In my expert clinic, I often see atypical chest
tightness, long-term low-inversion of ECG T wave, plus combined premature beat
or atrial fibrillation, no reliable evidence of dynamic myocardial ischemia,
and the buckle of 'coronary heart disease' hat The patients have been
used in hospitals at all levels, and a large number of so-called 'expanding crowns, anti-myocardial ischemia'
drugs, especially proprietary Chinese medicines, and even intensive
treatments of Polivi and aspirin have been used together, making patients both
sad and injured.
Such cases have even been misdiagnosed and mistreated for more than 10 years, so it is my
unshirkable duty to remove these misdiagnosed coronary heart disease hats! At
the same time, I also experienced the sense of accomplishment of the outpatient
work, because it relieves the patient's psychological pressure and financial
burden!
Coronary heart disease is a disease with a high rate of misdiagnosis. According to
incomplete statistics, the rate of misdiagnosis in China is
as high as 30-40%, and the rate of misdiagnosis in primary hospitals is as high
as 50%! There are many reasons for this misdiagnosis.
From the
patient's point of view, there is a partial understanding of coronary heart
disease, chest tightness, chest pain is equivalent to coronary heart disease,
the actual cause of chest tightness, chest pain and discomfort are very many
reasons, not necessarily coronary heart disease, and the so-called chest pain
is not equal to angina!
The mental nerves of the mental factors also
account for a large proportion; sometimes patients are unclear about their own
diseases, and it is also one of the important reasons why they cannot grasp the
key points, especially the friends of rural patients, who often describe their
diseases frequently, leading to doctors and patients.
Misunderstanding leads to
misdiagnosis, so doctors and patients patiently cooperate, communication is
clear in place, it is essential!
From the
doctor's point of view, the clinical situation of coronary heart disease is
more complicated. The doctor's experience and level (such as long-term
low-level inversion of ECG T wave does not mean that the myocardium must be
ischemia), the patient's patience may affect the accuracy of coronary heart
disease diagnosis and treatment.
From a professional point of view and my personal experience, patients
with genuine coronary heart disease usually have typical angina symptoms. As
long as the patient is clearly stated, experienced doctors have patiently asked
about the medical history.
Eight out of ten can be accurately judged. For
the majority of patients and friends, there is a basic understanding and
understanding of the typical myocardial ischemic symptoms (angina) of coronary
heart disease.
The angina
caused by true stenosis is often closely related to physical activity
and emotional agitation. It is mostly paroxysmal cramps or crushing pain, and
it can also be a feeling of depression.
Pain starts
from the back of the sternum or the anterior region of the cerebral region. The
range is not limited to one point. At least one slap in size can be radiated to
the left shoulder, arm, or even the little finger and ring finger.
Sometimes it
can also involve the neck, jaw, teeth, abdomen, etc. Rest or nitroglycerin
can be relieved, and the duration of each episode usually does not
exceed half an hour, but it is important to emphasize that severe pain
lasting longer is another matter!
Outpatients
also often encounter patients with non-true coronary heart disease who report
nitroglycerin or rescue pills, which may have a great effect. It is necessary
to have an experienced doctor to distinguish between right and wrong!
In general, the
patient's patience and careful patient consultation and patient communication
are the simplest and most effective means of diagnosing coronary heart disease.
If
careful diagnosis and judgment are made for undiagnosed or still suspected, coronary
CT or coronary angiography (referred to as crown) can visualize the
condition of coronary vascular stenosis, which is the gold standard for the
diagnosis of coronary heart disease, with an accuracy rate of 90. More
than %.
Third-level hospitals can generally perform this test. Without
these conditions, a simple exercise ECG plate experiment can
be performed with an accuracy of about 80%.
Finally, remind everyone that if you have symptoms such as
heartache, chest tightness, shortness of breath and palpitations, don't be busy
putting yourself a hat of coronary heart disease!
The best thing to do is
to go to the big hospitals with good conditions and experienced doctors to further
clarify whether these symptoms are coronary heart disease, otherwise they will
be injured and hurt.
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