Myocardial ischemia refers to a narrowing of the coronary arteries that supply blood to the heart, resulting in insufficient blood supply to the heart and lack of oxygen and blood to the heart muscle cells, which can lead to symptoms such as tightness in the chest, chest pain, and dyspnea. However, a common cause of similar symptoms is cardiac neurosis, which needs to be recognized.
I. How to determine whether there is myocardial ischemia
The main cause of myocardial ischemia is atherosclerosis of the coronary arteries, and the hardened plaques can cause narrowing of the arterial lumen. However, when the stenosis is not more than 50%, symptoms generally do not appear, while the coronary artery stenosis of more than 50% is the diagnostic criteria for coronary heart disease, at this time in the activities, it is possible to cause chest pain, chest tightness, shortness of breath and other symptoms of angina pectoris.
Cardiac neurosis due to plant nerve disorders can also cause angina-like symptoms. The difference with myocardial ischemia is that cardiac neurosis usually strikes when it is quiet and before going to bed, while myocardial ischemia caused by coronary heart disease usually strikes when it is active and when it is exerted.
The “gold standard” for diagnosing myocardial ischemia in the hospital is coronary CT or coronary angiography. The ECG is easily disturbed and may miss the diagnosis.
II. 5 commonly used drugs to improve myocardial ischemia
1. Nitrate drugs: commonly used nitroglycerin, isosorbide nitrate, isosorbide mononitrate and other drugs, can release nitric oxide (NO), prompting vasodilatation, reducing cardiac load, reducing cardiac tension, reducing cardiac oxygen consumption and alleviating symptoms of angina pectoris.
However, nitrate drugs will develop rapid resistance and become ineffective when applied continuously. Among them, nitroglycerin is only suitable for sublingual relief of symptoms during acute attacks of angina pectoris, and is not used for daily prophylaxis. Other nitrate drugs need to be used with “eccentric dosing” and set drug-free intervals.
2. Nicorandil: Nicorandil also belongs to the nitrate class of compounds, but with the nitrate class of drugs with a different mechanism of action, through the regulation of the cell membrane to the permeability of calcium and potassium ions to play the role of dilation of coronary artery vasculature, the effect of a long-lasting and no drug resistance.
3. Calcium channel blockers: including diphenhydramine drugs (such as nifedipine, amlodipine, felodipine, benidipine, etc.) and non-diphenhydramine drugs (such as diltiazem, verapamil, etc.), which can dilate blood vessels, reduce blood pressure on variant angina has a better therapeutic effect. One of the non-diphenhydramine drugs can also slow down the heart rate and is used in the treatment of cardiac arrhythmias.
4. Beta-blockers: commonly used metoprolol, bisoprolol, carvedilol, etc., by weakening myocardial contractility, slowing down the heart rate, lowering blood pressure, reducing myocardial oxygen consumption. It can improve the long-term prognosis of coronary heart disease.
5. Trimetazidine: not as angina pectoris symptomatic treatment of drugs, but the use of other anti-angina drug effect is not good, can be combined with trimetazidine. Trimetazidine can promote the energy metabolism of cardiomyocytes in hypoxia and ischemia, maintain the stability of the intracellular environment, protect cardiomyocytes, and increase the effect of other drugs.
III. Myocardial ischemia should pay attention to prevention
Factors that cause myocardial ischemia, in addition to age, genes can not be changed, other factors such as smoking, blood pressure, blood lipids, blood glucose and other factors can be changed. Keep doing to quit smoking and alcohol, weight control, adhere to exercise, regular work and rest, control the “three highs”, These can be effective in slowing down the progress of atherosclerosis, prevention of myocardial ischemia occurs.
Usually also pay attention to not too full diet, according to the changes in environmental temperature increase or decrease clothing, bath water should not be too cold or too hot, exercise should be measured, do not be too tired, maintain emotional stability, do not get angry, to avoid triggering myocardial ischemia symptoms.
To summarize, if the symptoms of chest tightness and shortness of breath occur during exertion and activities, you should go to the hospital for examination in time to confirm whether it is myocardial ischemia triggered by coronary artery stenosis. The use of drugs under the guidance of a doctor can improve the symptoms of angina in myocardial ischemia. It is important to adopt healthy lifestyle habits and to “prevent” diseases rather than “cure” them. If you have any questions about the use of medication, please consult your doctor or pharmacist.