What Is Coronary Heart Disease?

Coronary heart disease (CHD) is a collective term for heart disease (coronary atherosclerotic heart disease) and coronary artery functional changes (spasm) caused by myocardial ischemia and hypoxia caused by coronary artery atherosclerosis "Ischemic heart disease." Clinically, it can be divided into primary cardiac arrest, angina pectoris, myocardial infarction, heart failure and arrhythmia. CHD is a psychosomatic disease that seriously threatens people's health and causes a large number of deaths, and its incidence gradually increased half a century ago. Coronary heart disease is the most common heart disease in the elderly.

Coronary heart disease (CHD) is a collective term for heart disease (coronary atherosclerotic heart disease) and coronary artery functional changes (spasm) caused by myocardial ischemia and hypoxia caused by coronary artery atherosclerosis "Ischemic heart disease." Clinically, it can be divided into primary cardiac arrest, angina pectoris, myocardial infarction, heart failure and arrhythmia. CHD is a psychosomatic disease that seriously threatens people's health and causes a large number of deaths, and its incidence gradually increased half a century ago. Coronary heart disease is the most common heart disease in the elderly.

Chinese name

Coronary heart disease in the elderly

Foreign name

senior coronary heart disease

Causes of coronary heart disease in the elderly

The risk factors of coronary heart disease refer to the risk factors that affect the occurrence and development of coronary heart disease, and the order of their severity is: The increase in blood lipids, especially the increase in blood cholesterol can promote the occurrence and development of coronary heart disease. Hypertension, the higher the blood pressure, the higher the incidence. The prevalence of coronary heart disease in elderly people with systolic blood pressure above 180 mmHg is 6 times higher than that of 120 mmHg. Smoking, when the CO (carbon monoxide) in the smoke makes the blood oxyhemoglobin reach 90%, although it can increase the coronary blood flow, but because the coronary arteriosclerosis cannot compensate, myocardial ischemia is prone to occur. Nicotine in the smoke can cause coronary arteries to contract and easily induce angina. Obesity, family history, prone to coronary heart disease. Improper diet arrangement, such as heavy drinking, can make blood pressure rise suddenly and aggravate the severity of coronary heart disease. Lack of physical exercise can easily lead to obesity. Spiritual stimulation can easily increase blood pressure. Hyperuricemia. Reduced vital capacity. The risk factors of coronary heart disease in the elderly are more important, such as hyperlipidemia, hypertension, smoking and mental stimulation.

Classification of coronary heart disease in the elderly

Coronary heart disease is divided into 5 types, namely recessive coronary heart disease, angina pectoris, myocardial infarction, myocardial sclerosis and arrhythmia. In pathological anatomy, the coronary arteries of patients with recessive coronary heart disease have changed, but clinically the elderly do not have myocardial ischemia and generally have no cardiac symptoms. Angina pectoris is the most common cause of coronary artery arteriosclerosis and stenosis, and increased coronary stenosis. Males appear earlier than females, males are 50 years old, and females are 60 years old. The onset of angina pectoris is related to the degree of collateral circulation formed in the coronary circulation, and it is well formed. Angina pectoris appears less or not, and vice versa. Acute myocardial infarction, due to the occurrence of thrombosis in the hardened coronary arteries, causes local myocardial ischemia, and then develops into myocardial necrosis, etc., and even leads to myocardial rupture. Myocardial sclerosis is mainly related to coronary arteriosclerosis, chronic myocardial blood supply failure, myocardial dystrophy, atrophy, connective tissue hyperplasia, and finally myocardial sclerosis. Arrhythmias, coronary heart disease, especially acute myocardial infarction, arrhythmias are prone to occur in 80% of patients at the beginning, and more common ventricular premature beats, tachycardia, ventricular fibrillation, sinus bradycardia, atrioventricular border rhythm, and atrioventricular block. Arrhythmia can be the cause of acute myocardial infarction.

Differential diagnosis of coronary heart disease in the elderly

As the elderly increase in age, their physiological functions decline, their constitution is weak and their chronic diseases become entangled. Coronary heart disease increases with the increasing number of elderly people. In clinical, there are many manifestations of comorbidities, but the clinical characteristics of coronary heart disease are not obvious, and it is more difficult for doctors to diagnose and treat. Symptoms such as arrhythmia, angina pectoris, myocardial infarction, and heart failure are common in the clinic. Due to the rapid onset of the disease, it is easy to die suddenly when the disease is severe. Due to the physical function of elderly patients, degenerative changes begin to appear to some extent. Compared with middle-aged people, the clinical symptoms of coronary heart disease are not obvious. In the early stages, even some elderly patients have no obvious clinical symptoms. As the condition changes continuously, it is easy to miss the best time for diagnosis and treatment. During the onset of coronary heart disease, typical clinical symptoms are concealed. Older patients often experience nausea with vomiting and cough. Therefore, it is difficult for clinicians to make an accurate judgment during diagnosis and treatment. For example, based on the patient's insignificant clinical manifestations, it is misjudged for the first time as a respiratory or abdominal disease, which delays diagnosis and treatment. Some elderly patients also have first symptoms such as low back pain, which is easily misdiagnosed as intercostal neuritis by doctors, thus masking typical symptoms. There are many types of coronary heart disease comorbidities. If comorbidities occur, it will also easily affect the judgment of doctors, which will increase the incidence of misdiagnosis and missed diagnosis, which is not conducive to improving the exact diagnosis and treatment of coronary heart disease. Myocardial ischemia and cardiac conduction system disorders are the two major risk factors for coronary heart disease. Older patients often develop clinical symptoms of arrhythmia. For example, ventricular premature beats, atrioventricular block, and atrial fibrillation.

Coronary heart disease treatment principles in the elderly

After the discovery of coronary heart disease, care should be taken to prevent sudden death due to cardiac arrest. Pay attention to avoid emotional excitement and avoid excessive physical activity, but mild and appropriate physical exercise should be carried out to prevent atherosclerosis and obesity. Arrange a reasonable and balanced diet and consume more fruits and vegetables. Avoid excessive stress in work and life. Avoid psychological conflict. Get enough sleep, and advocate not smoking and drinking. Drugs can be used vasodilator drugs to actively treat arrhythmias. Patients with acute myocardial infarction should be hospitalized until they are out of danger.