All of coronary heart disease called coronary atherosclerosis heart disease, coronary atherosclerosis and angina as the main features of the main causes of cardiac blood supply to the coronary artery walls due to fatty calcification, a plaque deposition, causing Arterial branches narrow, resulting in regional myocardial ischemia caused angina. Cause heart failure, an irregular heartbeat, heart failure and other illnesses.
Coronary heart disease risk factors are high blood fat, hypertension, smoking, diabetes, lack of physical activity and obesity. In age of more than 40-year-old, the men more than women, are more mental work.
AMI is a branch of the coronary occlusion, interrupted blood flow, caused by Mycobacterium nutrition of the persistent ischemic myocardial necrosis, the death of heart disease is the primary cause of death. If lesions too large or rescue measures inadequate, would lead to cardiac rupture, cardiogenic shock, sudden death and other serious consequences. If the rescue in time, after a period of treatment and rest home, myocardial necrosis can Banhen repair, but most will cause heart failure, an irregular heartbeat, heart failure and other illnesses.
Diagnosis:
Angina is the main symptoms of coronary heart disease, are a group of temporary due to acute myocardial ischemia, the Syndrome anoxia by:
1. Chest compression asphyxia flu, nausea bulging flu-like severe burning pain, pain general 1-5 minutes, sometimes up to 15 minutes, to ease;
2. Pain often radiation to the left shoulder, left arm before the inside until the little finger and ring finger;
3. Pain in the heart of burden (for example, increase physical activity, excessive mental stimulation and Shouhan) when, in the rest or sublingual nitroglycerin for a few minutes after the service to disappear;
4. Onset of pain, can be associated with (also from time with) collapse, sweating, shortness of breath, anxiety, palpitations, nausea or dizziness symptoms.
5. Angina may also come from other over-the heavier the burden of heart disease, for example, anemia, aortic valve disease, arrhythmia, hyperthyroidism, and so on.
AMI is critical symptom of coronary heart disease, angina attacks are usually more frequent and heavier as the basis, there is also the history of angina and sudden cases of myocardial infarction (such cases the most dangerous, due to the lack of preparedness often caused by sudden death).
AMI's performance as:
1. Emergencies at the heart before or after the sternum area pain, to the left shoulder, his left arm or the radiation, and the pain more than half an hour, the rest of clothes and nitroglycerin can not be eased;
2. Shortness of breath, dizziness, nausea, chills, sweating, pulse fine;
3. Humidicool skin, grey, serious illness Bingrong;
4. About one-tenth of the patients is the only performance of syncope or shock.
5/13/2008
What is coronary heart disease
It is well known coronary heart disease is a病名, but to ask how the case is whether the coronary heart disease, inverted may not be able to say that very clearly. So, what is coronary heart disease? »Coronary heart disease is coronary atherosclerotic heart disease referred to. It is because of nutrient supply to the heart's blood vessels - in a coronary artery caused by atherosclerosis. This plaque of atherosclerosis, the accumulation in the coronary artery intima, the passage of time, grew larger, so that even coronary occlusion lumen stenosis, as water pipe or bottle mouth was a long gradual accumulation of alkaline water plug Or narrowed, resulting in a reduction of myocardial blood flow, insufficient oxygen supply to the heart of the normal work by the different levels of impact, resulting in a series of ischemic performance, such as chest tightness, Bieqi, angina, myocardial infarction And even sudden death, and so on.
Therefore, coronary heart disease also known as ischemic heart disease. Coronary heart disease in the country average prevalence rate of about 6.49 percent, and the prevalence rate of growth increased with age, so the elderly coronary heart disease is the most common form of cardiovascular disease.
Therefore, coronary heart disease also known as ischemic heart disease. Coronary heart disease in the country average prevalence rate of about 6.49 percent, and the prevalence rate of growth increased with age, so the elderly coronary heart disease is the most common form of cardiovascular disease.
