What are the symptoms of myocardial ischemia?

Myocardial ischemia is a relatively common physical disease. Generally, it is caused by abnormal energy of the heart or a pathological state of the heart, which can easily lead to myocardial ischemia. Myocardial ischemia is prone to symptoms of pain in the heart area. It can also easily lead to symptoms such as panic, shortness of breath, or heart palpitations. You need to get more rest and pay attention to your body.

Symptoms of myocardial ischemia

1. When you are tired or mentally stressed, you may experience dull pain behind the sternum or in front of the heart, or a tightening pain that radiates to the left shoulder and left upper arm, lasting for 3 to 5 minutes. It may be relieved on its own after rest and is accompanied by profuse sweating.

2. Chest tightness, palpitations, and shortness of breath occur during physical activity, which are relieved by rest.

3. Exercise-related sore throat, burning sensation, tightness, toothache, etc.

4. Chest pain and tightness after a full meal, cold weather, or drinking.

5. When the pillow is low when sleeping at night, you will feel chest tightness and shortness of breath, and you need to lie in a high pillow to feel comfortable; when you are sleeping soundly or lying flat during the day, you will suddenly have chest pain, palpitations, and difficulty breathing, and you need to sit up or stand up immediately to relieve the pain.

6. Feeling of panic, chest tightness, shortness of breath or chest pain during sexual intercourse or straining to defecate.

7. Sudden bradycardia, low blood pressure or syncope.

8. Unexplained fatigue and lack of energy.

9. Patients without typical symptoms only feel stomach discomfort, nausea, or toothache, cervical pain, etc.

examine

1. Examinations related to coronary heart disease

In order to detect myocardial ischemia as early as possible, people over 40 years old should undergo regular physical examinations to understand whether they have risk factors related to coronary heart disease, such as blood lipids, blood pressure, blood sugar, neck vascular ultrasound, cardiac ultrasound, electrocardiogram and other examinations.

Electrocardiogram is the most commonly used non-invasive examination. When a part of the myocardium is ischemic, it will affect the normal ventricular repolarization and may cause abnormal ST-T changes in the leads related to the ischemic area. The type of ECG changes in myocardial ischemia depends on the severity, duration, and site of ischemia. In typical myocardial ischemia, the leads facing the ischemic area often show ischemic ST segment depression and/or T wave inversion.

2. Load test inspection

It is an important method to screen high-risk patients for further coronary angiography, coronary intervention, coronary artery bypass surgery, evaluate the efficacy of drugs and surgery, and predict patient prognosis. Such as treadmill electrocardiogram, adenosine stress echocardiogram and multi-slice coronary CT. For patients with painless myocardial ischemia, ischemia provocation test is a very important auxiliary means.

3. Coronary angiography

It can directly observe the blockage of the main coronary artery and its small branches, and is the most valuable detection method for showing coronary atherosclerotic lesions.

treat

1. Treatment principles

Since myocardial ischemia carries the risk of myocardial infarction and sudden death, it should be treated as soon as possible when it is discovered. Actively prevent the occurrence of atherosclerosis. If it has occurred, it should be treated actively to prevent the progression of the lesion and strive to reverse it. Those who have developed complications should receive timely treatment to prevent deterioration and prolong the patient's life.

2. Drug treatment

Since the main mechanism of myocardial ischemia is the imbalance between myocardial blood (blood oxygen) supply and demand, the treatment of myocardial ischemia is nothing more than increasing myocardial oxygen supply and/or reducing myocardial oxygen consumption, so that the myocardial oxygen supply and demand can be restored to a balanced state.

(1) Antiplatelet drugs prevent and treat thrombosis, prevent coronary artery and cerebral artery thromboembolism, and reduce the risk of myocardial infarction, stroke, and cardiovascular death in patients with stable angina pectoris. If there are no contraindications, they should be taken long-term. Commonly used drugs include aspirin, clopidogrel, etc.

(2) β-blockers, such as metoprolol or its sustained-release tablets, can slow down the heart rate, reduce myocardial oxygen deprivation, and prevent sudden death. Beta-blockers are the first choice for stable angina pectoris. They can be used in combination with nitrates to complement each other. Generally, the dose should be started at a small dose and adjusted according to the treatment response and heart rate changes.

(3) Calcium ion blockers can inhibit myocardial contraction, reduce myocardial oxygen consumption, dilate coronary arteries, relieve coronary artery spasm, and improve myocardial blood supply. Commonly used drugs include verapamil, nifedipine, etc.