The patient's original question was, "How many years can myocardial infarction live at most?" ”。
Looks a little pessimistic!
This question really cannot be summed up in one word.
Because it is not a special case, do not talk about individual differences, that is, under normal circumstances, there are many factors that are common and determine how long patients with acute myocardial infarction can live and how they live. Every step of acute myocardial infarction treatment requires good cooperation between doctors and patients to minimize those adverse factors. We say it in two articles.
One of them is that opening the blocked coronary arteries as early as possible is crucial!
The most common cause of acute myocardial infarction is thrombosis in the coronary arteries of atherosclerotic narrowing, which completely blocks the blood vessels at once, and the myocardium dies of necrosis due to complete and persistent ischemia. Infarction, referred to as "ischemic necrosis".
The thrombus of acute myocardial infarction occurs suddenly and rapidly, so myocardial infarction occurs rapidly, progresses rapidly, and sometimes sudden cardiac death occurs.
However, coronary heart disease is preventable and treatable. Early prevention and treatment, patients with coronary heart disease can also live to a normal life expectancy.
Even when unstable angina and acute myocardial infarction occur, seizing the opportunity to treat it in time can save the dying myocardium, narrow the scope of infarction, protect cardiac function, and ultimately improve the prognosis, that is, the adverse outcome.
Acute myocardial infarction, a variety of factors determine the outcome of the patient. The damage to the heart muscle is directly related to the function of the heart and to life.
The response is to open the coronary pulse as soon as possible, restore blood supply, and save the dying heart muscle!
The location, area size, and whether it penetrates the wall of myocardial infarction directly affect the function of the heart, affect the ability of the heart to beat normally, and the ability to shoot blood normally. The main site of cardiac ejaculation is the left ventricle. Therefore, myocardial infarction of the left ventricle, especially large-area perforating myocardial infarction, is most at risk. Through-wall infarction, that is, the whole layer of the heart muscle, from the inside to the outside is necrotic. In general, if the area of myocardial necrosis in the left ventricle exceeds 40%, the patient will develop heart failure and cardiogenic shock.
Myocardial infarction is of course related to coronary artery disease.
Coronary artery disease, whether it is a single vascular lesion or multiple branches have lesions, the severity of the lesion, whether there is a lateral branch circulation is also very important.
Therefore, when acute myocardial infarction occurs, the most critical thing is to open the blocked coronary arteries as soon as possible, causing the coronary arteries of this myocardial infarction, which is medically called "criminal blood vessels".
At this time, the condition is to do coronary angiography, balloon expansion, stenting, open the "criminal blood vessel", stop the "crime" from continuing, and restore the blood supply. If it is too late to put a stent on the imaging, it is necessary to take the drug thrombolysis.
The "time window" for requesting treatment is 2 hours, 120 minutes. Of course, the sooner the better, the sooner the better. Over time, the area of infarction will expand, and the infarction will develop from subcardium to the full layer of myocardium.
Coronary heart disease can be multiple branches of coronary artery lesions. In the emergency department, the "criminal blood vessels" are generally treated, and other lesions are treated after the condition is alleviated and stabilized. So some patients will do it again after some time after the emergency stent. It wasn't something the doctor had forgotten.
In the 1980s, there was no coronary intervention in the mainland, and there was no technology for balloon expansion and stenting. Although we carried out pre-hospital emergency care for acute myocardial infarction, the first aid at that time was to carefully guard the patient, reduce the load on the patient's heart with drugs, improve the patient's condition, help the patient through the acute phase of myocardial infarction, and then slowly recover.
At that time, patients, because the coronary arteries were not opened, the area of myocardial infarction would be relatively large, the cardiac function would be relatively poor, the ventricular wall tumors were common, some patients would have arrhythmias, of course, there were many patients who could not resist. At that time, patients with myocardial infarction did not have "statin" drugs to lower cholesterol, and the treatment of anti-myocardial remodeling and anti-heart failure was not standardized, and there was a lack of drugs. Most of the patients we successfully rescued in that year died of heart failure more than 10 years after myocardial infarction, because of heart failure or sudden death. However, at that time, there were more middle-aged and elderly patients rescued.
Now the situation is different, and the means of treatment and drugs are advanced. The state began to establish chest pain centers in county-level hospitals, many county-level hospitals can carry out coronary interventional treatment, and there is thrombolytic therapy that cannot be intervened, so that in the early stage of myocardial infarction, the patient's dying myocardium is saved to the greatest extent, the scope of infarction is reduced, and the patient's heart function is effectively protected; in the later stage, there are standardized anti-arteriosclerosis, anti-platelet therapy, anti-myocardial remodeling, and protective cardiac function treatment, and many patients can live to life expectancy with quality.
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