The prognosis of coronary heart disease
The prognosis of coronary heart disease depends on the degree of stability and serious diseases, myocardial ischemia is the extent and scope of the more serious and more frequent attack, its occurrence infarction and death may be greater. After myocardial infarction patients has also increased the risk. Above the active intervention measures have proved to be significantly decreased infarction and coronary heart disease deaths, adhere to strictly regulate the treatment, to improve coronary artery disease and myocardial ischemia can extend life and improve the quality of life.
Acute myocardial infarction is how the
Acute myocardial infarction is acute coronary occlusion, interrupted blood flow, caused by the regional myocardial ischemic necrosis.
Pathogenesis
Coronary atherosclerosis causing lumen cardiac insufficiency and narrow, and the collateral circulation has not yet been established, due to the following reasons to increase myocardial ischemia in myocardial infarction.
First, completely occluded coronary vascular disease, atherosclerosis or endometrial hemorrhage, or lumen, arterial thrombosis persistent cramps, so that the lumen in complete occlusion.
Second, cardiac output dropped in shock, dehydration, bleeding, serious arrhythmia caused by surgery or cardiac output dropped, coronary flow serious shortage of irrigation.
Third, cardiac output increase aerobic take severe physical, emotional or drama or blood pressure, left ventricular load surge, increased secretion of catecholamine, aerobic cardiac output to be increased.
AMI often occurred in meal (especially the large consumption of fat), quiet sleep, or force the stool, this postprandial lipid due to increased blood viscosity is high, platelet adhesion enhancements, local blood flow slow, easy-platelet Gathered that thrombosis; sleep, the higher vagal tone, easily cause coronary artery spasm, increase the heart load forced the stool, these factors are conducive to the occurrence of acute myocardial infarction.
AMI can also occur in non-coronary atherosclerosis in coronary artery spasm, sometimes due to coronary thrombosis, inflammation, caused by congenital malformation. Myocardial infarction after a serious arrhythmia, shock or heart failure, coronary artery that may further reduce the flow of irrigation, expand the scope of myocardial necrosis.
Pathogenesis
Coronary atherosclerosis causing lumen cardiac insufficiency and narrow, and the collateral circulation has not yet been established, due to the following reasons to increase myocardial ischemia in myocardial infarction.
First, completely occluded coronary vascular disease, atherosclerosis or endometrial hemorrhage, or lumen, arterial thrombosis persistent cramps, so that the lumen in complete occlusion.
Second, cardiac output dropped in shock, dehydration, bleeding, serious arrhythmia caused by surgery or cardiac output dropped, coronary flow serious shortage of irrigation.
Third, cardiac output increase aerobic take severe physical, emotional or drama or blood pressure, left ventricular load surge, increased secretion of catecholamine, aerobic cardiac output to be increased.
AMI often occurred in meal (especially the large consumption of fat), quiet sleep, or force the stool, this postprandial lipid due to increased blood viscosity is high, platelet adhesion enhancements, local blood flow slow, easy-platelet Gathered that thrombosis; sleep, the higher vagal tone, easily cause coronary artery spasm, increase the heart load forced the stool, these factors are conducive to the occurrence of acute myocardial infarction.
AMI can also occur in non-coronary atherosclerosis in coronary artery spasm, sometimes due to coronary thrombosis, inflammation, caused by congenital malformation. Myocardial infarction after a serious arrhythmia, shock or heart failure, coronary artery that may further reduce the flow of irrigation, expand the scope of myocardial necrosis.
