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Ask the heart question: what is the change of coronary atherosclerosis-three-vessel disease?
At present, the etiology and pathogenesis of coronary heart disease have not been fully clarified, but through a lot of research, some risk factors have been found, such as hyperlipidemia, hypertension, smoking, diabetes, lack of physical activity and obesity, which can be adjusted and controlled by changing living habits and drug treatment. To this end, the following measures can be taken to prevent coronary heart disease:

1. Reasonable adjustment of diet: It is generally believed that cholesterol and saturated fatty acids in the diet should be restricted, unsaturated fatty acids should be increased, and vitamins C, B and E should be supplemented. And limiting the intake of salt and carbohydrates can prevent atherosclerosis.

2. Strengthen physical activity: Epidemiological investigation shows that the incidence of coronary heart disease in people who engage in certain physical labor and insist on physical exercise is lower than that in people who are sedentary and lack physical activity. At the same time, physical exercise has a good effect on controlling risk factors (lowering blood lipid, lowering blood pressure and losing weight) and improving blood circulation in patients with coronary heart disease.

3. control smoking; Smoking plays a role in the pathogenesis of coronary heart disease. It has been reported that among people aged 35-54 who died of coronary heart disease, smokers are 4-5 times more than non-smokers, and people who smoke more are more dangerous, up to 4-5 times. After quitting smoking, the incidence of myocardial infarction and the mortality of coronary heart disease are obviously reduced. The longer you quit smoking, the greater the effect. This shows the harm of smoking and the importance of quitting smoking.

4. Treatment of related diseases: Early detection and active treatment of hyperlipidemia, hypertension, diabetes and other diseases related to coronary heart disease, as far as possible to eliminate and control these risk factors, is very important to prevent coronary heart disease.

Patients with angina pectoris should try their best to avoid and correct all factors that can induce or aggravate angina pectoris, strive to improve coronary circulation and neuropsychiatric function, and relieve and prevent angina pectoris. Therefore, the following measures should be taken to prevent angina pectoris:

① Because angina pectoris is a chronic disease that needs long-term attention, patients should correctly understand the nature of the disease so as to treat it correctly. We should eliminate unnecessary anxiety and fear and cultivate optimism.

(2) reasonable arrangement of work, to prevent mental stress, physical labor. Get enough sleep. Avoid bad mental stimulation. Those who have an initial attack or suddenly become frequent and aggravated should have a short rest and recuperation in a quiet environment. Light physical labor or walking can reduce angina pectoris for ordinary patients. Avoid excessive or sudden exertion in daily life, such as chasing buses or walking fast or for a long time in strong wind or heavy snow. In any case, when you have angina pectoris, you should stop your activities immediately and rest quietly.

③ Like common patients with atherosclerosis, foods rich in animal fat and cholesterol should be restricted in diet, and obese people should gradually lose weight. Avoid a full meal. Tea and a small amount of coffee can be drunk if they do not cause obvious excitement or insomnia. A small amount of alcohol-free wine is also harmless, which may help dilate blood vessels and calm down. Patients with angina pectoris should try not to smoke.

④ Hypertension, anemia, hyperthyroidism and other diseases can increase the burden on the heart and aggravate angina pectoris, and should be actively treated. All kinds of arrhythmia can induce or aggravate angina pectoris and should be corrected as much as possible. The fundamental preventive measure of myocardial infarction is to prevent atherosclerosis. For patients with angina pectoris or suspected coronary heart disease, the above prevention and treatment measures of atherosclerosis and angina pectoris can play a certain role in preventing myocardial infarction.

treat cordially

The treatment of recessive coronary heart disease lies in the prevention and treatment of atherosclerosis.

When angina pectoris attacks, you should immediately stop moving. You can take 0.3 ~ 0.6 mg nitroglycerin or 5 ~ 10 mg isosorbide nitrate sublingually for 2 minutes, or crush 0.2 ml isoamyl nitrite and inhale it for more than 0/0 second. The side effects of these drugs include dizziness, blushing and occasional blood pressure drop, which is taboo for glaucoma patients. If patients have frequent attacks, they can take long-acting nitrates orally, such as isosorbide dinitrate. Propranolol can also be used for postpartum angina pectoris. Angina pectoris induced by physical labor or emotional excitement is called stable angina pectoris if the nature, frequency and time of pain attacks are almost the same within 1 ~ 3 months. Unstable angina pectoris with symptoms and new onset is called unstable angina pectoris, which gets worse in a few days or weeks. Variant angina pectoris is a kind of unstable angina pectoris. Propranolol is safe and effective in the treatment of unstable angina pectoris. Clinical reports show that propranolol combined with isosorbide dinitrate is more effective than single drug. Propranolol has antihypertensive and antiarrhythmic effects, so it is more suitable for patients with coronary heart disease accompanied by hypertension or arrhythmia. Calcium orange antagonists, such as propranolol and propranolol, can dilate coronary arteries in patients with stable angina pectoris and variant angina pectoris. Some people think that the effect of propranolol plus nifedipine is better than that of a drug. Maidaoming is an anti-angina drug that dilates blood vessels, 2 mg per tablet. It takes effect 2-4 seconds after sublingual administration or chewing, and can prevent angina pectoris. It lasts for 6-7 hours after oral administration. Side effects are headache and head swelling, but they are rare. Strong sublingual or oral action, not exceeding 1 mg each time. It can be used for patients with angina pectoris because it has the functions of dilating coronary artery and anticoagulation. Generally, Danshen tablets can be taken orally or intramuscularly for 2ml, twice a day. If angina pectoris or acute myocardial infarction often occurs, it can be intravenously dripped once a day, and the dosage is 8- 10ml. Persephone has anticoagulant effect, and it is taken orally for 25-50mg, three times a day. If the above measures cannot relieve angina pectoris, surgical treatment such as coronary artery bypass grafting can be used.

