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Liu Ying
Cardiology
About me
Benxi Central Hospital, Cardiovascular Department, Associate Chief Physician, has been engaged in cardiovascular clinical work for many years and has rich clinical experience in the diagnosis and treatment of cardiovascular diseases.
Proficient in diseases
Specializing in common cardiovascular diseases such as angina, high blood pressure, sudden death, arrhythmia, heart failure, premature beats, irregular heartbeat, myocardial infarction, cardiomyopathy, myocarditis, acute myocardial infarction, etc.
Voices
Constrictive pericarditis clinical manifestations
Patients with constrictive pericarditis often have a history of pericarditis, pericardial effusion, malignant tumors, and other diseases. Some patients have an insidious onset with no obvious clinical symptoms in the early stages. The main symptoms can include palpitations, exertional dyspnea, decreased exercise tolerance, fatigue, enlarged liver, pleural effusion, abdominal effusion, and edema of the lower limbs. Patients with constrictive pericarditis commonly present with elevated jugular venous pressure, and often have a reduced pulse pressure. Most patients exhibit a negative apical beat during systole, with a commonly faster heart rate. The rhythm can be sinus, atrial, or ventricular, with premature contractions possible, as well as Kussmaul's sign. In the late stages, muscle atrophy, cachexia, and severe edema can occur.
Can people with chronic heart failure smoke?
Patients with chronic heart failure should not smoke, as smoking can enhance the excitability of the sympathetic nervous system. Increased excitability of the sympathetic nervous system releases norepinephrine, elevating norepinephrine levels. This can cause peripheral vasoconstriction, increase the afterload on the heart, and accelerate heart rate. Both of these effects can increase myocardial oxygen consumption. Furthermore, norepinephrine has a direct toxic effect on myocardial cells, promoting myocardial cell apoptosis and participating in the pathological process of ventricular remodeling. Moreover, excitement of the sympathetic nervous system can also enhance myocardial stress, potentially promoting the occurrence of arrhythmias. Therefore, patients with chronic heart failure should not smoke.
Can dilated cardiomyopathy be inherited?
We say that dilated cardiomyopathy is a type of cardiomyopathy characterized by enlargement of the left ventricle or both ventricles, accompanied by systolic dysfunction. Some cases of dilated cardiomyopathy are familial, with the main inheritance patterns being autosomal dominant, X-linked recessive, and more rarely, mitochondrial inheritance. The cause of most dilated cardiomyopathies is unclear, but potential causes include infections, non-infectious inflammation, endocrine metabolic disorders, genetics, psychological trauma, and poisoning, including alcohol poisoning. Alcoholism is a common cause of dilated cardiomyopathy in China. Clinically, dilated cardiomyopathy presents with cardiac enlargement, heart failure, arrhythmias, thromboembolism, and sudden death.
Can acute pericarditis be cured?
Patients with acute pericarditis should identify the cause of pericarditis and treat accordingly, rest in bed until chest pain and fever subside, administer analgesics for pain relief, and if pericardial effusion occurs, administer corticosteroids for patients who do not respond well to other medications for absorbing effusion. In cases of excessive pericardial effusion leading to acute cardiac tamponade, immediate pericardiocentesis and fluid drainage are necessary. For persistent recurrent pericarditis lasting over two years, and in patients who cannot be controlled with steroids, or those with severe chest pain, surgical pericardiectomy may be considered as a treatment option.
Causes of arrhythmia
There are many causes of arrhythmia, which can be physiological or pathological. Pathological causes can originate from the heart itself or from other diseases. For instance, normal individuals might experience sinus arrhythmia, and circumstances such as staying up late, emotional excitement, or excessive fatigue can lead to premature beats or sinus tachycardia, among others. Other diseases, such as hyperthyroidism or fever, can cause an increased heart rate. For example, pulmonary embolism can lead to atrial fibrillation. Heart-related diseases, like heart failure, can cause ventricular premature beats, and diseases of the sinoatrial node itself can lead to sick sinus syndrome, among others.
