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Zeng Wei Jie
Cardiology
About me
Dr. [Name] graduated from Peking Union Medical College and specializes in the diagnosis and treatment of various cardiovascular and critical illnesses, especially acute coronary syndrome, refractory heart failure, resistant hypertension, myocardial disease, arterial pulmonary hypertension, and pulmonary embolism. Dr. [Name] has participated in several national research projects and has been involved in research funded by the National Natural Science Foundation and the Capital Medical Development Science Fund. Dr. [Name] has also received funding from the National Natural Science Youth Fund and the Special Fund for Basic Scientific Research of Central Universities. Additionally, Dr. [Name] has published 7 articles included in the SCI database.
Proficient in diseases
Specializes in the diagnosis and treatment of various cardiovascular critical illnesses, especially coronary heart disease, refractory heart failure, hypertension, myocardial disease, pulmonary arterial hypertension, and pulmonary embolism.
Voices
"Dou xing xin lv shi chang" translates to "sinus rhythm disorder" in English.
Sinus arrhythmia, including sinus tachycardia, sinus bradycardia, and sinus arrhythmia, is first and foremost a normal source of heart rate, that is, sinus rhythm. Based on this, its frequency is somewhat abnormal, and we differentiate it into sinus tachycardia or sinus bradycardia. There are cases where, although the frequency is between 60-100 beats per minute, the rhythm is irregular, which we refer to as sinus arrhythmia. So, sinus arrhythmia generally refers to these three conditions. In terms of management, sinus tachycardia often has a specific cause that needs correction. Sinus bradycardia, in some cases, leads to symptoms of insufficient cardiac output, such as fainting, which may require the installation of a pacemaker. Sinus arrhythmia usually does not require special treatment.
Arteriosclerosis is divided into several stages.
Arterial atherosclerosis sequentially manifests as three major types: lipid spots and stripes, atheromatous and fibrous atheromatous plaques, and complex lesions. According to the process of its occurrence and development, it can be subdivided into six types. The first type is lipid spots, which are small yellow spots on the arterial intima that gradually develop into the second type, lipid stripes, where some yellow stripes appear on the arterial intima. Then there is the third type, pre-lesional plaque, where more lipid droplets appear extracellularly. The fourth type is the atheromatous plaque, where lipids accumulate excessively and form lipid pools, and the intimal structure will be damaged. The fifth type is the fibrous atheromatous plaque, which is the most characteristic lesion of arterial atherosclerosis. The sixth type is a complex lesion, representing a severe condition.
Symptoms of pulmonary hypertension
The symptoms of pulmonary arterial hypertension are varied. In the early stages when pulmonary cardiac function is compensatory, the symptoms mainly include cough, phlegm, shortness of breath, difficulty breathing, and fatigue. Later, when pulmonary cardiac function becomes decompensated, symptoms of respiratory failure and right heart failure may occur. In cases of right heart failure, symptoms mainly manifest as systemic circulatory congestion, including visceral nausea, vomiting, palpitations, and pronounced shortness of breath. In respiratory failure, particularly pulmonary hypertension caused by pulmonary heart disease, symptoms like drowsiness, confusion, and gaze fixation, which are typical of pulmonary encephalopathy, may occur. Therefore, the symptoms of pulmonary arterial hypertension are diverse.
Risk factors for arteriosclerosis
The etiology of atherosclerosis is not yet fully understood, but the main risk factors include age and gender. The older the age, the higher the probability of occurrence, and the probability in men is higher than in women. Abnormal blood lipids, with the main treatment target being low-density lipoprotein, hypertension, smoking, glucose tolerance abnormalities, and obesity are all possible risk factors. Additionally, we cannot ignore family history; if there is a history of early-onset coronary heart disease in the family, then this risk factor is also very high. Moreover, personality is related, with Type A personalities being more prone to atherosclerosis. Dietary habits are also related; patients who often eat high-calorie, high-animal-fat, high-cholesterol foods are prone to develop the condition. There are also patients taking oral contraceptives, who are likely to develop atherosclerosis.
How to treat atrial myocardial infarction?