When acute myocardial infarction, you must stay in bed 1 ~ 2 weeks. If the condition is stable, you can do physical exercise in bed for 3 to 4 weeks, or help the patient sit up in bed. After 4 weeks, you can get out of bed gradually and walk slowly indoors. Some people advocate that you can get out of bed in the first week, but for patients with serious illness or well bleeding, it is best to stay in bed for a long time. If you have pain, arrhythmia, cardiac insufficiency and shock, you must actively treat it. It can be administered intravenously, or a catheter can be inserted into a coronary artery and filled with streptokinase. Acute myocardial infarction is the most serious type of coronary heart disease, with great risk. If there are serious complications, the mortality rate is particularly high, which used to be 80%. With the improvement of treatment method, it has been reduced to about 10 ~ 15%.

Health guide:

1. Regular life: Go to bed early and get up early, avoid staying up late to work, and don't 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: When sudden death occurs, you should race against time for first aid, and immediately carry out chest massage and artificial respiration. 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.

Nutrient source

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 regulation

1. Provide proper heat energy: With the increase of age after middle age, physical activity and other activities decrease relatively, and the basal metabolic rate also decreases. 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 patients with coronary heart disease

● Hawthorn: Hawthorn has the effects of lowering serum cholesterol and blood pressure, and promoting tracheal ciliary movement, eliminating phlegm and relieving asthma.

● Algae: kelp, seaweed, jellyfish, cauliflower, etc. , rich in minerals and multivitamins, has the effect of lowering blood pressure.

● Carrots: Carrots are rich in carotene and various nutrients, which can increase coronary blood flow, reduce blood lipids, promote adrenaline secretion, lower blood pressure and strengthen the heart.

● Soybeans and peanuts: Soybeans and bean products contain saponin cellulose, which can lower cholesterol in the body. Peanut contains a variety of amino acids and unsaturated fatty acids, which can prevent coronary atherosclerosis if eaten regularly.

● Onion: Onion can dilate blood vessels and reduce the resistance of peripheral blood vessels and coronary arteries.

● Ginger: Ginger mainly contains ginger oil. The effective components in ginger oil can prevent the absorption of cholesterol and increase the excretion of cholesterol. In addition, gingerol and gingerol in ginger can promote blood circulation.

● Corn: Corn has the function of anti-arteriosclerosis. The content of linoleic acid in fat, lecithin and vitamin E is as high as 60% or more, which can lower serum cholesterol, prevent hypertension and arteriosclerosis, prevent the decline of brain cells, help vasodilation and maintain the normal function of the heart.

● Buckwheat: Buckwheat contains rutin, chlorophyll, picrorhizine, buckwheat alkaloids and flavonoids. Rutin can reduce blood lipid and blood pressure, and flavonoids can strengthen and regulate myocardial function, increase coronary blood flow and prevent arrhythmia.

● Celery: Celery mainly contains volatile oil and mannitol. It has the effects of lowering blood pressure, calming, invigorating stomach and diuresis.

● Leek: Leek is rich in cellulose, volatile essential oil and sulfur-containing compounds, which can promote intestinal peristalsis, reduce the absorption of cholesterol and lower blood lipids.

● Mushrooms and edible fungi: Mushrooms and edible fungi are rich in protein, low in fat and almost free of cholesterol, and have obvious effects of lowering blood fat and blood pressure. Auricularia auricula can prevent thrombosis, arteriosclerosis and coronary heart disease.

● Sweet potato: Sweet potato is rich in sugar, vitamin C and carotene, which can effectively maintain the elasticity of human arterial blood vessels, keep joint cavity lubricated and prevent kidney connective tissue from shrinking. Eating sweet potatoes regularly can prevent fat deposition and arteriosclerosis.

Suggestions on nutrition conditioning

It is recommended to take Amway Nutrilite vitamin C, selenium VE, lecithin E, VD calcium magnesium tablets, marine essence Omega-3 EPA DHA, protein powder, cholesterol-lowering health capsules, vascular circulation health capsules and other products.

Lecithin E: It has the functions of emulsifying and decomposing oil, reducing blood viscosity, reducing lipid peroxide deposition on blood vessel wall and promoting the dissipation of atherosclerotic plaque.

VD calcium magnesium tablets: help muscles contract and expand, and help regulate the heartbeat.

Protein powder: enhance the body's immunity.

Omega-3 EPA DHA: EPA and DHA contained in it can regulate blood lipid, remove thrombus, reduce the concentration of low-density lipoprotein in blood, increase the content of high-density lipoprotein and prevent thrombosis.

Selenium VE: It can resist free radicals in vivo, reduce the production of lipid peroxide, and participate in the growth and repair of intima of arterial wall.

Top vitamin C: Helps decompose triglycerides, convert cholesterol into cholic acid, and scavenge free radicals.

Cholesterol-lowering health capsule