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CARDIOLOGY

CARDIOLOGY

1120 Heart Infarction Day: Call 120 in time to fight for “Golden Rescue” 120 points

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Recently, 35-year-old Xiao Li burst into chest pain, sweating, and screaming at 5 o’clock in the morning. The ambulance was sent to our hospital for emergency treatment. The electrocardiogram showed “extensive anterior wall myocardial infarction”. After rescue, blood flow recovery, Xiao Li’s conditionStabilize.About a week or so, I was discharged smoothly.Careful understanding of the medical history, Xiao Li for IT workers, long staying up late, and this myocardial infarction is not unrelated.
Guidance expert: Professor Wang Jingfeng, Secretary of the Party Committee of Sun Yat-sen Memorial Hospital and Director of Cardiovascular Medicine, Sun Yat-sen University, Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial Hospital, and Director of the Chest Pain Center, Associate Professor Luo Nian-Sang, November 20, 2019, is the sixth “heart attack treatment in China”day”.According to clinical data, there are about 1 million patients with acute myocardial infarction each year in China.A considerable number of patients, because of ignoring the early symptoms of myocardial infarction, have delayed the rescue time, so myocardial infarction is also known as the “number one health killer.”How to prevent myocardial infarction?Professor Wang Jingfeng, secretary of the Party Committee of Sun Yat-sen Memorial Hospital and director of Cardiovascular Medicine at Sun Yat-Sen University, reminded that once there is a chest pain, call 120 emergency calls immediately to get time for the rescue.In the presence of these symptoms, it is necessary to promptly “for help”. Acute myocardial infarction is myocardial necrosis caused by acute, persistent ischemia and hypoxia of the coronary arteries, which is often life-threatening.Professor Wang Jingfeng, secretary of the party committee and director of the Department of Cardiology, reminded that once the acute myocardial infarction occurs, the blood supply to some of the heart will suddenly stop. At this time, the blocked coronary artery should be cleared in time to allow the heart to regain blood supply.The ideal time to open a blood vessel is within 120 minutes after the onset of the disease, and every time it is delayed for one minute, there will be a large amount of myocardial cell necrosis.So how do you know if you have a correct diagnosis of your own or your family?Associate Professor Luo Nian-Sang introduced that most of the early patients with myocardial infarction will have the following symptoms: sudden unexplained pain in the area below the navel to below the chin, especially in the middle of the chest, or sudden pain in the left chest.Sweating, nausea, vomiting.About 90% of these phenomena are manifestations of myocardial infarction. At this time, the patient’s family must immediately dial 120 and request first aid.According to reports, the chest pain center is connected with the local 120 emergency center. The patient enters the myocardial infarction rescue network system as soon as he enters the 120 rescue vehicle. 120 will directly send the patient to the nearest chest pain center on the map.At the same time, the medical staff will report the patient’s ECG, blood pressure and other reports at any time on the rescue vehicle to the chest pain center doctor through the on-camera videophone or WeChat, and the chest pain center doctor will guide the doctor on the bus to use the medicine for the patient in real time.The green channel has won valuable time for the treatment of acute myocardial infarction.After the occurrence of myocardial infarction, you should lie still, remembering that the “infarction treatment of 123” rule, the director of the Department of Cardiology, Professor Wang Jingfeng reminded that once you suspect that you have a heart attack, the most important thing is to call for help, call 120 to the hospital.It is worth noting that you must lie flat at this time, don’t tamper with it, don’t walk to the hospital by yourself, and have oxygen inhalation at home or around you. This is the best way to deal with it.After the heart attack occurs, the doctor will take urgent and necessary treatment according to the patient’s condition.Cardiac interventional surgery.In patients who are in emergency intervention, the doctor will probe a metal wire and catheter from the patient’s wrist or thigh root artery, all the way up, into the heart’s coronary artery, to the blocked area, and open the catheter.The balloon expands the part of the coronary artery stenosis and allows the blood flow to return smoothly.Cardiac interventional surgery has a significant effect and minimal trauma.Heart bypass surgery.If the coronary artery disease is very complicated in patients with myocardial infarction, it is difficult to solve the problem by intervention alone. The doctor will recommend heart bypass surgery.That is, using an unobstructed blood vessel (usually taken from a patient or using artificial blood vessels), connecting the upstream and downstream of the blocked blood vessel, allowing the blood to bypass the narrow or blocked artery, like a viaduct, making the original lackThe blood myocardium gets ample blood supply.Cardiac bypass surgery is currently the most effective treatment for coronary heart disease.Drug thrombolysis.If the nearby hospital does not have the conditions for interventional and bypass surgery, then the doctor will also use the expedient – drug thrombolysis, choose intravenous infusion of thrombolytic drugs to dissolve the thrombus, open the blood vessels to the heart.Professor Wang Jingfeng said that after the occurrence of myocardial infarction, although the doctor promptly rescued, the patient’s heart function is often affected. Some people will have a bigger heart after myocardial infarction, and some people’s heart function will be significantly weakened, and may even be due to necrotic myocardium.The rupture causes the heart to rupture and die.Therefore, even if the patient with myocardial infarction recovers, it can’t be careless. It is most important to prevent it.Experts advise: prevention of myocardial infarction from the beginning of the regulation of emotions in addition to timely request for first aid in the onset, in daily life, can also prevent the occurrence of myocardial infarction from the regulation of mood, regular life and so on.Regarding the prevention of myocardial infarction, Associate Professor Luo Nian-Sang gave the following “tips”: 1. Be good at regulating emotions.The mood is kept cheerful, the emotions remain stable and optimistic, the bad stimulation of various life events is treated correctly and handled, and excessive emotional fluctuations are avoided; 2. The regular life rhythm is maintained.Moderate work and rest, to ensure adequate sleep and rest time.Watching TV, playing chess, playing poker, playing mahjong should not be too long;
3. The diet should be balanced and diversified.Eat more fresh vegetables and fruits, eat less animal fats, sugar, cream (especially animal offal, seafood), quit smoking, do not drink hard alcohol; 4. Exercise according to your own situation.You can exercise by swimming, climbing, playing sports, etc.If the physical quality is slightly poor, consider moderate activities, such as health exercises, walking, tai chi, qigong, etc. The key is to adapt to people and not to overload; 5. Regular medical examinations and timely medical treatment.Pay attention to regular check blood pressure, blood sugar, blood lipids and ECG.Usually, especially after a full meal or activity, sudden chest tightness, belching, chest area pain and dizziness, etc., should be checked as soon as possible.(Correspondent: Zhang Yang, Liu Wenqin, Huang Rui)

