Concealed heart disease refers to the heart disease without clinical symptoms. Because it has no common symptoms such as chest tightness, chest pain, palpitation and shortness of breath, it is easy to be ignored by patients.
However, hidden heart disease is very harmful, because once it comes on, people with severe heart disease will have difficulty breathing within a few minutes, and then die, so it is called "silent killer".
For example, although asymptomatic myocardial ischemia patients have no symptoms, coronary artery disease may have been very serious, which may lead to acute myocardial infarction or even face the risk of sudden death when emotional excitement or strenuous exercise.
The patient, Mr. Wang, always felt that he was in good health without obvious discomfort. One day, he suffered from chest pain and sweated profusely during the exercise, so he was immediately sent to the hospital for treatment.
Emergency ECG diagram: aVL, V3~V6 ST segment horizontal depression 0.05-0.15mV with T-wave positive and negative bidirectional (as shown in the figure). The myocardial zymogram also changed significantly (as shown in the figure), indicating myocardial ischemia.
Coronary angiography after admission showed that proximal circumflex artery was occluded; The proximal segment of right coronary artery was occluded.
After comprehensive clinical symptoms, Mr. Jiang was diagnosed with acute myocardial infarction, and was discharged after timely treatment.
In China, about 540000 people die suddenly from heart disease every year, of which more than 88% are caused by hidden heart disease. The Outline of the "Healthy China 2030" Plan emphasizes the development strategy of "health for all", and adheres to the working principle of focusing on the grassroots and focusing on prevention.
So, how to prevent and detect hidden heart disease in the community?
1. Healthy lifestyle
Active lifestyle intervention is the simplest and most effective way to prevent the occurrence and development of cardiovascular disease. Its purpose is to reduce blood pressure and control other risk factors.
For example, reasonable diet, weight control, smoking and drinking cessation, regular work and rest, proper exercise, and maintaining a pleasant mood.
In the cold season of autumn and winter, pay special attention to antifreeze! Because for patients with concealed ischemic heart disease, low temperature and eating raw and cold food are easy to cause coronary spasm or microcirculation blockage, thus inducing myocardial infarction.
2. Early diagnosis and timely treatment
The etiology of occult heart disease is complex. Early accurate diagnosis and timely treatment are important ways to promote the prognosis of patients.
Coronary angiography is the gold standard for the diagnosis of ischemic heart disease, but as an invasive examination method, middle-aged and elderly patients with underlying diseases have certain risks.
Therefore, non-invasive 24-hour dynamic electrocardiogram and exercise treadmill test have become common means to screen hidden heart disease, especially in the community.
24h dynamic electrocardiogram can continuously monitor the changes of patients' electrocardiogram for a long time, and accurately diagnose transient symptoms such as occult myocardial ischemia, occult arrhythmia and paroxysmal syncope by evaluating the heart rate and ST level of the human body in quiet and active states.
In the exercise treadmill test, the ECG of patients in the whole process from resting state to exercise state, then to the maximum limit state and recovery period is monitored in a standardized way to evaluate the myocardial ischemia of subjects in exercise state.
In addition, conventional cardiac ultrasound, coronary CT, as well as cardiac blood biochemical indicators such as BNP, CKMB, etc., are of certain significance in screening for occult heart disease.
In the era of big data science and technology, combined with advanced technical means, through dynamic ECG monitoring and other medical means, accurate community screening can be carried out. In the early stage of hidden heart disease, the location of the disease can be found as early as possible to avoid missing the best treatment time window and avoid serious adverse events.
