Toothache, sore throat, neck and back pain may be your heart sounding the alarm!

Staying up late, working overtime, and being under great pressure are topics that cannot be avoided. Recently, 38-year-old Xiao Yan encountered the year-end performance assessment stage. After working overtime for several days, he felt pain in his left shoulder. At first, he didn't take it seriously, thinking it was a shoulder and neck problem caused by sitting for a long time. However, not long after, the symptoms of toothache appeared again, accompanied by chest tightness, chest pain, and general fatigue. Xiao Yan quickly called 120 and went to the hospital emergency room. After an examination, it was terrible that he had a heart attack at such a young age, and the situation was extremely dangerous!

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01

What is a heart attack?
The heart is a real model worker, working non-stop. This continuous, high-intensity work requires sufficient energy. Oxygen and sugar are the main raw materials for the heart to produce energy, and these nutrients come from the blood transported by the coronary arteries. The coronary arteries are divided into the left coronary artery (including the left main trunk, the anterior descending branch, and the circumflex branch) and the right coronary artery, which conscientiously supply blood oxygen to the heart to ensure that the heart maintains normal function.

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Myocardial infarction refers to an acute blockage of the coronary arteries, insufficient blood supply to the myocardium, resulting in myocardial ischemia and necrosis, which can be a life-threatening emergency. Among them, coronary atherosclerosis is the most common cause of myocardial infarction. Previous heart disease, smoking, diabetes, dyslipidemia, overweight or obesity, unreasonable diet, long-term sitting, lack of exercise, stress, emotional excitement, weather changes, etc. are all causes of acute myocardial infarction.

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In response to Xiao Yan's condition, the hospital immediately arranged for an emergency coronary angiography. The results showed that the 38-year-old body had the blood vessels of an 80-year-old! Coronary angiography confirmed that Xiao Yan had two major coronary arteries with severe stenosis, one of which was almost completely occluded and had thrombosis. It was this blockage of the blood vessel that prevented blood oxygen from being supplied to the heart in time, causing large areas of myocardial ischemia and necrosis. If he had not been sent to the hospital in time, he would have been at risk of sudden death at any time. The doctor placed a stent in Xiao Yan's blood vessels and brought him back from the brink of death.

02

Why do young people also suffer from heart attacks?

Xiao Yan was very puzzled: he doesn't smoke, doesn't drink, and isn't very old, so how could he have a heart attack? Isn't myocardial infarction considered an old age disease? Studies have shown that myocardial infarction is no longer a disease that only affects the elderly, and more and more young people are being quietly targeted by it. In recent years, the incidence of acute myocardial infarction in people under 45 has been increasing year by year. Staying up late to work, stay up late to watch TV series, stay up late to play games, stay up late to browse the phone... However, even the youngest body can't stand the constant tossing of 997 or 857. Therefore, staying up late may not necessarily lead to financial freedom, but may lead to ending up in the ICU.

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An unhealthy lifestyle is often accompanied by unhealthy diet, overweight or obesity, long periods of sitting, etc. Xiao Yan admitted that when he was busy with work, he would just eat a few bites at a time. The more tired he was, the more he wanted to eat something "heavy". Milk tea, desserts, and supper were common. The gym membership card he bought a year ago was already gathering dust in the drawer. He had no time to go there when he was busy. When he didn't work overtime, he just wanted to go home and lie down like Ge You.

The heart has been "ravaged" by an unhealthy lifestyle for a long time and has become vulnerable. Mental stress and overwork are often the last straw that breaks the camel's back.

Smoking, unhealthy diet, irregular work and rest, staying up late for a long time, mental stress, overwork, sitting for a long time without exercise, being overweight or obese... young people take advantage of their young age and do not pay attention to their lifestyle, which may greatly increase the risk of myocardial infarction.

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Therefore, the occurrence of myocardial infarction does not happen overnight, but has long been "foreshadowed" in every aspect of life. Young people often have an acute onset of myocardial infarction, and usually do not have pre-adaptation of myocardial ischemia such as angina pectoris. Compared with the elderly, young people have a greater myocardial oxygen demand. Once an acute myocardial infarction occurs, the imbalance between myocardial oxygen supply and demand is significantly aggravated, often leading to large-scale or severe myocardial infarction, and increasing the chance of sudden death. Unfortunately, myocardial necrosis is irreversible! Xiao Yan's coronary artery aging rate is extremely inconsistent with that of a young person. The health of his blood vessels is the same as that of an 80-year-old man. His heart has suffered an irreversible blow, and the risk of heart failure, arrhythmia, and sudden death in the future is also very high.

What factors increase the risk of myocardial infarction?

· Heredity: If there is a family history of myocardial infarction in the direct relatives, such as parents, siblings or those with a history of myocardial infarction, especially a family history of premature coronary heart disease (male <55 years old, female <65 years old), the risk of myocardial infarction will increase.

Age: Men aged 45 and older and women aged 55 and older are more likely to have a heart attack than younger men and women.