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CARDIOLOGY

Is heart pain a angina?

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I believe that everyone has seen many symptoms of angina in their daily life, but everyone does not know what symptoms will occur when angina occurs, and they do not know how to take correct first-aid measures in time, which ultimately makes their health unpredictable.Estimated threat.What are the symptoms of angina?Let’s take a look at it in detail!What are the symptoms of angina?(1) angina has crushing pain, tightness, suffocation, burning pain, weight and chest pressure in the upper part of the sternum where sudden pressure of crushing occurs suddenly. The chest pain gradually increases, reaches a high tide in a few minutes, and can be radiated to the inner side of the left shoulder.Neck, lower jaw, upper mid-abdomen or shoulders.What are the symptoms of angina?With cold sweat, gradually reduce later, lasting for a few minutes, can be relieved by resting or taking nitroglycerin.Atypical can be tender in the lower sternum, upper abdomen or pre-cardiac.Some have only pain in the radiation area, such as throat nausea, jaw pain, and cervical tenderness.The symptoms of angina in the elderly are often atypical, but only chest tightness, shortness of breath, and fatigue.Older people with diabetes are even only feeling chest tightness without chest pain.(2) What are the symptoms of angina pectoris not limited to chest angina?The pain is often not limited to the chest, but it is often radiated to the throat in front of the neck, and the neck is felt like being caught.When it is painful, it radiates to the ulnar side and the back of the left upper limb, and radiates to the left shoulder, the three fingers on the inner side of the left hand, and the leg.May be associated with increased heart rate, increased blood pressure, sweating, fear and other sympathetic nervous performance.(3) angina pectoris sustained angina usually lasts for a few minutes or ten minutes, lasting for a few seconds is generally not angina, persisting for several hours without relief and accompanied by systemic symptoms such as sweating, fatigue, etc. may be acute myocardial infarction, and the pain continuesHours or even days are generally not angina or myocardial infarction.The above is the relevant content of the symptoms of angina pectoris, it is clear that the symptoms of angina after the emergence of its symptoms is very obvious, I hope that each of us can understand, to help avoid greater risk of damage.

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CARDIOLOGY

There is a kind of “diarrhea” that is a precursor to death!

