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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 does septal defect shunt?
Atrial septal defect is the most common congenital heart disease in adults, accounting for 20%-30% of all adult congenital heart conditions. The impact of an atrial septal defect on hemodynamics primarily depends on the amount of shunting. Due to higher pressure in the left atrium compared to the right atrium, a left-to-right shunt is formed. The amount of shunting depends on the size of the defect, as well as the compliance of the left and right ventricles and the relative resistance in the systemic and pulmonary circulations. Diseases that affect the compliance of the left ventricle, such as hypertension and coronary artery disease, can increase the extent of the left-to-right shunt. A continuous increase in pulmonary blood flow leads to pulmonary congestion, increasing the load on the right heart. Pulmonary vascular compliance decreases, progressing from functional pulmonary arterial hypertension to organic pulmonary arterial hypertension. As right heart system pressure continuously increases and eventually exceeds the pressure in the left heart system, the original left-to-right shunt reverses to become a right-to-left shunt, resulting in cyanosis.
Atrial fibrillation is caused by what?
Atrial fibrillation can occur in healthy individuals, sometimes triggered by emotional excitement, surgery, exercise, or excessive drinking. It often occurs in patients with existing cardiovascular diseases, such as rheumatic heart disease, coronary artery disease, hypertensive heart disease, hyperthyroidism, constrictive pericarditis, myocarditis, infective endocarditis, and chronic pulmonary heart disease. Atrial fibrillation can also occur in middle-aged and young adults without cardiac diseases, known as lone atrial fibrillation.
How is atrial fibrillation surgery performed?
Frequent atrial fibrillation attacks with a rapid ventricular rate, in cases unresponsive to drug treatment, can be managed by atrioventricular node ablation followed by the placement of a ventricular demand or dual-chamber pacemaker. Other treatment methods include radiofrequency ablation, surgical operations, and implantation of atrial defibrillators. In recent years, there have been significant advances in the methods for atrial fibrillation ablation, and the indications for atrial fibrillation ablation have been expanded. However, the success rate remains suboptimal and the recurrence rate is relatively high. Currently, international guidelines still categorize radiofrequency ablation as a second-line treatment for atrial fibrillation, not as the first choice treatment.
Can pulmonary hypertension cause coughing?
Pulmonary arterial hypertension is a commonly seen clinical condition with complex causes, which may arise from various cardiac, pulmonary, and pulmonary vascular diseases. When pulmonary arterial hypertension occurs, due to increased resistance in the pulmonary circulation, the load on the right heart will increase, eventually leading to right heart failure, thus causing a series of clinical manifestations. In the early stages, pulmonary arterial hypertension may not present with obvious symptoms, and discomfort may be felt during intense exercise, with most patients showing shortness of breath after activity. During the compensatory period of pulmonary heart function, symptoms such as palpitations, shortness of breath, fatigue, and decreased endurance may occur during activities, and acute infections can also exacerbate these conditions, potentially causing mild chest pain or hemoptysis. Some patients may exhibit signs of heart dysfunction, like coughing and expectorating phlegm.
How to treat patent ductus arteriosus?
The arterial duct connects the main pulmonary artery to the descending aorta, serving as the primary channel for blood circulation during the fetal period. After birth, it generally becomes obstructed within a few months due to disuse; if it remains open after one year, it is referred to as patent ductus arteriosus (PDA). The length and diameter of an unclosed arterial duct vary, affecting hemodynamics differently, and consequently, prognoses differ. An unclosed arterial duct can easily induce infectious endocarditis; thus, even if the shunt is small, it is advisable to seek early interventional or surgical treatment. The surgery has a high safety success rate and can be performed at any age. However, surgery is contraindicated for patients who have developed secondary pulmonary artery obstruction and exhibit right-to-left shunting.