Chinese medicine point of view of coronary heart disease
China's medical books in this disease already recorded. Such as "Lingshu dedicated chapter of": "I heartache, to hand-foot-Green Day, very painful, Xi Dan, died, the Xi Dan die." Referred to here the true heart, is critical of coronary heart disease, Ruoshi Governance, the rule is wrong poor prognosis. Such as "gold," says: "as thorns Xiongbitong have colic……." "Died a few days die." Han-swollen King "Golden Chamber" the most detailed description. Pointed out that "Chest of disease, relief of cough Tuo, harness pain, short gas, and Shen Chi Cunkou clock, closed the small number of tight……" a brief description for Chest Pain caused yang occlusion, and a brief description of Chest cards The characteristics of Chest Pain in the last bit of coke, the "Golden Chamber of straight," said: "heart and lung of the points, Guzuochuanke Tuo also." After almost a no-objection. To the Ming and Qing Dynasties, the original understanding, based on the treatment of the disease have unique perspectives. Such as "Lingshu Wuwei" has been "Xie Yi Shi heartache," the records. "Golden Chamber" Bi Xuan Yang stressed that the main principle of treatment, followed by the date is still the clinical, "WHO medical painful side effect in the door" with a Xiangwan aromatic Su Wen-way "rule Cubao heartache." Doctors later raised the treatment of the principle of promoting blood circulation Huayu, such as "Treatment yardstick, all the pain the door" with the agent safflower, Taoren, down-, Shixiaosan treatment died of blood heartache, "including the song" used to drink Salvia , "Lin admitted Gaicuo" with Xuefuzhuyu soup for Chest Pain heartache. All of these are today's treatment of coronary artery disease and effective prescription.
Cause
Etiology of the disease has not yet entirely clear, but that with hypertension, hyperlipidemia, blood hyperlipidemia, diabetes, endocrine functions, such as lower income groups and the age factor. Chinese medicine practitioners believe that this disease is the common pathogenic factors:
1. Shenqi loss with age, dirty gas function gradually retreat, or the old and Shen Kui, Mingmen Huoshuai not Wenxu the viscera, leading to bad air-stagnation, poor blood, Qi in blood stasis, or Shenyin lack deficit, not nourishment viscera of the Yam, Yin also can lead to blood stasis.
2. Hanxie intrusion due to lack of chest-yang, the evil Cheng Xu Yin Han invasion, Hanning gas stagnation, Bizu-chest, heart unreasonable for the Chest. Such as "Zhu Hou On the source of the disease," said: "Han Qi passengers in Wuzangliufu, and because of the virtual, on-chest, compared with Chest Pain."
3. Food Festival in not Feiganhouwei or long-term drinking, spleen and stomach damage, and transport of disorders, Tanzhuo of Health, chest-thirsty resistance, air-show Cheong, for the Chest.
4. Emotional disorders long-term lack of exercise. The spirit of inhibition, emotional loss of balance, or excessive nervousness, excessive virtual think, to poor blood, Qizhixueyu, Xinmaitong Stagnation of the Chest.
Pathogenesis
Really painful disease is chest-machine sluggish, Yin Han and the intrusion of evil on the nuisance caused by Tanzhuo. Gradually decline in the Shenqi, spleen loss-Yun, Tanzhuo of Health; Yin Han and Tanzhuo not, Bizu Xinmaitong, leading to further Qizhixueyu, appeared to bleeding for the characteristics of the Chest cards, serious Can be the true heartache, and even violence from heart-yang.
Cause
Etiology of the disease has not yet entirely clear, but that with hypertension, hyperlipidemia, blood hyperlipidemia, diabetes, endocrine functions, such as lower income groups and the age factor. Chinese medicine practitioners believe that this disease is the common pathogenic factors:
1. Shenqi loss with age, dirty gas function gradually retreat, or the old and Shen Kui, Mingmen Huoshuai not Wenxu the viscera, leading to bad air-stagnation, poor blood, Qi in blood stasis, or Shenyin lack deficit, not nourishment viscera of the Yam, Yin also can lead to blood stasis.
2. Hanxie intrusion due to lack of chest-yang, the evil Cheng Xu Yin Han invasion, Hanning gas stagnation, Bizu-chest, heart unreasonable for the Chest. Such as "Zhu Hou On the source of the disease," said: "Han Qi passengers in Wuzangliufu, and because of the virtual, on-chest, compared with Chest Pain."
3. Food Festival in not Feiganhouwei or long-term drinking, spleen and stomach damage, and transport of disorders, Tanzhuo of Health, chest-thirsty resistance, air-show Cheong, for the Chest.