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A 63-year-old male patient, accompanied by his wife, went to the hospital.Three days ago, 63-year-old Mr. Liu had abdominal pain and vomiting. At that time, the family did not care. I thought that the common gastroenteritis, after going to the pharmacy to buy anti-inflammatory drugs, the situation got better, but Mr. Liu was still faint.Feeling a little uncomfortable.Last night, Mr. Liu suddenly had a terrible stomachache and diarrhea, and he was sweating at the same time.The family took him to the hospital in the shortest time and said that the patient was upset.According to the experience, the doctor opened an electrocardiogram for Mr. Liu, but the family did not understand it. “It is obviously uncomfortable, why do you want to have an electrocardiogram?”Before the doctor explained it, in the twinkling of an eye, Mr. Liu suddenly slammed into the ground, and the medical staff began to rescue himself and exhausted all methods, but still could not return to heaven… Many people would ask why Mr. LiuThe condition will deteriorate so rapidly, which has to say the relationship between diarrhea and myocardial infarction.Note that diarrhea can induce diarrhea in many patients with myocardial infarction, it is difficult to think that it will induce myocardial infarction due to diarrhea.It is not known that diarrhea can be one of the manifestations of myocardial infarction. If it is not found in time, it will be like Mr. Liu.According to Zhang Yan, a professor at the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, the inferior myocardial infarction is a kind of myocardial infarction. This type of myocardial infarction is caused by special position. When the myocardial infarction occurs, the adjacent radial nerve is stimulated to form the stomach.Symptoms of intestinal disease.This is the main reason why many patients with MI have diarrhea before onset.In addition, during diarrhea, the body tends to lose a lot of water, which causes the blood volume to drop, so that the blood viscosity is increased.This means that the blood flow will slow down, it is easy to form a blood clot, and even cause coronary vascular occlusion, induce angina pectoris, myocardial infarction.Unexpectedly, diarrhea is an atypical symptom of myocardial infarction. The typical symptom of myocardial infarction is angina pectoris in the middle or left of the sternum. There is sudden death and pressure, which lasts for 5 to 15 minutes or more.Under normal circumstances, if the patient has more than 5 minutes of chest pain, it is necessary to be vigilant. For 20 minutes, it is not relieved to be highly suspected of myocardial infarction.In addition to the typical symptoms of these myocardial infarctions, everyone should pay special attention to the atypical symptoms of myocardial infarction, and diarrhea is one of them.Clinically, diarrhea is very likely to be a very important early manifestation of acute large-area myocardial infarction, but it is often overlooked by patients due to lack of experience, resulting in a major disaster.Atypical symptoms of myocardial infarction, not only diarrhea Clinically, 50% of patients, especially the elderly, the symptoms of myocardial infarction are not typical.In addition to diarrhea, the elderly should also pay attention to the following atypical symptoms of myocardial infarction, prevent problems before they occur.1, toothache, jaw pain, neck and shoulder pain Medically, the toothache caused by heart disease is called “cardiac toothache”, the patient will have severe pain when toothache, but the pain is not accurate.Even taking painkillers can’t be relieved, and radiation pain in the neck or tingling in the chest and back often occur.When the patient is also accompanied by sweating, pale, and dying, you should be alert to acute myocardial infarction.2, dizziness headache For the elderly, there are often cerebral circulatory disorders, mostly manifested as dizziness, headache, apathy, lethargy, disturbance of consciousness and so on.It is worth noting that when the heart attack is severe, it will be accompanied by clinical manifestations of limb paralysis or sudden loss of consciousness, convulsions, and the like. In this case, be alert to heart attack.3, palpitations, difficulty breathing For the elderly, there are often atypical symptoms of painless myocardial infarction, especially in diabetic patients.When the patient has symptoms such as abdominal discomfort, palpitations, belching, hypotension, shock, etc., be alert to the heart attack.This is mainly due to the decrease in autonomic dysfunction and poor pain sensitivity in diabetic patients or the elderly.In addition, when coronary heart disease patients suddenly have heart failure, and there is no other reason to explain, you should also consider the possibility of acute myocardial infarction.

Finally, Xiao Ji hereby appeals to everyone to pay more attention to the physical condition of the elderly. When faced with some minor problems in the body, do not take it lightly.Once you find that the elderly have some abnormal symptoms, you should go to the hospital for a checkup.References: [1]. “Why are you worried about abdominal pain and diarrhea?” 39 Health Net.2011-07-15
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CARDIOLOGY

“Net red diet” can prolong life?

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“Diet” is a simple and rude way of losing weight that is not recognized by the public.After the 90s, I began to pay attention to the era of health care. Of course, weight loss must also be scientific, so some people proposed “intermittent fasting (IF).”Similarly, from the diet point of view, intermittent fasting seems to be more reliable than simply “diet”, and gradually become one of the “net red diet.”What are the characteristics of intermittent fasting?Intermittent fasting is different from previous “no difference” diets, which have relatively strict time limits and limit food intake during a certain period of time.The most common ones are as follows: Time-limited fasting: fasting for 12 to 21 hours a day, eating outside of this time, without limiting the amount of calories eaten and the type of food.Fasting every other day: fasting every other day, no food on the day of fasting, and normal eating the next day.Improved fasting: It is too difficult to eat only 3-12 hours a day.It is too difficult to eat every other day.So there is a modified version of the fasting method, which is a normal diet for 5 days a week, randomly selected for two days for fasting or limiting calorie intake.Although there are quite a lot of patterns, there are also studies that show that there is no significant difference between the intermittent fasting and the conventional weight loss effect of reasonable control of caloric intake.So when we are fasting, are we hungry?Intermittent diet reduces the risk of heart failure!At the recent American Heart Association (AHA) Science Annual Meeting, the answer was given—although the weight loss effect may be average, intermittent fasting is actually a lot of benefits.The fasting study included about 2,000 patients with cardiovascular disease, with a ratio of non-fasted to fasted about 4:1.After 4.4 years of follow-up observations, other interfering factors were excluded, and patients with intermittent fasting had higher survival rates and heart failure, compared with patients with cardiovascular disease who did not have intermittent fasting.The risk of myocardial infarction is relatively reduced.Studies have found that during fasting, the nutrients in the blood are relatively reduced, while the concentration of toxic stress hormones is higher.At this point, the immune cells are stored in a nutrient-rich bone marrow compartment and remain alive, waiting for the next “going out.”Intermittent fasting not only does not destroy these immune cells, but also allows them to evolve stronger immunity.Researcher Dr. Horn said that fasting affects people’s hemoglobin, red blood cell count, growth hormone levels, etc., and also reduces sodium and bicarbonate levels, activates ketosis and autophagy, and these chain reactions cause heart failure.And the risk of coronary heart disease declines.So how long does it take to fasten the effect of “protecting the heart”?The researchers pointed out that it usually takes more than 12 hours to fasten the experiment, usually one or two days a week.Isn’t everyone suitable for intermittent fasting?Don’t worry.Although many studies have shown that the benefits of intermittent fasting are many, the specific mechanism is still unclear, and most of the research results are obtained from animal experiments or medical staff under strict supervision. At present, as an ordinary person, “longevity”The method is pretending to be early.For pregnant women, pregnant women and lactating women, young children and frail elderly are not suitable for intermittent fasting diet.In addition, patients who have undergone organ transplantation, have their own immune system suppressed, and are experiencing acute or severe chronic infections are not suitable for intermittent fasting.In short, although intermittent fasting has many benefits, it still needs to be weighed in many ways. It is not appropriate to follow suit blindly.39 Health Network (www.39.net) original content, can not be reproduced without authorization, offenders.For content cooperation, please contact: 0000 or 0000

