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7
Cai Li E
Cardiology
About me
Vice Chief Physician, Associate Professor, Master of Medicine, Communist Party Member. Engaged in clinical work in the cardiovascular department for 20 years.
Main achievements: 1 provincial research project, 1 municipal research project; 1 Science and Technology Progress Award (second prize); 1 core journal article; 7 national journal articles.
Proficient in diseases
Diagnosis and treatment of common and prevalent cardiovascular diseases.
Voices
How long does heart disease generally hurt?
1. Chest pain caused by angina due to coronary heart disease is located in the middle to lower third of the sternum, with unclear boundaries. It is often triggered by physical activities or emotional excitement and may radiate to the throat, lower jaw, left shoulder, and inner side of the left arm. The pain lasts for a few minutes to more than ten minutes, typically between three to five minutes, and rarely exceeds half an hour. It can be relieved by rest or by taking nitroglycerin under the tongue. The nature of the pain is feelings of stuffiness, pressure, or constriction, and may also feel like a burning sensation, but is not sharp like needle pricks or cuts. 2. The location and nature of the chest pain in acute myocardial infarction are the same as with angina, but it lasts longer, is more severe, and its triggers are less evident. It can occur even while at rest, accompanied by symptoms such as sweating, nausea, vomiting, heart palpitations, and difficulty breathing. Unlike with angina, regular rest or taking nitroglycerin under the tongue does not completely alleviate the pain.
Atrial septal defect can cause which complications?
Small atrial septal defects generally are asymptomatic, whereas medium to large atrial septal defects may result in pulmonary hypertension and right heart failure. The impact of an atrial septal defect on hemodynamics mainly depends on the amount of shunting, which in turn is determined by the size of the defect. It also relates to the compliance of the left and right ventricles and the relative resistance of the systemic and pulmonary circulation. Continued increase in pulmonary blood flow leads to pulmonary congestion, increasing right heart volume load. Pulmonary vascular compliance decreases, evolving from functional to organic pulmonary hypertension. This in turn continuously increases right heart system pressure until it surpasses the pressure of the left heart system, causing the original left-to-right shunt to reverse to a right-to-left shunt, leading to cyanosis. Atrial septal defects are generally asymptomatic but with the progression of the condition, symptoms such as exertional dyspnea, arrhythmias, and right heart failure may occur. In the advanced stages, about 15% of patients with severe pulmonary hypertension exhibit a right-to-left shunt and cyanosis, leading to the formation of Eisenmenger syndrome.
Why does pericardial effusion cause abnormal pulses?
Pulsus paradoxus refers to a condition where the pulse weakens significantly or disappears during inhalation, caused by a decrease in the left ventricular stroke volume. Normally, the strength of the pulse is not affected by the respiratory cycle. However, when cardiac tamponade, significant pericardial effusion, or constrictive pericarditis occurs, inhalation can restrict the relaxation of the right heart, leading to a reduced volume of blood returning to the heart and affecting the right heart’s output. Consequently, the amount of blood the right ventricle pumps into the pulmonary circulation is reduced. Furthermore, the pulmonary circulation is affected by the negative thoracic pressure during inhalation, causing pulmonary vessels to dilate and reducing the volume of blood returning from the pulmonary veins to the left atrium. Therefore, the output of the left heart also decreases. These factors lead to a weakened pulse during inhalation, which can sometimes be imperceptible, also known as pulsus paradoxus. This condition can be identified by a significant drop in systolic pressure by more than 10mmHg during inhalation compared to exhalation.
Arteriosclerosis has what manifestations?
Arteriosclerosis symptoms vary depending on the affected organ. Coronary arteriosclerosis primarily manifests as angina, while cerebral arteriosclerosis mainly results in cerebral embolism, potentially causing symptoms such as hemiplegia. Chronic cerebral ischemia can lead to cerebral atrophy and progress to vascular dementia. Aortic arteriosclerosis often displays no specific symptoms. Renal arteriosclerosis can cause refractory hypertension, and if a renal artery thrombosis occurs, it may lead to pain in the kidney area, oliguria, and fever. Chronic kidney ischemia can lead to kidney atrophy and progress to renal failure. Mesenteric arteriosclerosis can cause symptoms like indigestion, decreased intestinal tone, constipation, and abdominal pain. Arteriosclerosis in the limbs, often seen in the lower extremities, can cause symptoms such as coldness in the legs, numbness, and the typical intermittent claudication.
What blood pressure is considered low blood pressure?
Systolic pressure less than 90 mmHg and diastolic pressure less than 60 mmHg indicate low blood pressure. The normal blood pressure range for adult males and females of any age is a systolic pressure between 90 to 139 mmHg and/or diastolic pressure between 60 to 89 mmHg. High blood pressure is defined as having a systolic pressure of 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or higher. Arterial blood pressure varies among individuals, as well as by age and gender, with a general trend of increasing pressure as age advances, and the increase in systolic pressure is more pronounced than that in diastolic pressure. Before menopause, women tend to have slightly lower blood pressure than men of the same age, but after menopause, their blood pressure generally aligns with or even slightly exceeds that of their male counterparts.
How to regulate rapid heartbeat and insomnia?
If increased heart rate and insomnia are not due to cardiovascular disease, pulmonary disease, or thyroid disease, consider a diagnosis of cardiovascular neurosis. Patients with cardiovascular neurosis often present with numerous and variable complaints, lacking an intrinsic connection between symptoms. Common symptoms include palpitations, a heightened sense of heartbeat, chest tightness, labored breathing, a frequent feeling of insufficient air requiring opening windows or needing oxygen, accompanied by insomnia, vivid dreams, anxiety, loss of appetite, dizziness, tinnitus, sweating, cold hands and feet, and trembling hands. Treatment primarily involves psychotherapy, with medication as a secondary approach. Patients are encouraged to adjust their attitudes, organize their schedules properly, and engage in cultural, tourism, and sports activities. In cases of severe insomnia, the cautious use of drugs like midazolam or zopiclone may be considered. (The use of medications should be under the guidance of a physician)
What are the dangers of sinus arrhythmia?
Sinus arrhythmia, if it manifests as sick sinus syndrome, can lead to symptoms of insufficient blood supply to organs such as the heart, brain, and kidneys. These symptoms include episodic dizziness, dim vision, palpitations, fatigue, and decreased exercise tolerance. In severe cases, there may be angina, heart failure, transient loss of consciousness or syncope, and even sudden death. If there is an episode of tachycardia, symptoms such as palpitations and angina can occur. If the symptoms are significant, consideration may be given to pacemaker therapy. Sinus tachycardia and sinus bradycardia can be physiological or pathological. Physiological cases generally do not show symptoms, are not harmful, and do not require treatment. Pathological cases primarily focus on treating the underlying disease.