The patient is a 63-year-old retired male cadre. Chief complaint: repeated severe chest pain for 6 years, sudden onset of unconsciousness for 2 hours.
Past history: The patient suffered from severe chest pain repeatedly in the past 6 years, accompanied by chest tightness, sweating and heartbeat, as well as pain in the left shoulder and upper limbs. Each attack lasts for 2-3 minutes, and it is relieved after taking acid glycerin under the tongue, and it occurs frequently when you are nervous or tired at work. In the afternoon, the patient came home from work and felt a little dizzy and unwell. Two hours ago, he suddenly developed severe tension in the precordial area, and then he was unconscious and was admitted to the hospital urgently.
Past medical history: I have a history of hypertension for more than ten years, and my blood pressure fluctuates between 2 1.3/ 13.3~22. 6/ 14。
7 kPa (160/100-200/10mmhg), accompanied by dizziness and headache. Eat "hypotensive tablets" occasionally.
Personal medical history: addicted to alcohol and tobacco, smoking 65,438+0/2-65,438+0 packs a day, drinking a little, liking greasy food, having a blood pressure of 0, unconscious, unresponsive, dilated pupils, symmetrical on both sides, and no heart sound or breathing sound. Clinical diagnosis: Acute myocardial infarction cannot rule out intracranial hemorrhage.
After various rescue treatments, his heartbeat and breathing did not recover and he died.
2. What should I write about coronary heart disease? 1. Life is regular: go to bed early and get up early, avoid staying up late to work, and watch scary novels and TV before going to bed.
2. Physical and mental happiness: mental stress and emotional fluctuation can induce angina pectoris. You should avoid anger, panic, overthinking and overjoy.
Cultivate good habits such as raising flowers and fish, nourish feelings and adjust emotions. 3. Diet adjustment: Overeating greasy, fat and sugar will promote the deposition of cholesterol on the arterial wall and accelerate arteriosclerosis, so it is not appropriate to overeat.
Diet should be light, eat more digestible food, have plenty of vegetables and fruits, eat less and eat more meals, and eat less at dinner. Obese patients should control their food intake to reduce the burden on their hearts. 4. Quit smoking and drink less: Smoking is an important factor causing myocardial infarction and stroke, and you should definitely quit smoking.
Drinking a small amount of low-alcohol wine such as beer, yellow wine and wine can promote blood circulation and reconcile qi and blood. Hard liquor is forbidden.
Do not drink strong tea or coffee. 5. Combination of work and rest: You should avoid excessive physical labor or sudden exertion, and don't be overworked.
Walk slowly, climb the stairs and ride a bike, otherwise it will cause the heart rate to increase, blood pressure to rise, and induce angina pectoris. It is not advisable to exercise after a full meal.
Cold will make blood vessels contract, reduce blood supply to myocardium and cause pain, so pay attention to keep warm. Sexual life is highly stimulating, blood circulation is accelerated, the whole body needs more blood, and coronary artery blood supply is relatively insufficient, which is prone to angina pectoris or myocardial infarction, so strict control is appropriate.
After the complete recovery of myocardial infarction, sexual intercourse should be controlled at 1~2 times a month. 6. Proper rest: It is best to lie down and rest for a while when angina pectoris attacks.
You can work normally, but don't overwork. After the diagnosis of myocardial infarction is clear, you should lie flat in bed.
Within two weeks, all the patients' life activities are completed with the help of others, and it is absolutely forbidden to turn over, because turning over will increase the burden on the heart and lead to rupture of the myocardial infarction or cardiac arrest. It is advisable to urinate in bed to keep urine unobstructed.
If there are no serious complications, usually stay in bed for 2~3 weeks and stay in bed for 3~4 times a day. If there is no change after a week, you can get out of bed and sit in a chair for about half an hour, three or four times a day. In another week, you can take a walk in the bedroom.
Long-term bed rest is not good for heart recovery and requires proper exercise. You can do light manual labor in three months.
7. Physical exercise: Exercise should be chosen according to your physical condition and hobbies, such as playing Tai Ji Chuan, table tennis, aerobics, practicing the Eighteen Methods, etc. Do what you can, make the whole body circulate blood and reduce the burden on the heart.