4. Emotional disorders long-term lack of exercise. The spirit of inhibition, emotional loss of balance, or excessive nervousness, excessive virtual think, to poor blood, Qizhixueyu, Xinmaitong Stagnation of the Chest.
Pathogenesis
Really painful disease is chest-machine sluggish, Yin Han and the intrusion of evil on the nuisance caused by Tanzhuo. Gradually decline in the Shenqi, spleen loss-Yun, Tanzhuo of Health; Yin Han and Tanzhuo not, Bizu Xinmaitong, leading to further Qizhixueyu, appeared to bleeding for the characteristics of the Chest cards, serious Can be the true heartache, and even violence from heart-yang.
Coronary heart disease morbidity and mortality how
Cardiovascular disease as a hazard to human health, "the first killer", has spread to the world, many rich countries is a major disaster. Despite the First World War, myocardial infarction as the primary clinical types of coronary heart disease is still rare, but in 1940, coronary heart disease has become the United States and some of the major causes of death in industrialized countries. Because certain types of coronary heart disease diagnosis are still certain difficulties, it is usually with acute myocardial infarction morbidity and mortality to the representatives of coronary heart disease morbidity and mortality, with mortality rates more commonly used.
According to the World Health Organization in 1990 announced the 11 national information, 30 to 69-year-old Northern Ireland to the highest mortality rates of coronary heart disease, followed by Finland, Japan minimum. In the United States even though the mortality rates of coronary heart disease than 30 years ago, a drop of 40 percent, but the United States remained the first cause of death. 1988 U.S. National Centre for Health Statistics released by the United States in 1987 with the death toll and the cause of death of data show that heart disease accounted for 35% of the total cause of death, died of coronary heart disease accounted for 24.1 percent, the top ten causes of death of the first. Compared with developed countries, China is still low, coronary heart disease, but since the 1980s, China's cardiovascular disease morbidity and mortality rates were gradually rising trend. According to the report in 1984, died of coronary heart disease crude: 36.9/10 million for the city, rural 15.6/10 million. Cardiopulmonary vascular centre in Beijing from 1985 to 1989 Monica programme monitoring results show that in the organization by the WHO Monitoring Centre 48, China 35 to 64-year-old standard of coronary heart disease mortality rate higher than that of Japan alone, with the penultimate. Coronary heart disease mortality rate for males 000 49/10, 27/10 000 women with a higher mortality rate of Finland (493/10 million men, women 63/10 million), very different. From 1986 to 1990 China's population of 10 groups of hypertension, coronary heart disease, stroke incidence and risk factors of the prospective study results show that 38 19659 people in monitoring the years, acute myocardial infarction a total of 409 cases of men and women in 200 cases, the annual incidence Rates were 10 to 000 26/10, 8 to 000 13/10; mortality rates were 4 to 000 11/10 and 2 to 5 / 100,000. Of the total number of deaths of coronary heart disease death of 4.47% (male) and 72 (female). 96 Data show that the death toll of cardiovascular diseases account for the total death toll of about 1 / 3, which accounted for 45 percent of cerebrovascular disease, coronary heart disease accounted for 15 percent. Compared with Western countries, China is characterized by high incidence of stroke, coronary heart disease, lower.
