Hu Dayi, a well-known cardiovascular expert, once shared 2 patient experiences about cardiac stents.
I have a couple of friends who are alumni of mine, and a year ago, when I did a ct examination, I found that the middle section of the anterior coronary artery descending branch was 50%-60% narrow, but there were no symptoms of discomfort. His colleagues suggested further coronary angiography, the result did not reach the 70% stenosis of the stent of the "fooling people", and then suggested that the expensive coronary intravascular ultrasound was done, and the report sheet said that the middle section of the anterior descending branch was 71%, and finally enough to indicate the need to put a stent.
His wife also asked the surgeon before signing the informed consent form, can she not put the stent? The practitioner directly said: "No, it must be released, this is responsible for your family, and if you enter the catheter room, you will not be able to do it." ”
After the operation, he remembered my old classmate who studied heart, so he called me for consultation, and my answer was: I shouldn't let it go.
However, there is no regret medicine in the world, hey!
The other, a 48-year-old patient I met in Hunan, was found to have several blood vessel stenosis in the heart during a physical examination more than 6 months ago, the degree of 70% to 80%, the reason is due to his habits of smoking for a long time and staying up late.
Afterwards, he placed 3 stents on the advice of the doctor. When he was discharged from the hospital, the doctor told him to come back for 6 months. After 6 months, the contrast was reviewed and found that another blood vessel was 70% narrowed, and a fourth stent was released. This time, the doctor said, "Come back to me in 6 months." ”
This time he hesitated, and when he saw me, he asked me depressedly: "Can you stop putting the bracket after 6 months?" ”
My advice to him is: don't just wait and put the stent again, what you have to do is to fight for the reversal of the lesion, during this period try to quit smoking, insist on doing aerobic exercise, eat statin seriously, and reduce the LDL to less than 1.8 mmol/L.
After the patient listened, he felt that there was a light in his eyes in an instant, and he did it strictly according to my advice, and it was later understood that he never put the stent again.
In recent years, China's cardiac stent technology has developed rapidly, and the popularity rate has become higher and higher, and it is undeniable that it has indeed saved the lives of many patients with cardiovascular diseases, especially those with acute myocardial infarction. But at the same time, there are some problems, that is, the abuse of cardiac stents in China is serious. Many patients who should not be put and can not put stents are eventually put in the stent.
And this stems from the public's lack of understanding of cardiac stents, in order to eliminate everyone's misunderstanding of stents, today I will take you to understand the heart stents.
Cardiac stents, literally, are placed in a medical device during cardiac surgery to play a role in uncloging arterial blood vessels and saving the lives of many patients with acute myocardial infarction.
At present, there are three main types of coronary stents: bare metal stents, traditional drug elution stents and biodegradable stents.
Different stents, the indications are also different, so be sure to understand your own situation, and then choose a stent suitable for yourself, so as not to bring a variety of health risks. Of course, even the best stents are not necessary to implant if they do not meet the indications.
Hu Dayi, chief physician of the Department of Cardiovascular Medicine of Peking University People's Hospital, said: "The stent itself is of great significance to the treatment of vascular diseases, it is a good technology, but no matter how good the stent is, if the patient does not need it, then do not put it, otherwise it will only do more harm than good." Cardiac stents should have strict indications, as well as certain risks. ”
He believes that when treating the individual situation of heart disease patients, the first thing to do should be to provide the most suitable treatment method, rather than simply implanting stents, such as some sub-healthy people or patients aged 30 to 50, and do not necessarily put stents, then we should strive for reversal, do not put stents; or for some stable heart disease patients, there is basically no need to put stents.
Therefore, we must tell the patient clearly, what situation is suitable for release, what situation does not need to be released, do not let the cardiac stent become over-medical. In addition, more often, we should focus on prevention - quitting smoking, lowering cholesterol, controlling high blood pressure and diabetes, adhering to a reasonable diet and aerobic exercise, paying attention to psychological balance, etc.
So what are the indications for cardiac stents?
• Patients with acute myocardial infarction.
•Patients with typical angina symptoms, especially those at high risk of diseases such as hypertension and diabetes.
• Those with angina or myocardial ischemia, drug treatment but not satisfactory, coronary angiography suggests more than 75% of blood vessels are narrowed.
The specific suitability for stents also depends on the patient's specific situation.
For myocardial infarction, many times we are mainly based on prevention, so that the disease does not occur, and naturally there is no need to consider stents. In this regard, Hu Dayi put forward the "five major prescriptions", which people with cardiovascular diseases may wish to refer to.
The first: drug prescriptions
Each patient's specific situation is different, so the appropriate drugs, treatment plans, dosages, courses, etc. may be different, and individualized medications are required.
Second: exercise prescription
Appropriate exercise is beneficial to the body and mind, but patients with coronary heart disease belong to a special group, and exercise should pay attention to the way, frequency, and intensity, so that exercise can play a good drug effect.
The third: nutritional prescriptions
On the basis of reasonable collocation and balanced diet, try to be lighter, less oil and less salt, and eat more vegetables and fruits; Pay attention to controlling the total amount, do not overeat, eat eight points full.
Fourth: psychological prescription
The quality of emotions can also affect heart health, if you are in anxiety, panic, depression and other negative emotions for a long time, it is also detrimental to health, so such patients should also prescribe "psychological prescriptions" while prescribing drugs and pay attention to mental health.
Fifth: smoking cessation and alcohol restriction prescriptions
Tobacco and alcohol are one of the main factors leading to stroke, acute myocardial infarction and other diseases, so try to stay away from these adverse factors.
Summary: Although stents can sometimes save lives, it does not mean that implantation of stents can be done once and for all, only follow-up regular medication and comprehensive management can maximize its role.
Resources: [1] "Hu Dayi: Talk about the stability of coronary heart disease stents to be cautious". Dr. Hu Dayi.2018-05-29 [2] Life Times Hu Dayi: Stents are not the only option for patients. Dr. Hu Dayi.2020-0 8-07 [3] Hu Dayi: No matter how good the bracket is, if you don't need it, don't support it. Health World Cardiovascular Channel.2018-07-05 [4] Hu Dayi: Cardiac Stents Are Only the Beginning of Treatment. China Science Daily.2019-12-9 [5] "Grow knowledge! Cardiac stents are not placed indications to determine ". Changsha Fourth Hospital.2020-09-03
Reproduction without the author's permission is prohibited
#39 Health SuperGroup ##真相来了 #