How to maintain health after a myocardial infarction?
Myocardial infarction refers to the occurrence of ischemia and hypoxia in cardiac muscle cells, leading to necrosis of these cells. It is a very serious condition of the heart. Patients with myocardial infarction should pay attention to lifestyle adjustments, such as quitting smoking, limiting alcohol, adopting a low-salt and low-fat diet, eating less or avoiding fatty meat and animal offal, and avoiding staying up late, emotional excitement, fatigue, etc. It is also important to control high-risk factors of myocardial infarction, for example, patients with hypertension should control their blood pressure, those with diabetes should manage their blood sugar, and patients with high blood lipids should control their blood lipid levels and ensure they meet standard levels, etc., follow doctor’s advice, take medications on time, and have regular check-ups, etc.
How is constrictive pericarditis treated?
We say constrictive pericarditis refers to a disorder of circulatory disturbances caused by the heart being encased in a densely thickened fibrotic or calcified pericardium, which restricts the filling of the ventricles during diastole. Most patients with constrictive pericarditis will progress to chronic constrictive pericarditis. At this point, the only effective treatment method is pericardiectomy, but the perioperative risk is very high. A small portion of patients have short-term or reversible pericardial constriction, so for patients who are recently diagnosed and have stable conditions, it is possible to try anti-inflammatory treatment for 2-3 months unless complications such as cardiac cachexia, cardiogenic cirrhosis, or myocardial atrophy occur. For tuberculous pericarditis, anti-tuberculosis treatment is recommended to delay the progression of pericardial constriction, and post-surgery, anti-tuberculosis treatment should continue for one year.
What should be noted for dilated cardiomyopathy?
Patients with dilated cardiomyopathy should actively look for the cause of the disease and provide corresponding treatments, such as controlling infections, strictly limiting or abstaining from alcohol, treating relevant endocrine or autoimmune diseases, correcting electrolyte disorders, and improving nutritional imbalances, etc. In the early stages of dilated cardiomyopathy, although there is already enlargement of the heart and impairment of contractile function, there are no clinical manifestations of heart failure. At this stage, early pharmacological intervention should be actively implemented to slow down ventricular remodeling and further damage to the myocardium, delaying the progression of the disease. As the condition progresses, the patient's ventricular contractile function further decreases and clinical manifestations of heart failure appear. At this point, treatment should follow the guidelines for chronic heart failure. However, the specifics of the treatment and the choice of medication should be determined by a specialist based on the patient’s condition.
Causes of chronic heart failure
Chronic heart failure is the terminal manifestation and leading cause of death in cardiovascular diseases. Although there has been significant progress in the treatment of heart failure in China, the number of deaths from heart failure continues to rise. Coronary artery disease and hypertension have become the main causes of chronic heart failure. Rheumatic heart disease and valvular heart disease are also causes of chronic heart failure. Valvular heart diseases, such as mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, pulmonary valve diseases, and tricuspid valve diseases, can all lead to heart failure. Additionally, chronic pulmonary heart disease and high-altitude heart disease also have certain regional prevalences in China.
acute pericarditis clinical manifestations
The clinical manifestations of acute pericarditis include symptoms and signs. The symptoms of acute pericarditis are pain behind the sternum and in the precordial region, which often occurs during the fibrinous exudative phase of inflammation. The pain can radiate to the neck, left shoulder, left arm, and even the upper abdomen. The nature of the pain is sharp, related to respiratory movements. As the condition progresses, the pain can disappear and be replaced by difficulty breathing. Some patients may develop significant pericardial effusion leading to cardiac tamponade, resulting in symptoms such as difficulty breathing, edema, and other related symptoms. During acute pericarditis, the most diagnostically valuable sign is the pericardial friction rub, typically located in the precordial area. A typical friction rub can be heard consistent with atrial contraction, ventricular contraction, and ventricular relaxation, known as a triphasic friction rub, and so on.