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Tang Li
Cardiology
About me
Beijing Boai Hospital, Cardiovascular Department, attending physician, has been engaged in clinical work in cardiac internal medicine for many years, with rich clinical experience in the diagnosis and treatment of cardiovascular diseases.
Proficient in diseases
Specializes in the diagnosis of common cardiovascular diseases such as coronary heart disease, hypertension, arrhythmia, atrial fibrillation, paroxysmal supraventricular tachycardia, heart failure, myocarditis, congenital heart disease, cardiomyopathy, and atrial septal defect.
Voices
How is pulmonary hypertension treated?
The treatment of pulmonary hypertension mainly focuses on identifying the cause. For idiopathic pulmonary hypertension, treatment primarily targets vascular constriction, endothelial damage, thrombus formation, and heart failure. This is to restore the tension, resistance, and pressure of the pulmonary vessels, improve the patient's sexual function, increase cardiac output, and improve quality of life. The main treatments include: 1. Drug therapy, which includes calcium channel blockers, prostacyclin, nitric oxide, endothelin receptor antagonists, and related anticoagulants. Anticoagulants do not improve symptoms, but can slow down disease progression and improve prognosis in some aspects. However, in cases of right heart failure, hepatic congestion, and ascites, cardiotonic diuretics are used, such as digoxin and anti-calcium channel blockers, which can cause adverse reactions like decreased myocardial contractility. But these drugs should be administered under the guidance of a doctor. In advanced stages of pulmonary arterial hypertension, heart-lung transplantation may be considered.
Atrial septal defect should be consulted with the Department of Cardiology.
Atrial septal defect is a common congenital heart disease in childhood, and it is also the most common congenital heart disease in adulthood. The incidence rate of atrial septal defects is about 1/1500 live births, accounting for 5%-10% of all congenital heart diseases, and it is more common in females. Most children with atrial septal defect, in addition to being prone to respiratory infections such as colds, may have no obvious symptoms and their activities are not limited. It is generally not until adolescence that symptoms like shortness of breath, palpitations, and fatigue appear. Patients with atrial septal defects should seek treatment in departments such as cardiology, cardiovascular surgery, thoracic surgery, or pediatric cardiology.
How is hypertrophic cardiomyopathy treated?
The treatment of hypertrophic cardiomyopathy aims to improve symptoms, reduce complications, and prevent sudden death. The methods include improving ventricular compliance by reducing outflow tract obstruction, preventing thromboembolic events, and identifying high-risk patients for sudden death. Treatment needs to be individualized, and the main treatments include the following aspects: 1. Medication treatment. Drug treatment is fundamental, and drugs targeting outflow tract obstruction mainly include receptor blockers and non-dihydropyridine calcium channel blockers. For patients with congestive heart failure, targeted treatment is required. Anticoagulation treatment is necessary for patients with atrial fibrillation, and it is worth noting that for patients with chest discomfort, care should be taken to exclude outflow tract obstruction when using nitrate drugs to avoid exacerbation after use. Non-drug treatments include: 1. Surgical treatment: For patients with ineffective drug treatment and heart function class three to four, if there is severe outflow tract obstruction, septal myectomy should be considered. Currently, surgery is listed as the preferred treatment for suitable patients in consensus guidelines in both America and Europe. 2. Alcohol septal ablation; 3. Pacing therapy.
Hypertensive crisis blood pressure values
At any stage of hypertension development and other disease emergencies, severe life-threatening blood pressure increases can occur, requiring emergency treatment. Hypertensive crises include hypertensive emergencies and hypertensive urgencies. Hypertensive emergencies refer to severe blood pressure increases within a short time—hours or days—with diastolic pressure greater than 130 mmHg and/or systolic pressure greater than 180 mmHg, accompanied by severe dysfunction or irreversible damage to critical organs and tissues such as the heart, brain, kidneys, retina, and major arteries. Hypertensive urgencies may present as increased blood pressure but without obvious target organ damage.
What are the infectious causes of pericarditis?
The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.
How to treat atrial septal defect
Typical cardiac murmur ECG and X-ray findings may suggest the presence of an atrial septal defect. An echocardiogram can confirm the diagnosis, and it should be differentiated from conditions such as anomalous pulmonary venous return, pulmonary valve stenosis, and small ventricular septal defects. For the treatment of atrial septal defects, in adult patients, if echocardiographic evidence of increased right ventricular volume load is present, the defect should be closed as soon as possible. Treatment options include interventional and open-heart surgical procedures. Before the implementation of interventional surgeries, all cases of simple atrial septal defects that have caused hemodynamic changes, with signs of increased pulmonary blood flow, enlargement of the atria and ventricles, and corresponding ECG findings, should undergo surgical treatment. In older patients with severe pulmonary hypertension, surgical treatment should be approached with caution.
Why does patent ductus arteriosus cause a decrease in diastolic pressure?
In patients with patent ductus arteriosus, since the aortic pressure is significantly higher than the pulmonary artery pressure throughout the cardiac cycle, there is continuous blood flow from the aorta into the pulmonary artery through the open duct, causing a left-to-right shunt. This increases the blood volume in the pulmonary circulation, causing dilatation of the pulmonary artery and its branches. The blood flow returning to the left heart system also increases, thereby increasing the load on the left heart and causing the left heart to enlarge. Due to the diastolic diversion of blood from the aorta to the pulmonary artery, the peripheral arterial diastolic pressure decreases and the pulse pressure increases.
Can a ventricular septal defect heal itself?
Traditional views suggest that the best age to close atrial septal defects (ASDs) is between four and five years old, during preschool. The possibility of spontaneous closure of atrial septal defects larger than 8 millimeters in diameter is very low. If the defect is less than 4 millimeters, there is a possibility of healing. Currently, it is advocated that if an atrial septal defect still exists after the age of one year, and there is evident systolic murmur and fixed splitting of the second heart sound, or if heart catheterization and echocardiography show left-to-right shunting greater than 1.5:1, indicating a defect diameter of five to six millimeters or more, early surgery should be pursued to stop the left-to-right shunt to avoid causing pulmonary hypertension and endocarditis.
What are the symptoms of myocarditis?
The clinical manifestations of myocarditis in patients depend on the extent and location of the lesion. Mild cases may have no symptoms at all, while severe cases can even present with heart failure and shock. Most patients have precursor symptoms of viral infection one to three weeks before the onset, such as fever, general fatigue, and muscle soreness. Some patients have gastrointestinal symptoms like nausea and vomiting. Subsequently, they may experience palpitations, chest pain, breathing difficulties, edema, and even fainting or sudden death. The majority of clinically diagnosed myocarditis cases primarily present with or are primarily symptomatic of psychological frailty. A minority of patients may experience fainting or Aschner's syndrome as a result.
Symptoms of an infant's room septal defect
Symptoms of ventricular septal defect in infants are as follows: 1. Symptoms: If the mother had intrauterine infections within the first three months of pregnancy, was exposed to significant amounts of radiation, took teratogenic medications, or had metabolic disorders, these factors could contribute to the condition. The patient is prone to recurrent respiratory infections and exhibits symptoms of palpitations, shortness of breath, fatigue, and excessive sweating. If these symptoms worsen after physical activity or crying and are accompanied by cyanosis, congenital heart disease should be considered. Cyanosis can intensify during severe crying episodes, pneumonia, or heart failure in infants, and may be accompanied by a hoarse voice. 2. Physical signs: Notable findings include a bulging in the precordial area and diffuse apical impulse. A soft, systolic murmur can be heard between the second and third ribs along the left margin of the sternum.