Shenzhen News Network, December 15, 2023Xi The beating of the heart is a symbol of life.
Once upon a time, it was a no-go zone out of the reach of surgeons for a long time, and the last organ to be conquered by the Lancet. Nowadays, medicine has calmly solved most of the problems of the heart, but heart-related diseases are still the "number one killer" of human health.
Acute myocardial infarction (referred to as "myocardial infarction") is acute, complex and changeable, and has a high mortality rate, and is the "number one cardiovascular killer". At the onset of the disease, chest tightness is often accompanied by angina, and palpitation and shortness of breath may also occur. It is worth noting that acute myocardial infarction is not just a "disease of the elderly", and its incidence group has become younger and younger. "After a blood vessel blockage, the myocardium begins to die about 30 minutes and completely necrosis in about 6 to 8 hours, during which time the blocked blood vessel is opened sooner, the more myocardium survives. Chen Xiaolin, director of the Department of Cardiology of SUSTech Hospital, suggested that if chest tightness and chest pain occur, you must seek medical attention as soon as possible.
Cardiac interventional technology is a more advanced method of diagnosis and treatment of heart disease, and more and more cardiovascular diseases can avoid "thoracotomy and saw bones", and can be achieved through minimally invasive interventional technology.
"Pull to the limit" with death, and save lives with interventional surgery
13 years ago, when cardiac interventional technology was in the ascendant, Chen Xiaolin encountered a patient with left main occlusion who was "unattainable". A patient presented with chest tightness and discomfort and suddenly lost consciousness and had convulsions all over his body while waiting for outpatient treatment.
Chen Xiaolin, who rushed to the scene as soon as possible, performed cardiopulmonary resuscitation on the patient while learning about the medical history from his family, and out of professional sensitivity, Chen Xiaolin judged that the patient had suffered an acute myocardial infarction. Therefore, the green channel for the treatment of acute myocardial infarction was immediately activated, and emergency interventional surgery was carried out on the patient.
During the operation, Chen Xiaolin found that the patient's left main trunk was occluded.
The left main blood vessel supplies blood to the heart2 3 **, and once blood flow is acutely blocked, the vast majority of patients die before reaching the hospital, and less than 1 of the patients make it to the hospital aliveTherefore, acute occlusion of the left main trunk is a rare case among interventional cardiac practitioners.
The incidence of cardiogenic shock in patients who arrive at the hospital alive is as high as 77 8, and the mortality rate is extremely high, and accurate judgment and rapid and effective rescue are the keys to success.
With the support of anticardiogenic shock measures such as continuous cardiopulmonary resuscitation and intra-aortic balloon counterpulsation, Chen Xiaolin quickly opened the occluded left main for the patient. It took only 36 minutes from the onset of loss of consciousness to the opening of the occluded vessel, and the blood successfully poured into the occluded vessel.
After 1 week, the patient was discharged. When he heard the rhythm of his heartbeat, Chen Xiaolin's heart swelled with indescribable satisfaction, which also became the source of motivation for his continuous improvement in his career.
Different from cardiac surgery to open the chest, cardiac interventional surgery is a new type of diagnosis and treatment of cardiovascular diseases, and the progress is also very rapid, it is between internal medicine and surgery, and it is an invasive diagnosis and treatment method.
Our cardiology department is equivalent to half surgery, and in the final analysis, interventional diagnosis and treatment technology is the most important tool for cardiologists. Chen Xiaolin said. In the long run, with the continuous improvement of interventional technology and interventional devices, the indications for interventional intervention will continue to expand, from simple lesions to high-risk and complex lesions.
The Chest Pain Center is certified by the provincial level and can open blood vessels in as fast as 30 minutes
In recent years, there has been an increasing number of patients with acute myocardial infarction, aortic dissection, and acute pulmonary embolism, and chest pain is the main symptom of most cardiovascular emergencies. Chen Xiaolin said.
These diseases have a rapid onset and rapid change, and if they are not treated in a timely and correct manner, the prognosis is extremely poor. If the correct ** is taken within 2 hours of the onset of acute myocardial infarction, the mortality rate is only 1.
How to make accurate judgments and implement the correct ** in the shortest time is the key to saving the life of acute myocardial infarction. The establishment of the chest pain center is to enable patients with "heart" hanging by a thread to get the fastest and most accurate **, and to build an efficient and smooth "heart-saving" highway for chest pain patients.
In March this year, the Chest Pain Center of SUSTech Hospital successfully passed the certification of Guangdong Chest Pain Center. This means that the Chest Pain Center of SUSTech Hospital has reached the provincial standards and norms in terms of hardware facilities, comprehensive capabilities and the construction of a comprehensive treatment platform for chest pain diseases, which can treat patients with chest pain in a more timely and standardized manner.
As the medical director of the Chest Pain Center of SUSTech Hospital, Chen Xiaolin is on call 24 hours a day, as long as the patient's condition requires.