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CARDIOLOGY

Happy, your cardiovascular is healthy!

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From November 16th to 18th, the annual American Heart Association (AHA) Science Conference is in full swing in Philadelphia, USA.At the meeting, two studies with similar conclusions attracted our attention. Heart disease is closely related to depression and psychological stress. Moreover, only women’s psychological stress is related to heart disease, and there is no such connection among men.Does this mean that our lesbians are more likely to have heart disease because of their sentimentality??Learn about these two studies together.Heart disease is not only a physiological problem, but also a psychological problem. People with poor temper and temper are prone to high blood pressure and heart disease. In the public’s cognition, there is a vague concept of “emotional and heart disease.”The findings of the first study complement our perception that depression is also associated with heart disease.The study was conducted by a research team of the American Heart Association’s Dallas Health Information and Analysis team. The researchers investigated adult and non-fatal heart disease (such as heart failure, coronary heart disease, angina, heart attack) in adults over 20 years of age in the United States.Or the link between strokes.The study included more than 11,000 adults diagnosed with depression by using the Depression Questionnaire completed in the National Health and Nutrition Examination Survey (NHANES).About 1200 of these people have heart disease or stroke.The “Life’s simple 7” (ie blood pressure, cholesterol, blood sugar, activity, nutritional status, weight, smoking) developed by AHA was corrected.And by confounding factors such as age, income, education, gender, and ethnicity/ethnicity, by quantifying the link between depression and non-fatal heart disease and stroke, the team found that every level of depression increases – mild,Moderate, moderate or severe – the prevalence of nonfatal heart disease and stroke increased by 24%.Women’s psychological stress, cardiovascular events are well-known, stress will increase the body’s inflammatory response, leading to increased risk of heart attack and other major cardiovascular events.This second study from the AHA Science Conference found a gender difference in this physiopathological process: psychological stress only increases the risk of serious cardiovascular events in women with heart disease, which is not the case in men.The study was completed by an epidemiological team at the Emory University School of Public Health. The researchers measured 615 men and women who had heart disease (mean age 63 years, women 25%) before and after psychological stress activities.A change in the biomarker that reflects inflammation.To simulate stressful activities, the research team arranged participants to conduct a short speech test that included 2 minutes of preparation time and 3 minutes of presentation time.The tester’s inflammatory biomarkers—interleukin-6 (IL-6), monocyte chemoattractant protein 1 (MCP-1), and metalloproteinase-9 (MMP-9) were measured before and after psychological stress activities.Level.The specific operation level is to collect blood samples for measurement when the subject is at rest, and to collect the measurement again 90 minutes after preparation and speech (to give the body a certain time to produce and release inflammatory factors into the circulatory system).The results showed that under psychological stress – for every 1 unit increase in IL-6, the risk of serious cardiovascular events in women with heart disease increased by 41%; for every 10 units of MCP-1, women had serious heartThe risk of vascular events increased by 13%.However, with the increase in IL-6 or MCP-1, the risk of serious cardiovascular events in men has not increased.These findings are consistent with previous studies, suggesting that women with heart disease have different biological responses to stress than men, which may increase their risk of serious cardiovascular events.What can we do to deal with the psychological state and the risk of heart disease?In this way, not only is the temper associated with heart disease, depression and stress, but also a strong connection with heart disease.Mental and psychological stress, including depression, is associated with multiple heart attacks and interacts with each other.Researchers say that in clinical work, the role of psychosocial stress, or stress in daily life, is often not fully understood and focused, nor is it included in cardiovascular risk prevention guidelines.Researchers are calling on health care providers to provide effective advice to heart patients, especially women.Medical staff should help patients recognize the importance of “reducing stress through appropriate interventions” and provide them with appropriate mental health care and support.Well, my friends, life has been so difficult, the depression is bad enough, and now the risk of heart disease has increased?Even more exasperating is to specifically pick women to start… If you are advised to be happy, the small world does not want to stand and talk and not hurt.I only hope that you, dear, will remember your little heart and try to reduce the psychological stress.Don’t bear it alone in a state of depression. People who are willing to help you and that… there are so many!.
Remember the simple pleasure of being happy for a whole month after a new child?Do you remember the pleasure of smashing popsicles on the side of the road with your little friends?Don’t worry, they will all come back.You – never alone! , please do not reprint without the authorization of the copyright owner.

