with heart disease. Clinically, medical experts have long noticed that patients with biliary tract diseases can have symptoms, signs and ECG changes similar to coronary heart disease, especially middle-aged and elderly female patients, especially obese patients. The pathogenesis of gallbladder-heart syndrome may involve the following two points: ① Both gallstones and coronary heart disease are related to the disorder of lipid metabolism, so there may be some relationship between the etiology and pathogenesis. ② Biliary tract system and heart share the same pathway in innervation, which may be caused by nerve reflex.
The main manifestations of patients with gallbladder-heart syndrome are chest tightness, angina pectoris, arrhythmia, cardiac insufficiency and ECG changes. Some patients have pain in the right upper abdomen, and the effect is not good after treatment with cardiovascular drugs. The treatment of biliary-cardiac syndrome is mainly to treat biliary diseases, control biliary inflammation and remove biliary stones.
Nouns explain chest tightness
Chest tightness is a subjective feeling, that is, difficulty or insufficient breathing. In severe cases, I feel as if my chest was crushed by a stone, and even I have difficulty breathing. It may be the functional manifestation of body organs, or it may be one of the earliest symptoms of human diseases.
First, functional chest tightness: staying in a poorly ventilated room for a long time, or encountering some unpleasant things, or even quarreling with others, or in a low-pressure climate, often leads to chest tightness and fatigue. After a short rest, open the window for ventilation or breathe fresh air outdoors, relax and adjust your mood, and you will soon return to normal. Chest tightness like this may be functional.
Second, pathological chest tightness: caused by diseases of certain organs in the body, that is, pathological chest tightness. Such as: 1. Respiratory tract obstruction: tracheobronchial tumor, tracheal stenosis, tracheal external pressure (goiter, mediastinal tumor); 2. Lung diseases: emphysema, asthma, atelectasis, pulmonary infarction, pneumothorax; 3. Heart disease: some congenital heart diseases, rheumatic valvular heart disease, coronary heart disease; 4. Diaphragm diseases: diaphragm swelling, diaphragm paralysis; 5. Body fluid metabolism and acid-base imbalance.
Chest tightness in children often suggests congenital heart disease, myocarditis or mediastinal tumor; Chest tightness in young people often suggests spontaneous pneumothorax, mediastinal tumor and rheumatic valvular heart disease. Chest tightness in the elderly mostly suggests emphysema and coronary heart disease.