According to the World Health Organization in 1990 announced the 11 national information, 30 to 69-year-old Northern Ireland to the highest mortality rates of coronary heart disease, followed by Finland, Japan minimum. In the United States even though the mortality rates of coronary heart disease than 30 years ago, a drop of 40 percent, but the United States remained the first cause of death. 1988 U.S. National Centre for Health Statistics released by the United States in 1987 with the death toll and the cause of death of data show that heart disease accounted for 35% of the total cause of death, died of coronary heart disease accounted for 24.1 percent, the top ten causes of death of the first. Compared with developed countries, China is still low, coronary heart disease, but since the 1980s, China's cardiovascular disease morbidity and mortality rates were gradually rising trend. According to the report in 1984, died of coronary heart disease crude: 36.9/10 million for the city, rural 15.6/10 million. Cardiopulmonary vascular centre in Beijing from 1985 to 1989 Monica programme monitoring results show that in the organization by the WHO Monitoring Centre 48, China 35 to 64-year-old standard of coronary heart disease mortality rate higher than that of Japan alone, with the penultimate. Coronary heart disease mortality rate for males 000 49/10, 27/10 000 women with a higher mortality rate of Finland (493/10 million men, women 63/10 million), very different. From 1986 to 1990 China's population of 10 groups of hypertension, coronary heart disease, stroke incidence and risk factors of the prospective study results show that 38 19659 people in monitoring the years, acute myocardial infarction a total of 409 cases of men and women in 200 cases, the annual incidence Rates were 10 to 000 26/10, 8 to 000 13/10; mortality rates were 4 to 000 11/10 and 2 to 5 / 100,000. Of the total number of deaths of coronary heart disease death of 4.47% (male) and 72 (female). 96 Data show that the death toll of cardiovascular diseases account for the total death toll of about 1 / 3, which accounted for 45 percent of cerebrovascular disease, coronary heart disease accounted for 15 percent. Compared with Western countries, China is characterized by high incidence of stroke, coronary heart disease, lower.
The essence of coronary heart disease
People suffering from coronary artery disease, about 99 percent from coronary atherosclerosis caused. Therefore, coronary heart disease is actually referring to coronary atherosclerosis and heart disease, or coronary heart disease.
When the coronary atherosclerosis developed to a certain extent, which led the lumen of coronary artery stenosis, obstruction, can cause myocardial ischemia, lack of oxygen, and a series of symptoms (such as chest tightness, angina, etc.) And even myocardial infarction and life-threatening. This disease is coronary atherosclerotic heart disease. Its essence is myocardial ischemia. Therefore, also known as ischemic heart disease.
When the coronary atherosclerosis developed to a certain extent, which led the lumen of coronary artery stenosis, obstruction, can cause myocardial ischemia, lack of oxygen, and a series of symptoms (such as chest tightness, angina, etc.) And even myocardial infarction and life-threatening. This disease is coronary atherosclerotic heart disease. Its essence is myocardial ischemia. Therefore, also known as ischemic heart disease.
Coronary heart disease risk factors
At present the whole crowd that the main risk factors for coronary heart disease is the traditional risk factors for hypertension, hypercholesterolemia, smoking, diabetes and family history, hypertension, hypercholesterolemia, diabetes and smoking is considered the most important, but also Coronary heart disease were estimated 2 / 3 of these three factors is the role of a single or joint role in the cause, while research in recent years prompted the development of coronary heart disease associated with some of the new risk factors.
Hypertension: high blood pressure is considered an important risk factor for coronary heart disease. Patients with hypertension atherosclerosis than normal blood pressure significantly, the higher the level of blood pressure and arteriosclerosis more serious degree. High blood pressure not only has accelerated atherosclerosis, also accelerated the small arteriosclerosis, high blood pressure in patients with vascular rupture and occlusion of blood pressure were normal as early as about 20. Research shows that both systolic or diastolic blood pressure can predict a strong risk of CHD.
The current severe hypertension has no objection to the hazard, and the role of mild hypertension dispute, although most experts believe that such patients with lower levels of blood pressure, the risk of coronary heart disease caused smaller, but the proportion of the population, still can not be Ignored.
Hyperlipidemia: high serum total cholesterol has proved to be coronary heart disease risk factors. In the lower total serum cholesterol in the crowd in the East as well. Food is the impact of serum cholesterol level of the important factors, which also affects the coronary heart disease morbidity and mortality, autopsy studies and large-scale migration studies have confirmed this point. The type of dietary fat is also important, saturated fatty acids will increase serum cholesterol increased, while polyunsaturated fatty acids to reduce the increase.
