There are so many taboos for heart disease, but the three most critical ones are often ignored by many people.

A dozen years ago, putting a stent in the heart was a big deal, but now it has become a "minor operation". It seems that everyone on earth knows that coronary heart disease needs stent treatment, but how can we prevent the occurrence and development of coronary heart disease and avoid implanting heart stents? What problems should people with bad hearts pay most attention to? As the engine of the body, the health of the heart is of vital importance, but many times, people's understanding of relevant knowledge is only superficial. Let's talk about it today.

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01

When we say "heart disease"

What disease are we talking about?

Let's clarify a few concepts first: When you mention heart disease, do you think of coronary heart disease, angina pectoris, or myocardial infarction? Are they the same disease? What are the differences?

Strictly speaking, heart disease is a general term for all heart-related diseases, such as coronary heart disease, arrhythmia, heart failure, and cardiomyopathy. However, since coronary heart disease (coronary atherosclerotic heart disease) accounts for the vast majority of heart disease cases and is the most common, many patients equate the two.

Coronary heart disease is divided into stable angina pectoris, unstable angina pectoris and acute myocardial infarction according to the characteristics of the disease and the course of the disease. There are also clear boundaries between them:

① When the coronary artery is narrowed by about 75%, myocardial oxygen consumption will increase with strenuous activity or emotional excitement, but coronary blood supply will not increase accordingly due to the stenosis of the blood vessels, thereby inducing myocardial ischemia and causing angina pectoris; symptoms rarely occur at rest, which is called stable angina pectoris , formerly known as exertional angina pectoris .

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② As the stenosis of blood vessels worsens, especially the instability of coronary artery atherosclerotic plaques, platelets gather faster to the stenotic lesions, and angina pectoris occurs even when resting. This is called unstable angina pectoris . Heart stent implantation often occurs during this period. At this time, the risk of the disease increases sharply. If not treated in time, there is even a risk of acute myocardial infarction.

③ When the coronary artery stenosis worsens until it is completely blocked, it will cause irreversible necrosis of myocardial cells, leading to acute myocardial infarction . The various celebrity cardiac arrests and even sudden deaths that we often hear about in the news all happen during this period.

02

What is the biggest fear of coronary heart disease? Fear of delay!

As mentioned above, most patients with coronary heart disease, especially acute myocardial infarction, will go through three stages: stable angina, unstable angina and acute myocardial infarction. Although these three stages are irreversible, early intervention when stable angina is just discovered can often effectively delay the progression of the disease and even avoid stent implantation.

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Many frontline clinicians have a deep understanding of this. They often encounter patients who have "delayed" their treatment: they had symptoms of post-exertional angina pectoris several months before hospitalization, but because the symptoms were mild and short-lived, they did not pay attention to them at all; when they developed unstable angina pectoris or even acute myocardial infarction , stent implantation was inevitable. On the other hand, if many patients with stable angina pectoris could receive standardized drug treatment in a timely manner and undergo angiography again several years later, the vascular stenosis would hardly worsen, which would largely avoid the implantation of stents.

03

What is coronary heart disease afraid of? Fear of pseudoscience!

There is a lot of information on the Internet, and it is difficult to distinguish between true and false. Especially for coronary heart disease, which has a relatively high incidence rate, many statements on the Internet are very irresponsible. For example, we often see some articles about the treatment of acute myocardial infarction, many of which are useless, and some may even delay the disease and treatment! For example, using "fingertip bloodletting therapy" or keeping a "head and feet raised" posture will not reverse the damage caused by acute myocardial infarction to the body!

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If you have symptoms suspected of acute myocardial infarction, do not panic, lie down and rest without moving, and remember the two "120s": call 120 in time if you have chest pain or tightness, and strive for the golden 120 minutes of treatment. This can greatly reduce the mortality and disability rates.

04

What else should you be afraid of with coronary heart disease? Taking the wrong medicine!

As a doctor, one very frustrating thing is that I often see patients’ wallets being drained by various “threats”.

The various arteries in our body are like water pipes in a building. Even if they are carefully maintained, scale is inevitable. Atherosclerotic plaques are the "scale" on the arteries. Whether it is the coronary artery or the carotid artery, the appearance of plaques as we age can be understood as a "normal" phenomenon.

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Many unscrupulous merchants will deliberately exaggerate the harm of plaques, saying that it is a blood vessel blockage that can cause myocardial infarction and cerebral infarction, and then promote a large number of health products or even "three-no products". These things not only fail to "remove plaques", but also have the risk of inducing liver and kidney failure!

If plaques appear in the arteries, should I take medicine? This depends on the patient's blood lipids, blood pressure, blood sugar, and whether there are concurrent diseases, and a professional doctor will make a comprehensive judgment.

It is right to pay attention to heart health, but don't follow the trend blindly or believe everything you hear. Maintain a healthy diet and lifestyle, have regular checkups, go to the hospital if you feel unwell, don't give rumors and scammers a chance to succeed, take care of your body, and don't let your wallet be hurt for no reason.

Author | Zhang Jianbo, attending physician of the Department of Cardiology, Cangzhou Central Hospital

Review | Ma Qingchun, Chief Physician and Professor of Cardiology, Peking University People's Hospital

This article is produced by the "Science Rumor Refutation Platform" (ID: Science_Facts). Please indicate the source when reprinting.

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