Acute myocardial infarction hospitalization.
A general treatment, absolute bed rest, Jin Yixiaohua diet. Stool maintain patency (available fruit I.). Sedation. Oxygen: general nasal catheter oxygen, the oxygen flow L 2-4; analgesic drugs, it should be noted the blood pressure drop, respiratory depression and vomiting, and other side effects; guardianship: ECG, blood pressure and respiration, heart rate, rhythm, volume guardianship, open vein.
Second, restrictions and reduce infarct size (1) drug treatment ① intravenous nitroglycerin, hypotension, or low blood volume, tachycardia cautiously uses; ② β-blockers, used to high blood pressure, heart rate fast, ST increased significantly, chest pain. Prohibited in heart failure, low blood pressure and slow arrhythmia; ③ calcium blockers, there is no evidence that can reduce infarct size. Such as severe hypertension or coronary artery spasm can choose nifedipine and diltiazem-Zhuo, attention should be paid to the use of taboo. (2) thrombolytic therapy ① indications: the incidence of acute myocardial infarction within 6 h (preferably within 4 h) of Q-wave myocardial infarction. No contraindications; ② taboo: A recent active bleeding or bleeding tendency, serious hypertension, cerebrovascular disease, a serious liver and kidney diseases, senior citizens (aged> 70 years); ③ commonly used drugs and Usage: streptokinase, urokinase and tissue-type plasminogen activator, and its main complication is bleeding, especially life-threatening intracranial hemorrhage can be, should be noted. (C) Emergency percutaneous transluminal angioplasty (PTCA) and surgical bypass surgery: thrombolytic contraindications applicable to thrombolysis in patients with failure of the serious residual stenosis after thrombolytic therapy should be scheduled for PTCA or surgical bypass surgery;
Third, treatment of complications of AMI
4. Recovery treatment (secondary prevention) (1) in the treatment of coronary heart disease risk factors: hyperlipidemia are advised to control diet, low-fat, low-carbohydrate, high-fruit, vegetables diet, daily limit fat intake less than 30% of total calories, and be hypolipidemic medication, commonly used for several lipid drugs: (1) Polyunsaturated Kang, (2) Connaught value, (3) Jiangzhi isopropyl, (4) nicotinic acid, lowering triglycerides and low-density cholesterol. Treatment of hypertension, diabetes, smoking, (b) to continue drug treatment, isosorbide dinitrate, aspirin, β-blockers (3) complete the following inspections: radionuclide myocardial imaging, blood-pool imaging, ultrasound echocardiography, Holter, late potential. There are ischemic myocardium, coronary angiography should be made, if necessary, treatment and interventions such as coronary artery bypass grafting or PTCA.
A general treatment, absolute bed rest, Jin Yixiaohua diet. Stool maintain patency (available fruit I.). Sedation. Oxygen: general nasal catheter oxygen, the oxygen flow L 2-4; analgesic drugs, it should be noted the blood pressure drop, respiratory depression and vomiting, and other side effects; guardianship: ECG, blood pressure and respiration, heart rate, rhythm, volume guardianship, open vein.
Second, restrictions and reduce infarct size (1) drug treatment ① intravenous nitroglycerin, hypotension, or low blood volume, tachycardia cautiously uses; ② β-blockers, used to high blood pressure, heart rate fast, ST increased significantly, chest pain. Prohibited in heart failure, low blood pressure and slow arrhythmia; ③ calcium blockers, there is no evidence that can reduce infarct size. Such as severe hypertension or coronary artery spasm can choose nifedipine and diltiazem-Zhuo, attention should be paid to the use of taboo. (2) thrombolytic therapy ① indications: the incidence of acute myocardial infarction within 6 h (preferably within 4 h) of Q-wave myocardial infarction. No contraindications; ② taboo: A recent active bleeding or bleeding tendency, serious hypertension, cerebrovascular disease, a serious liver and kidney diseases, senior citizens (aged> 70 years); ③ commonly used drugs and Usage: streptokinase, urokinase and tissue-type plasminogen activator, and its main complication is bleeding, especially life-threatening intracranial hemorrhage can be, should be noted. (C) Emergency percutaneous transluminal angioplasty (PTCA) and surgical bypass surgery: thrombolytic contraindications applicable to thrombolysis in patients with failure of the serious residual stenosis after thrombolytic therapy should be scheduled for PTCA or surgical bypass surgery;
Third, treatment of complications of AMI
4. Recovery treatment (secondary prevention) (1) in the treatment of coronary heart disease risk factors: hyperlipidemia are advised to control diet, low-fat, low-carbohydrate, high-fruit, vegetables diet, daily limit fat intake less than 30% of total calories, and be hypolipidemic medication, commonly used for several lipid drugs: (1) Polyunsaturated Kang, (2) Connaught value, (3) Jiangzhi isopropyl, (4) nicotinic acid, lowering triglycerides and low-density cholesterol. Treatment of hypertension, diabetes, smoking, (b) to continue drug treatment, isosorbide dinitrate, aspirin, β-blockers (3) complete the following inspections: radionuclide myocardial imaging, blood-pool imaging, ultrasound echocardiography, Holter, late potential. There are ischemic myocardium, coronary angiography should be made, if necessary, treatment and interventions such as coronary artery bypass grafting or PTCA.