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CARDIOLOGY

Eating heart after 6 pm?

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On November 16th, local time, the American Heart Association (AHA) Science Annual Conference kicked off in Philadelphia, USA.When Xiao Bian was seriously watching the topic, there was a study that successfully attracted my attention – eating in the evening may damage the heart… 01 7 indicators, how many do you do?The researchers conducted a one-year study of 112 women aged 33 or so. At the beginning and end of the study, seven indicators from the American Heart Association’s “Life’s simple 7” were used to assess cardiovascular health.Indicators include non-smoking, active exercise, eating healthy foods, controlling weight, and measuring cholesterol, blood pressure and blood sugar levels.Heart health scores were calculated based on Life’s simple 7.Where does this indicator come from?Life’s Simple 7 is a cardiovascular health guide issued by the American Heart Association in January 2010. It improves the diet and lifestyle of people through seven indicators to ensure cardiovascular health.The goal of this guide is to increase cardiovascular health in the United States by 20% by 10 years, while reducing cardiovascular mortality by 20%.A healthy lifestyle, with reference to Life’s Simple 7, guides you to reduce risk factors and improve cardiovascular health by changing lifestyles.Women who participated in the study recorded their daily diet on a computer or mobile phone and recorded their meal time.Researchers used data to study the relationship between eating time and cardiovascular health.The researchers found that although most of them ate after 6 pm, those who consumed more calories after 6 pm had poorer cardiovascular health.For every 1% increase in calorie intake after 6 pm, cardiovascular health will decline.Specifically, women who consumed more calories after 6 pm had higher blood pressure, BMI levels, and poorer long-term control of blood glucose.This is especially true when eating after 8 pm.The principal of the study, Dr. Nour Makarem, a postdoctoral fellow in cardiology at the Vagelos College of Physicians and Surgeons, said: “So far, most of our research has been limited to what to eat and eat.The results of this study suggest that controlling the amount of time spent eating at night and the amount of calories ingested may be a viable way to protect your heart.” This reminds Xiaobian of the United States in San Francisco in March this year.A study on the annual meeting of the Diabetes Association (ADA)… 02 In the morning, like the emperor, the evening is like the lecture of the topic, the University of Alabama expert Courtney Peterson said: close to sleep time orIt is the same amount of calories that eats and eats while sleeping, which is more fattening than eating at an earlier time.That is to eat dinner too late or eat supper, especially to make people gain weight.The expert proposed a plan to eat a big meal for breakfast, reduce food for dinner and eat early.She believes that the food ratio of early, middle and late should be 50%: 30%: 20%.As for why eating later, the expert said – because our body follows the circadian rhythm.In the 24-hour cycle of circadian rhythms, our bodies follow the laws of metabolism, physiology and behavior.From 18:00 to 21, we are at the highest blood pressure.From 6 am to 9 am, it is the fastest time for blood pressure to rise.(Specific content to see here: no lunch, dinner should be like 乞丐! ADA announced the best meal time and order!) Also mentioned a point that everyone can practice, is to eat much less than at night to eat lessPeople who eat much in the morning have much less hunger.This little editor has deep experience, and it is true that eating too much for breakfast is not very hungry.04 Do not eat after 6 o’clock, how about going to bed early?Although the expert’s research said that after 6 o’clock, eating and hurting the heart, but now the white-collar workers may have just got off work at 6 o’clock, and have not counted overtime (the daily work of the small series), this point must not have or just eaten.However, the study also mentioned that people who consume more calories are more harmful, so it is actually a good idea to eat at night. Xiaobian only eats vegetarian dishes and high-protein fish at night. How do you eat?Welcome to leave a message to discuss and discuss!Second, it is the problem of sleeping.Sleeping late at night is indeed the reason why everyone eats nightingale, and is one of the causes of obesity!Previously, Xiaobian also saw a study saying that after four days and nights, it would be fat. I believe that many people who work overtime and night work are reflected in the legendary “overwork!”.
Even if it is “overwork,” it is not fat!So, ask if you want to eat less at night and go to bed early!Not much to say, Xiaobian wants to wash and sleep. , please do not reprint without the authorization of the copyright owner.

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CARDIOLOGY

Summary of article: atrial fibrillation anticoagulant therapy, heart rate control and rhythm control