8. Active treatment: adhere to the necessary drug treatment and control diseases that can aggravate coronary heart disease, such as hypertension, diabetes and hyperlipidemia. 9. First aid for sudden death: In case of sudden death, you should race against time for first aid and immediately perform cardiopulmonary resuscitation.
Lie the patient on his back on a wooden board or the ground, knock the patient's left chest two or three times with his fist, hold the patient's nostril, and blow 1 time from mouth to mouth for 1 second, then press the heel of one hand (the other hand is overlapped on the hand) at the junction of 1/3 and 2/3 under the sternum, straighten your elbows and press down vertically. Artificial respiration 1 time, cardiac compression 5 times, and so on.
General artificial respiration every minute 16~ 18 times, heart compression 80~90 times. Need medical staff to the scene to rescue. Nutritional reasons 1, fat has an unshirkable responsibility: epidemiological survey results show that the total intake of dietary fat is directly proportional to the incidence and mortality of atherosclerosis.
In areas where fat intake accounts for more than 40% of total thermal energy, the incidence of atherosclerosis among residents has increased significantly. The total amount of dietary fat is the main factor affecting the concentration of cholesterol in blood, so excessive fat intake is an important factor leading to coronary heart disease.
2. Cholesterol is a risk factor for coronary heart disease: the serum cholesterol concentration of patients with coronary heart disease is significantly higher than that of normal people. Clinical studies have found that the concentration of serum cholesterol in residents with high incidence of coronary heart disease is much higher than that in people with low incidence, and the intake of cholesterol in diet is directly proportional to the incidence of atherosclerosis.
Therefore, the higher the intake of cholesterol, the higher the amount absorbed by the human body and the higher the probability of inducing coronary heart disease. Diet conditioning 1, supplying proper amount of heat energy: with the increase of age after middle age, physical activities and other activities are relatively reduced, and the basal metabolic rate is also reduced.
Therefore, the heat energy required every day is correspondingly reduced. If you are overweight, you should reduce the supply of heat energy to lose weight, and maintaining the ideal weight is the goal of dietary nutrition to prevent coronary heart disease.
Many patients with coronary heart disease often suffer from overweight or obesity, so we should limit the intake of heat energy in food or increase energy consumption to keep the weight within the ideal range. 2. Control the fat intake: Under normal circumstances, the daily fat intake should account for less than 30% of the total calories.
Appropriately increasing the supply of unsaturated fatty acids and reducing the intake of saturated fatty acids, the cholesterol in food should be controlled below 300 mg per day, which can reduce the serum cholesterol level to some extent and prevent blood coagulation. 3. Limit cholesterol intake: High cholesterol is a powerful inducing factor for coronary heart disease.
If the content of dietary cholesterol is not restricted, it will not only aggravate symptoms, but also induce other diseases. As a preventive diet, it should not exceed 300 mg per day, and the therapeutic diet should not exceed 200 mg per day. Foods with high cholesterol are forbidden.
The cholesterol content of river fish or marine fish is low, such as herring, grass carp, carp, soft-shelled turtle, yellow croaker, pomfret and hairtail. 4, the supply of appropriate carbohydrates: especially obese or hyperlipidemia patients need more attention.
Polysaccharides, such as dietary fiber, sitosterol and pectin, should be selected to reduce cholesterol. Obese people should limit staple food and eat more foods with high dietary fiber such as coarse grains, vegetables and fruits, which is conducive to the prevention and treatment of hyperlipidemia and coronary heart disease.
5, supplement minerals and vitamins: eat more fresh green leafy vegetables, especially dark vegetables, these foods are rich in carotene and vitamin C, fruits are rich in vitamin C, containing a lot of pectin.
Hawthorn is rich in vitamin C and carrots, which has obvious coronary artery dilating and sedative effects. Kelp, laver, Nostoc flagelliforme and auricularia auricula are rich in methionine, potassium, calcium and iodine, which are beneficial to the treatment of coronary heart disease.
In addition, vegetables contain a lot of cellulose, which can reduce the absorption of cholesterol. Food choice of people with coronary heart disease ● Hawthorn: Hawthorn has the functions of lowering serum cholesterol and blood pressure, and also has the function of promoting.