If your heart is pounding, you need to see a doctor as soon as possible.
Keynote speakers:
Professor Chen Qiuxiong, Director of Cardiovascular Department, Guangdong Provincial Hospital of Traditional Chinese Medicine
June 6th is China Atrial Fibrillation Day. When mentioning stroke (stroke), many people think of high blood pressure, diabetes, etc., but in fact, there is another kind of 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 strokes caused by atrial fibrillation are also more dangerous, and many patients suffer permanent disability or even death. It is also known as the "invisible killer" behind strokes. 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 micro-course to launch a special series of micro-courses on atrial fibrillation. Professor Chen Qiuxiong, director of the Cardiovascular Department of Guangdong Provincial Hospital of Traditional Chinese Medicine, is invited to teach Answer your questions.
Text, pictures/Guangzhou Daily all-media reporter Zhang Qingmei
Patients with atrial fibrillation are more likely to have a stroke
Atrial fibrillation is the most common arrhythmia, clinical manifestations are palpitations, fatigue, dizziness, chest tightness, shortness of breath, fast and slow heartbeat, etc. There are 8 million patients with atrial fibrillation among residents aged 30 to 85 in China. With the aging population, the number of patients with atrial fibrillation is increasing.
The current research analysis shows that the occurrence of atrial fibrillation originates from the abnormal signals sent by the veins of the heart, and these signals spread throughout the heart through the dissemination of the heart structure, just like the output of intricate circuits, and a large part of strokes related to the heart Associated with atrial fibrillation.
"At present, everyone has more understanding of strokes caused by 'three highs', but strokes caused by atrial fibrillation are more insidious and easily overlooked. Once they occur, they will be more harmful." Professor Chen Qiuxiong introduced, long-term, Persistent atrial fibrillation can cause heart enlargement, heart failure, and can even lead to sudden death. Atrial fibrillation can easily lead to thrombosis, and once the thrombus falls off, 90% of them 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 death and disability rate because of the larger infarct size. Data show that the mortality rate can reach 25% within 30 days and 50% within one year.
Be vigilant when your heart is pounding
Clinical statistics found that "three highs", heart failure, advanced age, obesity, valvular disease, drinking and smoking, sleep apnea syndrome, and staying up late are all high-risk factors for atrial fibrillation. According to Professor Chen Qiuxiong, 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 imbalance, low sodium and potassium, electrolyte imbalance, or alcoholic cardiomyopathy caused by drinking can also lead to atrial fibrillation;
Psychiatric and neurological factors, which are important factors leading to atrial fibrillation, are also very easily overlooked factors.
Dr. Zhang Tong from the Cardiovascular Department 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 heart pounding, and some people have shortness of breath and difficulty breathing after activities... No matter how old the patient is, once the heart pounding occurs, it is necessary to Be vigilant and see a doctor in time, it is best to have a 24-hour electrocardiogram to clarify the cause."
Stroke caused by atrial fibrillation can be prevented and cured
Chen Qiuxiong said that the heart function of patients with atrial fibrillation will be affected, generally only reaching 70% of normal people. Although stroke caused by atrial fibrillation is very harmful, it can be prevented or treated. The key is to do it as early 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. Pay attention to those with more than 3 episodes a year. If the atrial fibrillation persists for more than 7 days, you must actively intervene to avoid a series of complications.
Chen Qiuxiong said that if the atrial fibrillation is caused by valvular heart disease, the problem of the valve must be corrected first, and then the atrial fibrillation should be dealt with. In addition, other causes of atrial fibrillation, whether paroxysmal or persistent , there are three main directions in the treatment of such patients:
Control medication as much as possible. At present, the treatment of atrial fibrillation mainly relies on anticoagulant drugs, and 80% of patients must use anticoagulant drugs.
Radiofrequency ablation to help the heart restore sinus rhythm. At present, catheter radiofrequency ablation of atrial fibrillation can maximize the return of patients to sinus rhythm (normal heart rhythm), and left atrial appendage occlusion is a new trend in the treatment of stroke prevention in patients with atrial fibrillation, which can effectively reduce patient mortality, disability rate.
If ablation is not possible, especially for persistent atrial fibrillation, the rate of the ventricle should be controlled to prevent the heart from beating so fast if the atrial fibrillation is large and complex.
In addition, daily life should also pay attention, including healthy diet, regular life, proper exercise, regulating mood, releasing stress, quitting smoking and drinking.
"Patients with heart disease also need to exercise, but they should choose an exercise method that suits them according to the specific situation. The main thing is to feel comfortable after exercising. They should do what they can and not be too violent."
Reminder: Do not stop the medicine without authorization
Clinically, although the emergency caused by atrial fibrillation is not very common, once it occurs, it will cause great harm. According to Chen Qiuxiong, there are mainly the following three situations:
One is that the thrombus falls off and causes 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 feels that the symptoms of asthma, dyspnea, and uneven lying are similar to the symptoms of heart failure. At this time, it should be treated according to heart failure and dial 120 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 had a severe large-area cerebral infarction, and I was unable to recover when I went to the hospital for rescue.
Guangzhou Daily