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Anticoagulant anticoagulant therapy reduces the risk of thromboembolic stroke in patients with atrial fibrillation, but at the same time increases the risk of intracranial hemorrhage and other severe bleeding.Patients taking non-valvular atrial fibrillation (patients with atrial fibrillation without moderate-to-severe mitral stenosis or without mechanical valve replacement) should take oral anticoagulants depending on the patient’s CHA2DS2-VASc score.The guidelines recommend that males with CHA2DS2-VASc≥2 points and women with ≥3 points should receive oral anticoagulant therapy; men with CHA2DS2-VASc=1 points and women with CHA2DS2-VASc=2 points may be considered for oral anticoagulant therapy;Males with CHA2DS2-VASc=0 and women with CHA2DS2-VASc=1 did not need anticoagulation therapy.All patients with atrial fibrillation with moderate to severe mitral stenosis and mechanical valve replacement should be treated with anticoagulation.1. Selection of anticoagulant therapy Currently, non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban and edoxaban), also known as direct oral anticoagulationDrug (DOAC) or a new oral anticoagulant, rather than the vitamin K antagonist warfarin (coumarin or other), is recommended for patients with non-valvular atrial fibrillation.Patients with moderate to severe mitral stenosis or mechanical valve replacement should be treated with warfarin.2. Left atrial appendage sealing left atrial appendage (LAA) is the main source of thromboembolism in patients with atrial fibrillation.In patients undergoing cardiac surgery, LAA closure can reduce the risk of thromboembolism.For patients with non-surgical atrial fibrillation with long-term anticoagulation contraindications, percutaneous left atrial appendage closure may be considered.Heart rate control In the first-line treatment of chronic atrial fibrillation, ventricular rate control has been widely accepted as an alternative to rhythm control.Because antiarrhythmic drugs have a certain toxicity, the use of these drugs for rhythm control is not superior to simple heart rate control in preventing serious complications.Loose heart rate control (resting heart rate <110 bpm) is especially easy to achieve in patients with normal structure and no heart failure, and is as effective as strict heart rate control (resting heart rate <80 bpm).In addition, heart rate can be controlled by atrioventricular node ablation and permanent ventricular pacing in some patients.1. β-adrenergic blockers intravenous β-blockers (such as metoprolol or esmolol) can acutely control ventricular rate during atrial fibrillation or atrial flutter.Oral beta blockers are commonly used for long-term heart rate control.For patients with coronary heart disease or systolic dysfunction, beta blockers are superior to calcium channel blockers.However, patients with asthma or decompensated heart failure should be used with caution.2. Calcium channel blocker Non-dihydropyridine calcium channel blocker, diltiazem and verapamil can effectively slow the ventricular rate in atrial fibrillation and atrial flutter.In patients with underlying heart disease, intravenous injection of these drugs can cause hypotension or bradycardia, especially when using a cardiac inhibitor (such as a beta blocker).For patients with asthma, long-term use of diltiazem and verapamil or better than beta blockers, but they can not be used in patients with decompensated heart failure or Wolff-Parkinson-White syndrome.Unlike diltiazem and verapamil, dihydropyridine calcium channel blockers (all other calcium channel blockers are available in the United States) usually do not have heart rate control.Rhythm Control For emergency cardioversion in patients with symptomatic or unstable AF, DC cardioversion should be preferred.Antiarrhythmic drugs, especially amiodarone, are also used to restore and maintain normal sinus rhythm.1. Antiarrhythmic drugs Currently, antiarrhythmic drugs can be used to prevent the onset of paroxysmal atrial fibrillation and to maintain sinus rhythm after cardioversion.2. Catheter ablation radiofrequency ablation can restore sinus rhythm, and may be superior to antiarrhythmic drugs in maintaining sinus rhythm, improving symptoms, exercise capacity and quality of life.Related complications are rare but can be fatal.In patients with symptomatic heart failure and reduced ejection fraction, catheter ablation reduces hospitalization and mortality in patients with heart failure. Weight loss obesity is one of the risk factors for atrial fibrillation.In a randomized trial, 150 symptomatic atrial fibrillation and BMI >27 kg/m2 were included.Studies have shown that structured weight management procedures can reduce the number, severity, and duration of atrial fibrillation episodes compared to simple lifestyle recommendations. , please do not reprint without the authorization of the copyright owner.

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CARDIOLOGY

Women who eat much later in the evening are more likely to have cardiovascular disease