· Smoking: This includes smoking cigarettes and long-term exposure to secondhand smoke.

Hyperlipidemia: High levels of low-density lipoprotein cholesterol (“bad” cholesterol) are most likely to narrow your arteries; high levels of triglycerides also increase your risk of heart attack.

· Diabetes: Diabetes not only damages the heart and blood vessels, but also makes the heart become "stunned" and insensitive to pain, thus delaying the detection of the disease.

· High blood pressure: High blood pressure can damage your arteries, especially if it's not controlled.

· Obesity: The longer the waistline, the shorter the life span.

Lack of exercise: Lack of exercise can lead to increased blood lipid levels and obesity. People who exercise regularly are more likely to have higher blood lipid levels than those who lack exercise.

The temperature difference between day and night is large, and many infectious diseases are prevalent. We should pay more attention, strengthen physical exercise, develop good habits, and greet the end of the year with a healthy body.

03

Heart attack is not silent - be alert if you have these symptoms

Some patients may experience symptoms such as chest discomfort, precordial pain, palpitations, shortness of breath, and fatigue a few days to months before the onset of the disease.

1) Typical symptoms

The onset of the disease is usually characterized by chest pain, which is concentrated behind the sternum and in front of the heart, and is the size of the palm of the hand. It lasts for more than 20 to 30 minutes without relief. The degree is severe, oppressive, and unbearable, accompanied by a sense of impending death. It often radiates to the left shoulder, the inner side of the left arm, the ring finger and the little finger, or to the neck, pharynx, or mandible. Rest and sublingual nitroglycerin generally cannot relieve the pain.

2) Atypical symptoms

A small number of patients may not have obvious chest pain, or even experience pain in the area between the mouth and navel, such as sore throat, toothache, neck pain, left shoulder pain, etc., accompanied by chest tightness, shortness of breath, dyspnea, upper abdominal pain, nausea, and vomiting. In severe cases, symptoms may directly include cold limbs, sweating all over the body, confusion, syncope, and sudden death.

Not all myocardial infarction patients have similar symptoms. Some have milder symptoms, while others have more severe symptoms. The more and more obvious the symptoms are, the greater the possibility of myocardial infarction.

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How to determine whether there is a potential risk of acute myocardial infarction? Take an electrocardiogram in time and nearby! Combined with blood tests, you can preliminarily determine whether there is a myocardial infarction.

04

How to save yourself when a heart attack occurs? Remember two 120s

When a heart attack occurs, it is crucial to seek medical treatment promptly. If not treated in time, it will be life-threatening.

When a heart attack occurs, remember the 120 rule:

Dial 120 emergency number immediately; the golden time for treating myocardial infarction is 120 minutes.

Wait for the ambulance to arrive and take any medications recommended by medical staff.

While waiting for 120, rest on the spot, avoid getting emotional, and do not drive to the hospital by yourself.

This is not recommended:

✘ Underestimating the condition: Being young is no longer a safe bet for myocardial infarction. As long as the symptoms highly suspect the possibility of myocardial infarction, do not take chances and seek medical attention in time.

✘ Taking nitroglycerin at will: The blood pressure of some patients with myocardial infarction is lowered during the onset of the disease. Nitroglycerin has a blood pressure lowering effect. Taking nitroglycerin at this time will make the condition worse.

✘ Driving to the hospital by yourself: If the condition suddenly worsens, it will delay medical treatment and even cause a traffic accident, resulting in secondary injury.

✘ Don’t go to a designated hospital: The golden time for treating a heart attack is very short, so you should seek medical treatment nearby.

05

Why is autumn and winter the peak season for myocardial infarction?

In autumn and winter, the human body is stimulated by cold, the excitability of the sympathetic nervous system increases, the secretion of catecholamines in the body increases, causing vasoconstriction, faster heart rate, greater cardiac workload, and increased oxygen consumption. At this time, the myocardium suffers from ischemia and hypoxia, and the probability of angina pectoris increases significantly.

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Coldness can also induce the rupture of plaques in blood vessels, making platelets easier to aggregate, increasing blood viscosity, concentrating the blood and forming blood clots, which is also an important cause of myocardial infarction.

Sympathetic nerve excitement and catecholamines can also cause coronary artery spasm, so we should pay great attention to it in autumn and winter!

06

How to avoid heart attack?

The most important thing is to change your lifestyle: quit smoking, limit alcohol consumption; eat more fruits, vegetables and fish; eat less meat and eat a light diet; control your weight, exercise regularly and avoid sitting for long periods of time. In autumn and winter, control your blood pressure and keep warm.

In addition, physical examinations are very important. They can detect whether you are overweight, obese, have high blood pressure, diabetes, hyperlipidemia, etc. at an early stage. If the above conditions are found, intervention and treatment must be carried out as soon as possible. Do not take it lightly just because you think you are young.

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Author: Chen Jiahui, Doctor of Medicine, Fudan University, Cardiologist, Zhongshan Hospital, Fudan University

Editor: Tiara