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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
Causes of Arteriosclerosis
Arteriosclerosis, the most common and important type of arteriosclerosis, is characterized by thickening and hardening of the arterial walls, loss of elasticity, and narrowing of the lumen. The causes are currently considered to be related to several factors, including age and gender, with older males being more prone. Patients with abnormal blood lipids, hypertension, smokers, those with diabetes or impaired glucose tolerance, obese patients, and those with a family history are all more likely to develop arteriosclerosis. Due to the incomplete certainty of the causes, its prevention and control are also managed through multiple factors.
How is arteriosclerosis treated?
To treat arteriosclerosis, we differentiate treatments based on the severity of the condition. For early-stage patients, we emphasize the control of lipids, blood pressure, and blood sugar to potentially slow the progression of arteriosclerosis. For patients who have already suffered damage to target organs, such as cerebral infarction, myocardial infarction, renal artery stenosis, or mesenteric artery stenosis, treatment might significantly rely on medication, and could possibly require the use of stents or even surgical bypass procedures. For the general population, we emphasize primary prevention, which includes a reasonable diet, appropriate exercise, and a balanced mental state to effectively prevent the disease.
How is pulmonary hypertension measured?
There are usually two methods to measure pulmonary arterial hypertension. One is through echocardiography to estimate, by measuring the speed of tricuspid regurgitation and then calculating the systolic pressure of the pulmonary artery through a formula. This method may overestimate or underestimate, hence its accuracy is not reliable. The gold standard is measuring pulmonary artery pressure via right heart catheterization. The downside of this gold standard is that it is an invasive procedure, which needs to be performed in a catheterization room; compared to ultrasound, it is also more costly. These are the two methods, each with its pros and cons. We need to choose based on the patient's situation.
Treatment of Arteriosclerosis
The treatment of arteriosclerosis includes general preventative measures, pharmacological treatment, interventional procedures, and surgical operations. General precautions involve a balanced diet, with some patients needing to lose weight, increasing the intake of fruits and vegetables, quitting smoking and limiting alcohol consumption, and adopting a low-fat diet. Additionally, it is advised that patients engage in appropriate physical labor and sports activities, while also maintaining an optimistic and calm mindset. Pharmacological treatment is quite specialized, mainly including lipid-lowering and antiplatelet therapies. Then, there are cases with clear symptoms, such as renal artery stenosis or coronary artery narrowing, where interventional treatments can be considered. For those unsuitable for interventional procedures, surgical treatments, such as bypass surgery, might be considered.
What medicine is used for arteriosclerosis?
Commonly, some medications used to adjust blood lipids are employed, primarily to lower low-density lipoprotein levels, and some are also aimed at achieving target levels for triglycerides. These include statins, fibrates, and niacin. For some patients, antiplatelet drugs might be necessary to prevent acute thrombus formation and avoid acute incidents. For those who have already formed a thrombus, thrombolytic drugs can be used within a certain time window for some patients. For patients with coronary artery accumulation leading to angina, vasodilators, receptor blockers, or calcium channel antagonists might be used to alleviate the symptoms of angina.
What medicine to take for arteriosclerosis?
Drug therapy is an important component of the treatment for atherosclerosis and mainly includes the following types. The first is to regulate blood sugar and lipids, keeping them under control to slow down the process of atherosclerosis. The second involves taking antiplatelet medications to prevent the formation of blood clots, especially since some plaques, particularly soft plaques, are prone to rupture. For some patients who have already formed blood clots, thrombolytic therapy might be considered, but this is not typically necessary for all patients. Additionally, because high blood pressure can accelerate the progression of atherosclerosis, some patients also need to take antihypertensive drugs. For patients with narrowed blood vessels and severe symptoms, such as angina, vasodilators, including nitrates, might be used. Therefore, the treatment choices may vary depending on the severity of the condition, and the modes of drug therapy differ. (Note: Specific medications should be taken under the guidance of a doctor.)
Pulmonary hypertension belongs to which department?
Pulmonary hypertension is a relatively complex disease with many types, and the department to which a patient should go depends on the type. For example, patients with idiopathic pulmonary hypertension often need to visit the department of cardiology. Similarly, pulmonary hypertension associated with left heart disease also falls under the jurisdiction of cardiology. However, if the pulmonary hypertension is related to hypoxia, these patients typically belong to the department of respiratory medicine. Furthermore, there are cases of chronic thromboembolic pulmonary hypertension, where patients can be seen either in cardiology or respiratory medicine. Therefore, answering which department pulmonary hypertension belongs to is a complex issue that requires classification based on the cause of the disease.
The earliest lesions of arteriosclerosis
The earliest lesion of atherosclerosis is the formation of lipid spots and streaks. The so-called lipid spots are small yellow dots that appear on the arterial intima. Under pathological observation, these are small areas of macrophages containing lipid droplets, forming a cluster of foam cells. As this small yellow dot develops, it gradually turns into a yellow streak made up of layers of macrophages containing lipids. The intima also comprises smooth muscle cells and lipids, as well as an infiltration of T cells, resembling a yellow streak on the intima.
What tests are used for arteriosclerosis?
If arteriosclerosis is in the early stages, we need to understand the situation with lipids and blood sugar, so lipid and blood glucose tests should be done. Later on, when some atheromatous plaques appear, examinations such as color Doppler ultrasound and cardiac echocardiography can be done to assess blood flow and the degree of narrowing in the vessels. For some severe narrowings, consider conducting a CTA, MRI, or angiography, which can non-invasively understand the lesions of arteriosclerosis. For some patients, if there is a need for interventional treatment, invasive, selective arterial angiography can be performed to understand the condition of the lesions. Therefore, different tests can be chosen at different stages.
How to treat pulmonary hypertension?
Pulmonary arterial hypertension (PAH), depending on its various causes, has different treatments. The treatment commonly referred to as for pulmonary arterial hypertension specifically targets Group 1 PAH. This category of PAH has some targeted medications that are quite effective, such as prostacyclin medications, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. These drugs target pulmonary artery pressure among other things. In addition to targeted treatments, anticoagulant therapy is usually necessary. When right heart failure occurs, diuretic therapy may be needed. In advanced stages, heart-lung or lung transplantation might be required.