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From November 16th to 18th, 2019, the American Heart Association (AHA) scientific conference will be held in Philadelphia, USA.According to a preliminary study published in advance, women who ate more late in the evening were more likely to have cardiovascular disease than women who did not.
In this preliminary study, researchers evaluated 112 women (average age 33 years, Hispanic 44%) at the beginning and one year after the study using the American Heart Association’s Cardiovascular Health Guide Life’s Simple 7 indicator.) cardiovascular health.The researchers then calculated the heart health score based on the Life’s Simple 7 indicator.Life’s Simple 7 is the first cardiovascular health guide issued by the American Heart Association in January 2010. It improves people’s diet and lifestyle through seven indicators to achieve optimal cardiovascular health.The goal of the guide is to increase cardiovascular health in the United States by 20% from 2010 to 2020 and reduce cardiovascular mortality in the United States by 20%.These 7 indicators refer to maintaining a body mass index (BMI) of 18.5 to 24.5; a moderate exercise of at least 150 minutes per week or a vigorous exercise of 75 minutes; quitting smoking at least one year ago, or never smoking; ensuring total cholesterol levelsLess than 200 mg/dL; maintain blood pressure below 120/80 mmHg; fasting blood glucose levels below 100 mg/dL; meet five key healthy dietary ingredients of AHA—eat more than 4 and 1/2 cups of fruits and vegetables per dayEat at least two oily fish (such as squid, squid and squid), eat less sweets, eat three or more whole grains a day, and eat less than 1500 mg of sodium a day.To maintain a healthy diet.The study participants recorded electronic food diaries on a computer or mobile phone and reported what they ate, how much they ate, and when they were eating within a week of the study and 12 months later.The data in the food diary completed by each female participant was used to determine the relationship between heart health and the time they were eating.These researchers made the following findings: (1) Although most study participants ingested some food after 6 pm, people who consumed more calories per day after this time had worse heart health.(2) For every 1% increase in calorie intake after 6 pm, heart health will decline.(3) Specifically, women who consume more calories after 6 pm are more likely to have higher blood pressure, higher body mass index, and poor long-term glycemic control.(4) After 8 pm, every 1% increase in calorie intake, similar results will appear.(5) This effect on blood pressure is more pronounced in Hispanic American women who consume most of the calories at night, even after adjusting for age and socioeconomic status.The study’s lead author, Dr. Nour Makarem, associate researcher at the University of Columbia’s Waglos School of Internal and External Medicine, said, “So far, the lifestyle to prevent heart disease has focused on what we eat and how much we eat. These preliminary results suggest thatThe intake time and proportion of calories during dinner, and intentional control of eating at night may represent a simple and modifiable behavior that may help reduce the risk of heart disease.” Makarem is also an early childhood professional committee for epidemiology and prevention at the American Heart Association.A member of the American Heart Association’s Council on Epidemiology and Prevention Early Career Committee.He said that these results should also be verified in larger samples and in other populations.
The American Heart Association funded the study through the Go Red For Women Strategically Focused Research Network program.Dr. Kristin Newby, Chairman of the Network Oversight Advisory Committee, a research focus on the cherished women’s heart, said that such research is important to help women of all ages better understand and manage their health risks.Newby is also a professor of medicine and cardiology at Duke University in Durham, North Carolina.He said, “I think this is an important study. For now, it is basic, informative, but not conclusive, but I think it is nutritional and its cardiovascular risk factors.The relationship provides some very interesting new insights that we have never considered before. Whether you are 20, 30, 40, or 70 or 70, start thinking about your heart health.It’s too early. If you are healthy now or you have a heart attack, you can always do more. This is accompanied by agility and heart health.”

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CARDIOLOGY

Matsumoto’s suspected stroke was admitted to hospital and is now out of danger!

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Japanese media reported that on November 16th, Japanese book-level cartoonist, “The Galaxy Express 999” and “Space Battleship Yamato” and other outstanding works, Matsumoto, had difficulty breathing after attending a movie theater in Turin, Italy.Suspected of stroke symptoms, was urgently sent to the hospital for rescue.It is understood that Matsumoto has been out of danger on the evening of November 16, and the hospital said that he only had difficulty breathing and had no stroke.The 81-year-old Matsumoto has escaped the “stroke”, but some people are not so lucky.Stroke is the number one cause of death among Chinese residents. It is very violent and urgent. It is often dangerous. Even if it is rescued, patients often leave a lot of sequelae, which greatly affects the quality of life in the future.Although the stroke is sudden, there are also a few “signals” hidden in it. Grasping these clues will reduce the danger as much as possible.Signal 1: Drowsiness, no sorrow, yawning, do you feel that you don’t sleep enough?No matter how long you take a break, you still can’t get tired of your body and even yawn.This may be caused by a narrowing of the blood vessels in the brain, resulting in the inability to supply enough blood oxygen.Signal 2: People who speak fluently when the mouth is unclear or the mouth is level, suddenly there are symptoms of slurred speech and even drooling, which is likely to be a manifestation of stroke.Signal 3: transient black blindness, short-sighted vision blurred if there is a sudden blackout, can not see things, but will recover after a few seconds or a few minutes, or a short visual impairment, and recover within an hour,And don’t leave sequelae, don’t be lucky, it may be a precursor to a stroke.Sudden ischemia in the brain may cause short-term black blindness and blurred vision. Patients are often accompanied by dizziness, nausea, and vomiting.Signal 4: The arms can not be flat on one side of the limbs, which is one of the main manifestations of stroke.If your arms cannot be lifted to the same level as your shoulders at the same time, even if one arm cannot lift, you need to be vigilant.In addition, suddenly feel the hands and feet are not flexible, numbness, unable to stabilize the grip, etc., may also indicate a stroke.Signal 5: Sudden severe headache Blood pressure will rise sharply before stroke, and severe headache will occur. At this time, you need to call 120 immediately for rescue.The symptoms of stroke are often less obvious, often only a few hours or days, and are easily overlooked by patients, thus delaying the optimal treatment opportunity.When the above abnormalities occur, whether it is a high-risk group of strokes, you should pay attention to it, and seek medical advice and treatment in time.

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CARDIOLOGY

Before the onset of myocardial infarction, 10 major pain “parts” illustration!

