In recent 20 years, due to the improvement of intensive care and treatment level, the in-hospital mortality rate of acute myocardial infarction has decreased significantly, from about 30% to below 10%. However, the increase of patients with re-infarction or multiple infarction has become one of the main causes of death after myocardial infarction. Therefore, in addition to active treatment in acute phase, rehabilitation and secondary prevention after myocardial infarction should be strengthened to prolong patients' lives, improve their quality of life and restore their working ability. Secondary prevention after myocardial infarction includes: 1. Carry out health publicity and education for patients and their families, so that patients and their families can understand the condition, understand the significance of various prevention and control measures, reduce worries about the disease, and actively cooperate with prevention and control. 2. Arrange a reasonable diet, reduce the intake of total fat, saturated fatty acids and cholesterol, and limit the total calories of overweight people. If the blood lipid level is still obviously abnormal after 3 months of diet adjustment, the blood lipid regulator can be selected according to the characteristics of blood lipid abnormality. Smokers should be reminded to pay attention to stress. Smoking is not only a risk factor for arteriosclerosis, but also a risk factor for angina pectoris, myocardial infarction and reinfarction. In the convalescent patients with myocardial infarction, the incidence of reinfarction of smokers is about twice as high as that of non-smokers or smokers who have quit smoking. A multi-center study in Norway showed that the reinfarction rate of smokers was 45% lower than that of non-smokers/0/7 months after myocardial infarction. After 3 years, the mortality and reinfarction rate of smokers due to heart causes were significantly lower than those of smokers. Passive smoking is as dangerous as smokers, so relatives of patients should be urged to quit smoking. It is best for patients to work in a smoke-free environment after returning to work. Smoking may induce coronary artery spasm and platelet aggregation, and reduce the reserve capacity of coronary artery and collateral circulation. In patients with hypercholesterolemia, the degree of smoking is highly correlated with coronary atherosclerosis. Smoking can aggravate coronary atherosclerosis and easily induce re-infarction. 4. Appropriate physical activity and exercise. Walking, gymnastics, Tai Ji Chuan, Qigong and other exercise methods can be used to enhance physical fitness. 5. Patients with hypertension or diabetes should be properly controlled. 6. Antiplatelet therapy. Platelet injustice plays an important role in the process of atherosclerosis and in myocardial ischemia, myocardial infarction or sudden death caused by coronary artery spasm, thrombosis or myocardial microcirculation aggregation. Aspirin is a cheap and easily available antiplatelet preparation with few side effects and convenient for long-term application. 7. Use beta blockers. A large number of clinical trials have proved that beta blockers can reduce the incidence of reinfarction, sudden death, cardiac mortality and total mortality after myocardial infarction. Commonly used beta blockers include propranolol, aminoacyl propranolol and metoprolol. 8. After the recovery of acute myocardial infarction, you should insist on taking medicine under the guidance of a doctor, follow up in outpatient department, observe the condition and adjust the medication. If angina pectoris reappears, you should go to the hospital for treatment in time to prevent another infarction.
