A pounding heart requires an early diagnosis
Keynote speakers:
Professor Chen Qiuxiong, Director of Cardiovascular Department of Guangdong Provincial Hospital of Traditional Chinese Medicine
June 6 is China Atrial Fibrillation Day. When it comes to stroke (stroke), many people think of high blood pressure, diabetes, etc., but in fact, there is a stroke caused by heart disease that is more unexpected and more harmful-that is, atrial fibrillation.
Compared with people without atrial fibrillation, the incidence of stroke in patients with atrial fibrillation is five times higher, and the stroke caused by atrial fibrillation is also more dangerous, and many patients suffer from permanent disability or even death. It is also known as the "invisible killer" behind stroke. What is atrial fibrillation? What's the harm? What does it have to do with stroke? During the COVID-19 pneumonia epidemic, what changes have been made to the treatment plan for patients with atrial fibrillation... Guangzhou Daily Health has an appointment with a famous doctor to launch a series of micro-courses on atrial fibrillation. Professor Chen Qiuxiong, director of the Department of Cardiovascular Science of Guangdong Provincial Hospital of Traditional Chinese Medicine, was invited to give a lecture All questions and answers.
Text and photos / All media reporter Zhang Qingmei of Guangzhou Daily
Atrial fibrillation patients are more likely to have cerebral infarction
Atrial fibrillation is the most common arrhythmia, with clinical manifestations such as palpitations, fatigue, dizziness, chest tightness, shortness of breath, and fast and slow heartbeat. There are 8 million people with atrial fibrillation in Chinese residents aged 30 to 85. With the aging of the population, the number of patients with atrial fibrillation is increasing.
The current research analysis shows that the occurrence of atrial fibrillation originates from abnormal signals sent by the veins of the heart, and these signals spread through the heart through the spread of the heart structure, just like the output of an intricate circuit, of which a large part of heart-related strokes is associated with atrial fibrillation.
"At present, everyone has a lot of knowledge about strokes caused by 'three highs', but strokes caused by atrial fibrillation are more insidious and easy to be ignored. Persistent atrial fibrillation can cause heart enlargement, heart failure, and even sudden death. Atrial fibrillation easily leads to thrombus accumulation. Once the thrombus falls off, 90% of it will cause cerebral infarction.
Every year, 500,000 to 600,000 people in China suffer from stroke due to atrial fibrillation. Cerebral infarction caused by atrial fibrillation has a higher infarct size and a higher mortality and disability rate. Data show that the mortality rate can reach 25% within 30 days and as high as 50% within one year.
A pounding heart should be a cause for alarm
Clinical statistics have found that "three highs", heart failure, advanced age, obesity, valve disease, drinking and smoking, sleep apnea syndrome, and staying up late are all high-risk factors for atrial fibrillation. Professor Chen Qiuxiong introduced, specifically, the main causes of atrial fibrillation are as follows:
Suffering from heart disease, such as coronary heart disease, cardiomyopathy, myocarditis, congenital heart disease, etc.;
Endocrine diseases, such as hyperthyroidism, can cause atrial fibrillation;
Acidosis, acid-base balance disorders, low sodium and potassium levels, electrolyte imbalances, or alcoholic cardiomyopathy caused by drinking alcohol can also cause atrial fibrillation;
Psycho-neurological factors, which are an important factor leading to atrial fibrillation, and are also very easy to ignore.
Physician Zhang Hao from the Department of Cardiovascular Diseases of Guangdong Provincial Hospital of Traditional Chinese Medicine reminded that with the increase of age, the incidence of atrial fibrillation is getting higher and higher, so middle-aged and elderly people should pay special attention. "Patients feel differently, some patients have no symptoms, some patients feel a pounding heart, and some people have shortness of breath and difficulty breathing after exercise... No matter how old the patient is, once the heart pounding occurs, it is necessary to Be vigilant, seek medical attention in time, and preferably do a 24-hour electrocardiogram to clarify the cause."
Stroke caused by atrial fibrillation is preventable and treatable
Chen Qiuxiong said that the cardiac function of patients with atrial fibrillation will be affected, generally only reaching 70% of normal people. Although stroke caused by atrial fibrillation is dangerous, it can be prevented and treated. The key is to do it as soon as possible.
The first thing is to figure out what type of atrial fibrillation you have. If you only have 2 episodes a year, don't worry too much. Attention should be paid to those who have more than 3 episodes a year. If atrial fibrillation persists for more than 7 days, it is necessary to actively intervene to avoid a series of complications.
Chen Qiuxiong said that if atrial fibrillation is caused by valvular heart disease, the valve problem must be corrected first, and then atrial fibrillation is treated. In addition, other causes of atrial fibrillation, whether it is paroxysmal or persistent atrial fibrillation There are three main directions for the treatment of such patients:
Try to control with medication. At present, the treatment of atrial fibrillation mainly relies on anticoagulants, and 80% of patients use anticoagulants.
Radiofrequency ablation to help the heart restore sinus rhythm. At present, catheter radiofrequency ablation of atrial fibrillation can restore sinus rhythm (normal heart rhythm) to the maximum extent, and left atrial appendage closure is a new trend in the treatment of stroke prevention in patients with atrial fibrillation. It can effectively reduce patient mortality, disability rate.
If the ablation cannot be performed, especially persistent atrial fibrillation, the ventricular rate should be controlled for those with a large atrium and a complex structure, so that it does not beat so fast.
In addition, pay attention to daily life, including healthy diet, regular life, proper exercise, regulating mood, releasing stress, quitting smoking and drinking.
"Patients with heart disease should also exercise, but they should choose the exercise method that suits them according to the specific situation. After exercising, they should feel comfortable. They should do what they can and not be too violent."
Reminder: Do not stop taking the medicine without authorization
Clinically, although emergencies caused by atrial fibrillation are not very common, once they occur, they are very harmful. According to Chen Qiuxiong, there are mainly the following three situations:
First, the thrombus fell off and caused a stroke. At this time, you must call 120 immediately and send the patient to the hospital as soon as possible.
The second is that the patient perceives that the symptoms of asthma, dyspnea, and lying unequal are similar to the symptoms of heart failure. At this time, it should be treated according to heart failure, and 120 should be called in time.
Third, some patients will have long pauses when the rapid atrial fibrillation is suddenly converted to sinus rhythm, that is, the short-term arrest, and the patient will faint. If family members or colleagues know that the patient is atrial fibrillation patient, they can help press the heart. , or raise the patient's feet to reduce the probability of brain death, and call 120 in time.
"It is not recommended for patients to take Angong Niuhuang Pills, Suxiao Jiuxin Pills, etc. These have no clear effect, and they should call 120 immediately."
"What I'm most worried about is that patients stop taking the drug without authorization, which often leads to unimaginable consequences." Chen Qiuxiong introduced that he had seen a patient in his 70s who had persistent atrial fibrillation for many years and had been taking anticoagulation according to the doctor's instructions. I stopped taking the medicine at the end of last month because of bleeding gums, but after only 4 days, I developed a severe large-area cerebral infarction, and I was unable to recover when I went to the hospital for rescue.
Guangzhou Daily