Smoking: Smoking is atherosclerosis an independent risk factor. Smoking CHD mortality increase was mainly due to myocardial infarction and sudden coronary death. Epidemiological study results show that: smoking and the risk of coronary heart disease is directly proportional to smoking; Zhiyan suction aspiration than other types of tobacco dangers of large autopsy results found that the extent of atherosclerosis smokers than non-smokers in serious And more smoking affects not only the incidence of coronary heart disease, myocardial infarction also affect the prognosis; passive smoking are subject to the same hazards; lower the age, the higher the relative risk; quit smoking can reduce the risk of CHD.
Diabetes and impaired glucose tolerance: diabetes and impaired glucose tolerance so that the risk of cardiovascular disease increased. Hypertension, obesity, insulin resistance, hyperinsulinemia, hypertriglyceridemia, low HDL-C frequently co-exist, these factors will be accelerated atherosclerosis.
Overweight and obesity: overweight that weight gain over a particular standard, often used BMI (body mass index, BMl) to indicate that weight kg / (height m) 2 ≥ 25 for the overweight. Obese refers to the proportion of body fat too high, such as the weight of men over women, or 25 percent more than the 30 percent of body weight. After large number of epidemiological studies, that it is coronary heart disease risk factors, primarily through the effects of blood pressure and serum cholesterol levels.
The lack of physical activity: It is now concerned with the movement of information between coronary heart disease deaths are mostly observational studies, failed to draw causal relationship. 1987 Review of the one summed up the results of 43 epidemiological studies, concluded that moderate or severe physical activity can reduce the risk of coronary heart disease. CDC's evaluation that the epidemiological, clinical and laboratory has confirmed the argument of physical activity and the links between the prevention of coronary heart disease, the mechanism is that physical activity can control weight, increase glucose tolerance and insulin sensitivity, lower blood pressure, improve crown Vein blood flow, increased HDL. But for those not accustomed to peacetime movement, strong physical activity is likely to trigger coronary heart disease risk of acute myocardial infarction attack. For a long time regular activities, each time interval is not long, can protect people not in use because of coronary heart disease or myocardial infarction vigorously and trigger the other hand, not the people, particularly known to have coronary heart disease Or the risk of coronary heart disease, violent activity may pose a risk to patients. Physical activity in daily life often can not protect patients or due to strong physical activity is not a result of myocardial infarction. So publicity also must take into account this problem.
And the spirit of the type of stress: Some people have found that Type A male actors with angina, myocardial infarction than the risk of Type B are twice as high, there are also women in the same association. The concept of vulnerable patients with coronary heart disease, including pressure to bear the physical and emotional response (including anger, cynicism, doubts, reflected in the hostility and repression).
Clotting risk factors: GPIIIa is the main platelet integrin, which is a transmembrane sugar-protein complex. Its role as a receptor, mediated platelet fibrinogen binding to the surface and subsequent platelet aggregation. A case-control study of the United States to observe the PIA2 GPIIIa gene polymorphism (Leucine -33 was replaced by proline) and emergency thrombosis between the association, its significance in the notice of hypertension, smoking, high cholesterol or hyperlipidemia Diabetes and other known risk factors for coronary heart disease on.
Homocysteine: high homocysteine (Hey) is produced during the metabolism of methionine a sulphur content of amino acids, several case-control study of the plasma Hcy had a high level, high rates of coronary heart disease. European collaborative action plans to further affirmed it as an independent risk factor.
Lipoprotein (a): lipoprotein (a) [LP (a)] and the lipid composition similar to LDL, the protein apo (a) part of how kringle structure, with a high degree of homology pro fiber solution. It can direct role in protein and fiber, can inhibit the fibrinolytic plasminogen role. In structure, it has to thrombosis and atherosclerosis of the potential.