Dietary taboo
Supplement vitamin c and trace elements. In order to strengthen the elasticity and toughness of blood vessels and prevent bleeding, trace element iodine can reduce the deposition of cholesterol, fat and calcium salts on blood vessel walls and hinder the formation of atherosclerotic lesions (seafood is rich in iodine); Magnesium can improve myocardial excitability, which is beneficial to inhibit arrhythmia (magnesium is more abundant in green leafy vegetables). It is advisable to eat more coarse grains and crude fiber to prevent constipation from having adverse effects on the heart. Avoid: control the intake of heat energy food and don't make your body overweight. Avoid eating too much animal fat and animal offal with high cholesterol. To control salt intake, it is best not to eat pickles, bean paste, sausages, bacon or eat less. Avoid alcohol, tobacco and irritating food. Principles of healthy diet for patients with myocardial infarction. Myocardial infarction is the main complication of coronary heart disease, and a reasonable diet is of great significance to the treatment of myocardial infarction. Patients with acute myocardial infarction should stay in bed strictly and not take too much nutrition. When eating, they should pay attention to the following problems: (1) Limit calorie intake to reduce the burden on the heart. Especially in the early stage of the disease, we should eat less and eat more meals, mainly liquid, and avoid too cold or overheated meals. With the improvement of the disease, you can appropriately increase semi-liquid food and gradually increase heat energy. It is allowed to eat moderate amounts of lean meat, fish, fruits, etc. Keep the gastrointestinal tract unobstructed at all times to prevent overexertion during defecation. (2) The diet should be balanced, light and nutritious, so as to improve the nutritional supply of the body, including myocardial cells, protect and maintain the heart function, and promote the early recovery of patients. Excessive and irritating food should be avoided, and strong tea and coffee should not be drunk. Avoid eating a lot of fat, because it may lead to slow blood flow and platelet aggregation due to the increase of blood lipid and blood viscosity after meals. (3) Pay attention to the balance of sodium and potassium, and appropriately increase the intake of magnesium to prevent or reduce complications, especially the occurrence and development of arrhythmia and heart failure. A low-salt diet is generally recommended, but if there is too much sodium loss in urine in the acute stage, there is no need to limit sodium too much. The intake of sodium, potassium and magnesium in the diet should be adjusted at any time according to the condition. (4) Acute myocardial infarction with cardiac insufficiency often leads to gastrointestinal dysfunction, and more attention should be paid to diet. Before 1 ~ 2 days, only liquid diets such as hot water juice, rice soup, honey water and lotus root starch were given, 6 ~ 7 times a day, each time 100 ~ 150 ml. If the patient's heart function improves and the pain is relieved, he can gradually increase some diets, such as lean meat, steamed egg white, and thin rice porridge. With the recovery of the disease, coronary heart disease can be treated with diet 6 weeks after illness, but the diet still needs to be soft and digestible.
Family prevention and control
Don't carry heavy objects.
It is necessary to bend over and hold your breath when lifting heavy objects, and its physiological function is similar to holding your breath hard, which is a common cause of myocardial infarction in elderly patients with coronary heart disease.
relax
Live happily, keep peace of mind, and be able to cope with everything calmly; Take part in appropriate sports activities, but avoid fierce competitions. Even if it is a competition, it should be aimed at exercising and increasing fun, regardless of winning or losing.
Moderate exercise
Generally speaking, in order to achieve the purpose of exercise, there should be serious physical exercise at least three times a week, each time not less than 20 minutes, but not more than 50 minutes. Exercise at first, such as raising your arms and stretching your legs. At the end of the exercise, you should do some relaxing activities, you can't stop the activities immediately, and you can't sleep immediately after the exercise, otherwise it will easily cause dizziness and be bad for your heart. Before taking part in physical exercise, we should first measure the tolerance of the body. Don't exercise excessively, which will lead to a sharp rise in blood pressure, left ventricular fatigue and heart failure. The amount of exercise generally depends on age and health. If you are a person with normal cardiopulmonary function, you can decide according to the maximum heart rate limit after exercise. The specific calculation method is to subtract the age from 220 and multiply it by O.75. For example, if you are 60 years old this year, then (220-60) x 0.75: 120 times, if it exceeds 120 times, it will have adverse effects on your health.
Matters needing attention in bathing
Don't take a bath when you are full or hungry. The water temperature should be equal to the body temperature. If the water temperature is too high, the skin blood vessels will obviously expand, and a large amount of blood will flow to the body surface, which may cause cardiac and cerebral ischemia. Bathing time should not be too long, and the bathroom is generally stuffy and unventilated. In this environment, people's metabolic level is high, and they are prone to hypoxia and fatigue, especially in elderly patients with coronary heart disease. Patients with severe coronary heart disease should take a bath with the help of others.