Atrial myocardial infarction is also a type of myocardial infarction. Isolated atrial myocardial infarction is relatively rare and often coexists with ventricular infarction. Therefore, the treatment principles for myocardial infarction are essentially the same, focusing on promptly improving myocardial ischemia, myocardial necrosis, and the long-term prognosis of the patient. The treatment mainly includes: first, reperfusion therapy, which involves thrombolysis for ST-segment elevation cases, stent placement for most patients, and bypass surgery for a small number of patients. The second aspect is secondary prevention and treatment, including antiplatelet therapy, blood pressure control, blood sugar management, diet, exercise, and other comprehensive treatments. The peculiarity of atrial myocardial infarction is that some patients may experience atrial fibrillation, thus some of these patients may require treatment to control ventricular rate.
Late-stage symptoms of pulmonary arterial hypertension
The prognosis of pulmonary hypertension depends on the function of the right heart. The main symptoms in the final stage of pulmonary hypertension are those of right heart failure. At this time, the patient mainly shows symptoms such as swelling of the lower limbs, oliguria, and abdominal distension. The difficulty in breathing may be slightly less severe than in the early stages. These symptoms are mainly caused by venous congestion in the systemic circulation, which prevents blood from returning from the lower limbs, leading to edema or ascites in the lower parts of the body.
Clinical symptoms of low blood pressure
The clinical symptoms of hypotension mainly depend on its type. For example, in patients with orthostatic hypotension, symptoms such as dizziness, syncope, or even falling may occur when moving from a lying to a standing position. For hypotension caused by shock, it can be divided into hypovolemic shock and shock caused by reduced cardiac output, which may lead to symptoms like reduced urine output, cold and clammy skin, rapid heart rate, and short pulse. The clinical symptoms caused by cardiac tamponade are also generally related to reduced cardiac output. If the hypotension is caused by gastrointestinal bleeding, symptoms like vomiting blood and black stools may occur. Thus, the symptoms of hypotension can vary greatly depending on the cause.
Can atrial fibrillation be completely cured?
Regarding whether atrial fibrillation can be completely cured, it essentially depends on the definition of being completely cured. If the criterion is complete cessation of medication, then many patients cannot achieve this. However, if the standard is conversion of atrial fibrillation back to normal sinus rhythm, then it is achievable for many patients, such as those with paroxysmal atrial fibrillation, who suffer from recurrent episodes and do not respond well to medication. In such cases, radiofrequency ablation might be attempted, and there is a high likelihood that after the treatment, the rhythm will convert to sinus rhythm. In this sense, some people can be considered cured. However, whether anticoagulation therapy can be discontinued depends on their thromboembolic risk score. This means that even if atrial fibrillation converts to sinus rhythm after radiofrequency ablation, some patients still need long-term anticoagulant medication. Therefore, from the perspective of discontinuing medication, such patients with atrial fibrillation are not considered cured.
How is arteriosclerosis treated?
The treatment of arteriosclerosis includes general preventive measures, pharmacological treatment interventions, and surgical interventions. General protective measures include reasonable dietary practices, appropriate physical exercise, proper arrangement of work and life, maintaining a pleasant mood, quitting smoking, limiting alcohol consumption, and controlling some disease-related risk factors such as hypertension, diabetes, dyslipidemia, obesity, etc. The main pharmacological treatment focuses on lipid-lowering and antiplatelet medication. For some patients with symptoms of angina pectoris, such as symptoms of target organ damage, treatment may involve dilating the blood vessels. Interventional treatment indications are now relatively broad. For some who are not suitable for interventional procedures, surgical treatments can be considered.
What causes low blood pressure?
There are many causes of low blood pressure. A significant portion of chronic hypotension is due to physical constitution, with some patients who are generally frail having consistently low blood pressure but no symptoms. This type is quite common. Secondly, postural hypotension is also fairly common, often seen in elderly people or those taking antihypertensive medications, such as receptor blockers. These patients may experience transient dizziness and transient low blood pressure when getting up, known as postural hypotension. Moreover, the more common type is acute, sustained low blood pressure, which includes various causes of shock, myocardial infarction, cardiac tamponade, or acute blood loss, which can be life-threatening conditions requiring urgent treatment.