Of atherosclerosis spectrum of lipoprotein (ALP): caused by atherosclerosis of the spectrum lipoprotein (atherogenic lipoprotein profile, ALP) is a certain genetic basis of several metabolic disorders integrated. AS mainly shown by the strong role of small particles of low-density lipoprotein (LDL2) increased, high triglycerides (TG) hyperlipidemia and low levels of HDL. Are accompanied by insulin resistance based on the metabolic syndrome (Reaven's Syndrome X). Germany PROCAM study early
Hypertension: high blood pressure is considered an important risk factor for coronary heart disease. Patients with hypertension atherosclerosis than normal blood pressure significantly, the higher the level of blood pressure and arteriosclerosis more serious degree. High blood pressure not only has accelerated atherosclerosis, also accelerated the small arteriosclerosis, high blood pressure in patients with vascular rupture and occlusion of blood pressure were normal as early as about 20. Research shows that both systolic or diastolic blood pressure can predict a strong risk of CHD.
The current severe hypertension has no objection to the hazard, and the role of mild hypertension dispute, although most experts believe that such patients with lower levels of blood pressure, the risk of coronary heart disease caused smaller, but the proportion of the population, still can not be Ignored.
Hyperlipidemia: high serum total cholesterol has proved to be coronary heart disease risk factors. In the lower total serum cholesterol in the crowd in the East as well. Food is the impact of serum cholesterol level of the important factors, which also affects the coronary heart disease morbidity and mortality, autopsy studies and large-scale migration studies have confirmed this point. The type of dietary fat is also important, saturated fatty acids will increase serum cholesterol increased, while polyunsaturated fatty acids to reduce the increase.
Smoking: Smoking is atherosclerosis an independent risk factor. Smoking CHD mortality increase was mainly due to myocardial infarction and sudden coronary death. Epidemiological study results show that: smoking and the risk of coronary heart disease is directly proportional to smoking; Zhiyan suction aspiration than other types of tobacco dangers of large autopsy results found that the extent of atherosclerosis smokers than non-smokers in serious And more smoking affects not only the incidence of coronary heart disease, myocardial infarction also affect the prognosis; passive smoking are subject to the same hazards; lower the age, the higher the relative risk; quit smoking can reduce the risk of CHD.
Diabetes and impaired glucose tolerance: diabetes and impaired glucose tolerance so that the risk of cardiovascular disease increased. Hypertension, obesity, insulin resistance, hyperinsulinemia, hypertriglyceridemia, low HDL-C frequently co-exist, these factors will be accelerated atherosclerosis.
Overweight and obesity: overweight that weight gain over a particular standard, often used BMI (body mass index, BMl) to indicate that weight kg / (height m) 2 ≥ 25 for the overweight. Obese refers to the proportion of body fat too high, such as the weight of men over women, or 25 percent more than the 30 percent of body weight. After large number of epidemiological studies, that it is coronary heart disease risk factors, primarily through the effects of blood pressure and serum cholesterol levels.
The lack of physical activity: It is now concerned with the movement of information between coronary heart disease deaths are mostly observational studies, failed to draw causal relationship. 1987 Review of the one summed up the results of 43 epidemiological studies, concluded that moderate or severe physical activity can reduce the risk of coronary heart disease. CDC's evaluation that the epidemiological, clinical and laboratory has confirmed the argument of physical activity and the links between the prevention of coronary heart disease, the mechanism is that physical activity can control weight, increase glucose tolerance and insulin sensitivity, lower blood pressure, improve crown Vein blood flow, increased HDL. But for those not accustomed to peacetime movement, strong physical activity is likely to trigger coronary heart disease risk of acute myocardial infarction attack. For a long time regular activities, each time interval is not long, can protect people not in use because of coronary heart disease or myocardial infarction vigorously and trigger the other hand, not the people, particularly known to have coronary heart disease Or the risk of coronary heart disease, violent activity may pose a risk to patients. Physical activity in daily life often can not protect patients or due to strong physical activity is not a result of myocardial infarction. So publicity also must take into account this problem.
And the spirit of the type of stress: Some people have found that Type A male actors with angina, myocardial infarction than the risk of Type B are twice as high, there are also women in the same association. The concept of vulnerable patients with coronary heart disease, including pressure to bear the physical and emotional response (including anger, cynicism, doubts, reflected in the hostility and repression).