Dietary precautions
1, food is soft, eat less and eat more meals: due to the low blood pumping function of patients with myocardial infarction, gastrointestinal mucosal function is weakened, blood stasis, digestive dysfunction, loss of appetite and decreased secretion of digestive juice appear. Therefore, we should usually eat digestible and semi-liquid soft food. At the same time, eat 4-5 times a day, and it is not easy to eat too much. Otherwise, due to abdominal fullness, the blood flow of abdominal organs will increase relatively, and the blood flow of coronary artery will decrease relatively, which will easily induce arrhythmia, aggravate the degree of myocardial infarction, heart failure and angina pectoris, and even cause sudden death. 2. Low cholesterol and low fat diet: Corn oil, rapeseed oil, sesame oil, peanut oil and soybean oil should be used as edible oils in daily diet. Vegetable oil contains no cholesterol and is an unsaturated fatty acid, which is beneficial to the recovery of patients. We should avoid eating animal offal with high cholesterol and excessive animal fat, and eat more soy products. The total intake of cholesterol per day should be controlled below 300 mg. 3, salt restriction: too much sodium can increase the sensitivity of blood vessels to various antihypertensive substances, cause arteriolar spasm, and raise blood pressure. Sodium also has a strong water absorption effect. Too much salt will increase the blood volume, which will directly increase the burden on the heart. Therefore, the daily salt intake of patients with myocardial infarction should not exceed 4g. 4. Control the total calorie intake: Clinical data show that obese people are more likely to suffer from myocardial infarction, because too much fat surrounds the heart and oppresses the myocardium, resulting in weakened myocardial function, so it is necessary to control the weight and limit the total calorie. In the case of rest, it is advisable to supply 25-30 kcal/kg body weight every day. 5. Supplementing trace elements and vitamin C: Magnesium and iodine in trace elements play an important role in lowering serum cholesterol, which can reduce and slow down the formation of atherosclerotic lesions and the deposition of calcium salts and cholesterol on blood vessel walls. Vitamin C can prevent bleeding, promote wound healing and enhance blood vessel elasticity. Foods rich in vitamin C are mainly fruits and vegetables, especially strawberries, tomatoes, fresh dates and kiwis. Laver, laver, jellyfish, fish, shrimp and so on contain more iodine, which can be eaten alternately in daily diet, and magnesium is more in green leafy vegetables. [4]
Pay attention to climate change
Under the influence of severe cold or strong cold air, coronary artery spasm and secondary thrombosis can cause acute myocardial infarction. When the climate changes drastically and the air pressure is low, patients with coronary heart disease will feel obviously uncomfortable. Data show that low temperature, strong wind and rainy weather are one of the causes of acute myocardial infarction. Therefore, every time the weather is bad, patients with coronary heart disease should pay attention to keep warm, or take crown-expanding drugs appropriately for protection.
Do daily protection.
In the daily life of patients with coronary heart disease, various protective measures are very important. At the same time, it is necessary to understand and identify the premonitory symptoms of myocardial infarction and deal with them in time.
emergency measures
Don't panic if you have premonitory symptoms of myocardial infarction. First of all, the patient should stay in bed immediately, keep quiet, avoid mental stress, take nitroglycerin under his tongue, or call a doctor immediately to make a diagnosis and treatment on the spot. At the same time, be prepared to be sent to the hospital. The traffic must be smooth and comfortable. Patients should avoid walking and be transported on a stretcher when the situation is relatively stable. Nitroglycerin and other crown expanding drugs can be used continuously or intermittently during transportation. When ECG changes are accompanied by severe symptoms, it should be treated as myocardial infarction. Some patients with acute myocardial infarction can be avoided, even if myocardial infarction occurs, the infarction range is small, the symptoms are mild, the complications are few, the recovery is easy, and the survival rate is obviously improved.
Beneficial natural herbs
Black radish, pseudo-ginseng, acacia, chelidonium majus, dandelion, fennel, ginkgo (ginkgo), hawthorn fruit, hops, equisetum, Irish moss, lobelia chinensis, parsley, alfalfa and rose hips are all helpful to treat myocardial infarction.