A 68-year-old male patient suddenly fainted while riding the subway, and after the 120 ambulance arrived at the scene, an urgent electrocardiogram showed acute myocardial infarction. The pre-hospital ambulance staff immediately uploaded the patient's electrocardiogram to the working group of the Chest Pain Center of SUSTech Hospital, and the interventional cardiologist intervened in advance to grasp the basic situation of the patient before the patient was admitted, and Chen Xiaolin quickly diagnosed the patient with acute myocardial infarction and cardiogenic shock.
The chest pain center immediately activated the green channel for treatment, and the catheterization laboratory was ready within 5 minutes. Under the protection of a temporary pacemaker, coronary angiography revealed acute thrombotic occlusion of the right coronary artery and successfully implanted a stent. The patient's vital signs returned to stable on the second day after surgery, and he was discharged from the hospital on the fifth day.
The "working group" of the Chest Pain Center of SUSTech Hospital includes many "group friends" such as cardiology, emergency department, and intensive care medicine, and a number of community grassroots medical institutions "jointly build a regional collaborative treatment network, make full use of medical Internet technology and the construction of chest pain green channels, so that the patient information network can be transmitted in real time to achieve pre-hospital first aid and in-hospital rescue.
The establishment of the Chest Pain Center has changed the previous medical treatment model for patients with chest pain. "At present, patients with chest pain are basically controlled within 90 minutes from admission to the operating table, with an average time of 60 minutes, and the occluded blood vessels can be opened on the operating table in 30 minutes at the earliest. Chen Xiaolin introduced.
"No matter how heavy the lead coat is, it is not as heavy as the responsibility on the shoulders".
Since joining SUSTech Hospital in January 2020, Chen Xiaolin has established the Department of Cardiac Interventional Medicine from scratch, carried out cardiac interventional diagnosis and treatment technology, and rapidly improved the level of treatment of acute and critical cardiovascular diseases. In the past four years, an average of about 6 8 patients with acute myocardial infarction have been treated every month, with a success rate of 99 2, reaching the international advanced level. In the past 4 years, he has led the team to complete more than 1,500 interventional surgeries for various cardiovascular diseases, with a success rate of 99 68.
I accidentally chose medicine, but once I did, I treated it with a lifetime of loyalty and passion. For Chen Xiaolin, choosing medicine is "choosing one thing for a lifetime, not for prosperity and ingenuity".
Cardiac intervention has a variety of advantages over traditional surgery, the patient is easy to accept, the damage is small, the recovery is fast, and it is almost bitter, "First of all, this is a minimally invasive surgery, the patient has little trauma, and there is no need to stay in bed after surgery, which reduces pain;Without full anesthesia, surgical complications are greatly reduced;The cost is also correspondingly lower than cardiac bypass surgery. "Behind the benefits to patients is the contribution of unknown doctors.
During the operation, you must wear a heavy lead suit, lead scarf, etc. Wearing more than 30 pounds of lead clothing every day, standing in front of the operating table for several hours, the radiation "eaten" in a day is equivalent to taking tens of thousands of chest X-rays.
If the permanent pacemaker implantation is successful, it can be completed in one hour, and in a complicated case, it may take two hours, in addition to being tired and sweating, backache and leg pain, but also to bear the damage of decreased immunity and increased risk of cancer.
There is only one life, and when the patient's life is in his own hands, no matter how heavy the lead clothes are, there is no heavy responsibility on his shoulders. Chen Xiaolin said that interventional cardiologists are highly dangerous and have great psychological pressure, but since they have chosen this profession, they must persist and love.
Famous doctor introduction
Xiaolin Chen, Director of the Department of Cardiology, Southern University of Science and Technology Hospital, Chief Physician, Professor, Master's Supervisor. He graduated from the First Military Medical University in 2003 with a doctorate degree in internal medicine (cardiovascular disease), and worked as a postdoctoral researcher at the postdoctoral research station of clinical medicine of Sun Yat-sen University from 2004 to 2005. He has been honored as "Lingnan Famous Doctor" and "Good Doctor of Southern Guangdong", and has been awarded the titles of "Outstanding Young and Middle-aged Experts and Top-notch Talents" and "Famous Doctor Studio" at the municipal level. He has presided over 2 provincial and ministerial scientific research projects, 3 municipal scientific research projects, participated in 2 national natural science projects, and 1 major military scientific and technological research project. He has written 1 monograph and published more than 70 academic articles, including 2 SCI papers. He has won 1 second prize of provincial science and technology, 1 first prize of municipal level, 2 second prizes of municipal level and 4 third prizes of municipal level.
Professional good at:
Interventional diagnosis and treatment of cardiovascular diseases, including coronary heart disease (angina, myocardial infarction), peripheral blood vessels (arteriovenous stenosis, occlusion, thrombosis), pacemaker implantation (unit double-chamber pacemaker, CRT D) and pulmonary artery (stenosis, embolism).