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Li Wei is 72 years old. Five days ago, he found that his right lower plate was dull and painful. He thought it was periodontitis. After eating anti-inflammatory drugs for three days, his toothache still didn’t improve. He went to the dental clinic for examination.However, during the examination, Li Wei had symptoms of asthma and chest tightness, and the family quickly sent him to the big hospital.In the emergency department, Li Wei was almost in a coma. After being rescued, he was sent to the intensive care unit.After electrocardiogram and other examinations, Li Wei was the heart failure caused by myocardial infarction. After the doctor’s active rescue, Li Wei finally got out of danger.Why is it a toothache, but later it is a heart stalk?The doctor said that Li Wei has had coronary heart disease for many years. This time he felt that the toothache was not a real toothache, but a symptom of an acute myocardial infarction.Middle-aged and elderly people, especially those with cardiovascular disease, diabetes, high blood fat and long-term smoking and drinking, do not regard toothache as inflammation of the teeth and neglect the possibility of myocardial infarction.The symptoms of myocardial infarction are not only chest pain, but also various “involving pain”, which is easily overlooked and delayed.Because of the pain of the heart attack, it can cause pain to radiate to other parts of the body. For example, toothache is one of them.In general, there are ten common sites of myocardial infarction.The ten parts of the body are painful. Be alert to the heart stalk!

In addition to pain in the onset of myocardial infarction, there are five times when the heart attack is high, and these five moments are called the devil’s moment of the heart.The 5 devils always have one time: many elderly people with myocardial infarctions go to the toilet when they go to the toilet. This is because middle-aged and elderly people need excessive exertion when they experience poor bowel movements, resulting in increased intra-abdominal pressure.The blood pressure rises rapidly, adding a burden to the heart.If you have high blood pressure disease, it is easier to induce myocardial infarction.Therefore, middle-aged and elderly people with coronary heart disease should pay attention to not excessive force during defecation. If necessary, they can use drugs to assist defecation, so as not to induce myocardial infarction.Time 2: Alcohol can cause brain excitement, blood pressure, heart rate, and arrhythmia when drinking alcohol. If you have cardiovascular and cerebrovascular diseases, it is easy to induce acute myocardial infarction.Therefore, patients with coronary heart disease need to avoid alcohol in peacetime, but also pay attention to diet.Time 3: When we are taking a bath, when we are taking a bath, the blood vessels of the whole body are in an expanded state. If there is an elderly person with cardiovascular and cerebrovascular diseases, in the relatively closed space of the bathroom, it is easy to cause heart and cerebral ischemia due to lack of oxygen.Thereby inducing myocardial infarction.Older people with cardiovascular disease should not take a bath after a meal or when they are hungry. The bath time should not be too long. The water temperature is best like body temperature. Older people should best carry out with the help of others.Time 4: When getting up in the morning, people just wake up from sleep, breathing and heartbeat will start to accelerate, and blood circulation will also speed up. For the elderly, aging blood vessels are easily ruptured by blood flow and form blood clots.Finally, it causes a heart attack.Don’t worry when you wake up in the morning, you must first move slowly in bed and get up again.Time 5: Many people think that snoring is normal when snoring, but sleeping snoring is actually potentially dangerous.When a person snoring, there will be an apnea, and the myocardial oxygen consumption will increase, which may lead to acute myocardial ischemia. In severe cases, the myocardial infarction will be induced.If you always snoring while sleeping, you should go to the hospital for treatment.Once a heart attack occurs, time is life, because myocardial infarction is a time-dependent disease, only 4-6 hours to rescue the golden period.However, many people have made mistakes in the case of myocardial infarction, resulting in many patients losing the best treatment time.Experts say that when you encounter a heart attack, you must remember that 2 don’t, 1 must.First aid in myocardial infarction, 2 don’t, 1 must drink water. Many people think that they should drink more water when they have a myocardial infarction. However, if the patient is already fainted and unconscious, drinking water is prone to aspiration, leading to aspiration pneumonia.For patients with myocardial infarction, it is undoubtedly worse.In addition, if you drink too much water for a patient with a myocardial infarction, the water will quickly enter the bloodstream, diluting the blood and increasing the blood volume, adding an extra burden to the heart that is already fragile.Do not blindly cardiopulmonary resuscitation Although cardiopulmonary resuscitation is a common first-aid method, it is not necessary to use it for patients with myocardial infarction, but to judge the patient’s condition first.Cardiopulmonary resuscitation is suitable for patients with heartbeat and respiratory arrest, but patients with myocardial infarction do not necessarily have breathing and heartbeat. If cardiopulmonary resuscitation is performed on patients with myocardial infarction who have breathing or heartbeat, it will increase the risk of arrhythmia and cause death.It is necessary to dial 120 for patients with myocardial infarction in time. If it is not a professional medical staff, it is difficult to make a correct judgment to take first-aid measures. It is best to call 120 emergency calls immediately. Do not drive or go to the hospital by yourself, so as not to miss the best treatment.time.Middle-aged and elderly people must remember that a heart attack is not only a chest pain, but other symptoms can not be ignored.A few noteworthy moments, be careful and be careful. If you have a heart attack, remember to “2 don’t, 1 must”.This article is full of dry goods, worth collecting and sharing!Reference article: 1, “Shoulder pain after a week!Don’t neglect the 10 major painful parts of the heart attack + 10 devil moments. Health Times. 2019-07-022, “Toothache may also be myocardial infarction”. People’s Daily Online – Life Times. 2018-10-223,Heart attack “illustration of pain”, remember the key moment to save your life!》.澎湃新闻.2019-09-05
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