"Dr. Luo, I am a patient in Tongliao, Inner Mongolia, only 41 years old this year, diagnosed with coronary heart disease in the middle of 20 years, the doctor didn't tell me too much at that time, just let me take medicine and pay attention to my diet, I didn't pay much attention at the time, just kept coming, some time ago I suddenly felt frequent chest pain, so I went to the hospital for an examination, and was finally told that the blood vessel was 80% stenosis , made me think about whether to have a stent, but I was too young to have a stent so early, and wanted to ask if you should have a stent, or if there was any other way".
This is the help message I saw last night, I think there are a lot of information points worth mentioning, and by the way, I will give you a good talk about stents, conduct a more detailed science popularization, and tell you the clinical significance and applicable conditions of stents.
Angiography is an abbreviation, its full name in the clinic is called "coronary angiography", which is a key examination in the field of diagnosis and treatment of heart diseases, and is the gold standard for diagnosing coronary heart disease.
However, although contrast is relatively accurate, it is not the first choice in clinical application, because it is invasive, invasive, and expensive.
We only need to do angiography to determine the location and extent of stenosis if the symptoms are severe but the diagnosis is unclear, and other relevant tests consider the condition to be more severe and stent surgery is required.
The core of coronary heart disease lies in the blood vessels, and the coronary arteries are the backbone of the trunk, its stenosis and blockage will greatly affect the blood circulation, when the patient performs angiography on a certain coronary artery, the results show 80%, which means that the disease is in the middle and late stages, because the many blood vessels in the human body can not only have a certain stenosis and blockage, but the vast majority of blood vessels have varying degrees of blockage, this 80% It is only the most serious one, all things considered, the patient must have a clinical fact of myocardial ischemia, so it needs to be intervened as soon as possible**.
80% is not an optimistic value in terms of stenosis alone, it only needs to deteriorate a little bit, it is infinitely close to 100%, so the doctor recommends that the patient is correct about the stent.
However, before evaluating the disease, we cannot only look at one aspect, the degree of stenosis of the patient does meet the indication for stent surgery, but from the patient's consultation description, I did not see other information, so I cannot give an accurate diagnosis, considering the patient's young age, so I am more optimistic about his physical condition, and may not necessarily need to undergo stent surgery.
Cardiac stent is just a common name, but it is deeply rooted in the hearts of the people, which mainly refers to the heart, in fact, it is not to press the stent on the heart, but to implant the stent into the narrowed and blocked coronary artery, and then through the expansion of the balloon to firmly fit the stent to the blood vessel wall, and artificially stretch it open, restore the normal flow of blood.
The recirculation of blood greatly alleviates myocardial ischemia, so patients will feel that the symptoms are relieved or disappeared at this stage, and the effect can be said to be immediate, but there are also a small number of patients who have undergone stent surgery, and the symptoms still have not been greatly improved, this is because the blockage inside other blood vessels is also more serious, although the blockage of the patient's stent is recovered, it still cannot restore the myocardial blood supply as a whole, and is still in the pathological stage of myocardial ischemia, so there will be obvious abnormal symptoms.
Seeing this, there should be many friends who have seen the limitations of the stent: "The stent is not carried out from **on**, and the cause of the patient's blood vessel blockage still exists, but it is only operated at the blockage position and temporarily stretched, but over time, not only the blockage of other parts will be further aggravated, but even the part of the stent may be blocked twice or three times."
Therefore, it is safe to say that cardiac stents are only a first-aid measure, not a routine ** measure.
If the patient's stenosis is not high, does not seriously affect daily life, and does not have a more serious related disease, then even if the stenosis is 80%, there is no need for stent surgery first aid.
This patient with coronary heart disease is younger, only 38 years old when he was diagnosed 3 years ago, here I do not think that his blood vessels have severe atherosclerosis, and he did not specifically explain related diseases, so I also assume that he has no related high-risk diseases, comprehensive consideration, I think its key ** factors are not the traditional perception of age, three highs, diet, life Xi.
He may be more because of the coronary vascular spasm contraction caused by nerve factors, there may be a certain degree of lesion on his lower cervical or thoracic vertebrae, so it causes greater pressure and stimulation to the nervous system, if he has not noticed this, the condition will deteriorate rapidly in the past three years, and the spasmodic contraction of coronary blood vessels will lead to local tears of smooth muscle, creating strong conditions for the formation of plaque thrombosis.
At this time, we need to carry out a two-pronged approach, on the one hand, to carry out ** on the root cause of the lesion to avoid subsequent continuous effects;On the other hand, through nerve regulation, nerve excitation is relieved, blood vessels are dilated, myocardial activity is restored, and blood is restored.