Clotting risk factors: GPIIIa is the main platelet integrin, which is a transmembrane sugar-protein complex. Its role as a receptor, mediated platelet fibrinogen binding to the surface and subsequent platelet aggregation. A case-control study of the United States to observe the PIA2 GPIIIa gene polymorphism (Leucine -33 was replaced by proline) and emergency thrombosis between the association, its significance in the notice of hypertension, smoking, high cholesterol or hyperlipidemia Diabetes and other known risk factors for coronary heart disease on.
Homocysteine: high homocysteine (Hey) is produced during the metabolism of methionine a sulphur content of amino acids, several case-control study of the plasma Hcy had a high level, high rates of coronary heart disease. European collaborative action plans to further affirmed it as an independent risk factor.
Lipoprotein (a): lipoprotein (a) [LP (a)] and the lipid composition similar to LDL, the protein apo (a) part of how kringle structure, with a high degree of homology pro fiber solution. It can direct role in protein and fiber, can inhibit the fibrinolytic plasminogen role. In structure, it has to thrombosis and atherosclerosis of the potential.
Of atherosclerosis spectrum of lipoprotein (ALP): caused by atherosclerosis of the spectrum lipoprotein (atherogenic lipoprotein profile, ALP) is a certain genetic basis of several metabolic disorders integrated. AS mainly shown by the strong role of small particles of low-density lipoprotein (LDL2) increased, high triglycerides (TG) hyperlipidemia and low levels of HDL. Are accompanied by insulin resistance based on the metabolic syndrome (Reaven's Syndrome X). Germany PROCAM study early
The definition and classification of coronary heart disease
What is coronary heart disease »
All of coronary heart disease called coronary atherosclerosis of Zangbing, also known as ischemic heart disease. Because of serious coronary atherosclerosis causing lumen stenosis or obstruction, or on the basis of this merger cramps, thrombosis increased lumen obstruction caused nutrition coronary heart insufficiency, cardiac ischemia, or hypoxia occurred infarction A heart attack. In general coronary artery stenosis ≥ 50%, can be said to coronary heart disease.
Coronary heart disease is divided into five types:
1, silent type of coronary heart disease;
2, angina of coronary heart disease;
3, myocardial infarction of coronary heart disease;
4, ischemic cardiomyopathy of coronary heart disease;
5, died of coronary heart disease;
All of coronary heart disease called coronary atherosclerosis of Zangbing, also known as ischemic heart disease. Because of serious coronary atherosclerosis causing lumen stenosis or obstruction, or on the basis of this merger cramps, thrombosis increased lumen obstruction caused nutrition coronary heart insufficiency, cardiac ischemia, or hypoxia occurred infarction A heart attack. In general coronary artery stenosis ≥ 50%, can be said to coronary heart disease.
Coronary heart disease is divided into five types:
1, silent type of coronary heart disease;
2, angina of coronary heart disease;
3, myocardial infarction of coronary heart disease;
4, ischemic cardiomyopathy of coronary heart disease;
5, died of coronary heart disease;
Coronary heart disease is how the
Coronary atherosclerosis in the formation, in the role of various risk factors, coronary artery endothelial cells damage, lipid deposition invasive coronary artery wall, resulting in smooth muscle cells, monocytes and fibroblasts proliferation, platelet aggregation adhesion formation of thrombus , A prominent plaque in the cavity so that the cavity is narrow and blocked blood flow to myocardial ischemia and hypoxia.
The prognosis of coronary heart disease
The prognosis of coronary heart disease depends on the degree of stability and serious diseases, myocardial ischemia is the extent and scope of the more serious and more frequent attack, its occurrence infarction and death may be greater. After myocardial infarction patients has also increased the risk. Active intervention measures have proved to be significantly decreased infarction and coronary heart disease deaths, adhere to strictly regulate the treatment, to improve coronary artery disease and myocardial ischemia can extend life and improve the quality of life.
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