Subscribe
58
Xie Zhi Hong
Cardiology
About me
The Secretary-General and Standing Committee Member of the Cardiovascular Disease Professional Committee of the Rehabilitation Medical Association in Ganzhou City, and a member of the Ganzhou City Working Committee of the Heart Emergency Branch of the China Medical Health International Exchange Promotion Association. He has chaired 4 provincial and municipal-level research projects, participated in more than 20 research projects, and published over 20 papers.
Proficient in diseases
Specializes in the diagnosis and treatment of coronary heart disease, hypertension, and structural heart disease. Research interests include hypertension, coronary heart disease, arrhythmia, and cardiac rehabilitation.
Voices
Is perimembranous ventricular septal defect serious?
The ventricles are separated by the interventricular septum, which divides the left and right ventricles. Typically, after blood is ejected from the left ventricle and oxygenated by tissues, it returns to the right ventricle. The blood from the right ventricle gets oxygenated through the pulmonary artery before it can return to the left ventricle. These two should be isolated from each other before passing through the lungs. The interventricular septum consists of the membranous and muscular parts, and a defect in either part can affect oxygenation. Therefore, whether the defect is in the membranous or muscular portion is not an indicator for diagnosing the severity of the interventricular septum defect; rather, the size of the defect should be considered. Generally speaking, a defect of about 10mm in the interventricular septum, especially when accompanied by other conditions such as Tetralogy of Fallot, is considered severe. Moreover, when the defect reaches over 10mm, surgical intervention is required as minimally invasive surgery would not be feasible; these are considered severe interventricular septum defects. Also, there are cases with multiple complex defects or larger defects that should be surgically treated as soon as possible.
Will being overweight affect the surgery for a ventricular septal defect?
Ventricular septal defect surgery is performed by puncturing the right femoral vein, guiding the catheter into the inferior vena cava, through the atria and ventricles, and reaching the defect via the right ventricle. The occluder can then be delivered through the catheter into the left ventricle, where the umbrella is opened, followed by opening it in the right ventricle; this describes the surgical process. Therefore, generally speaking, the surgical process is not affected in most patients who are obese. However, severe obesity can impact the accuracy of vascular localization during puncture by the surgeon. Secondly, if complications such as anesthesia issues or other emergencies arise during the surgery, severely obese patients may experience a reduced success rate in emergency surgical interventions, hence it is recommended that patients control their weight. Furthermore, severe obesity can exacerbate the cardiac load originally induced by the ventricular septal defect, thus affecting the surgical tolerance in patients whose cardiac function is already compromised by the defect. It is recommended that these patients control their weight.
The causes of recurrent pericardial effusion
Pericardial effusion can be caused by many factors, such as acute pericarditis or chronic tuberculous pericarditis. Other causes include hypothyroidism, tumors, heart failure, and severe hypoproteinemia due to liver dysfunction, all of which can lead to pericardial effusion. Common pericardial effusion infections, hypothyroidism, or heart failure might improve after treatment. However, if the cause of certain intractable diseases cannot be removed, pericardial effusion may recur. For example, pericardial effusion caused by malignant tumors and hypoproteinemia is common in patients with cirrhosis, severe liver failure, or nephrotic syndrome. Such individuals often experience recurring pericardial effusions. Another example is patients with heart failure, who, in the terminal stages of heart disease, also frequently experience recurrences of pericardial effusion. Therefore, managing recurrent pericardial effusions in patients, particularly when not due to infectious factors, can be quite challenging.
Can a patent ductus arteriosus be treated with minimally invasive surgery?
Patent ductus arteriosus refers to the condition in infants where the ductal connection between the pulmonary artery and the aortic arch from the embryonic period remains open after the first year of birth. Generally, this duct is tubular or funnel-shaped and most cases can be treated minimally invasively. Surgical treatment is considered only if there are severe adhesions involving the aorta or pulmonary artery, or there are developmental issues. Therefore, patent ductus arteriosus can be treated with minimally invasive surgery, and most cases are amenable to such treatment.
Heart failure is neither tachycardia nor bradycardia.
Heart failure refers to the condition in which the heart's pumping function is relatively or absolutely insufficient, resulting in a series of symptoms. Patients may exhibit symptoms such as chest tightness, shortness of breath, difficulty breathing, and sometimes even cyanosis of the lips. Severe cases can lead to sudden death. Tachycardia and bradycardia are only due to disturbances in the patient's cardiac conduction system, causing the heart rate to accelerate or slow down. If the patient's heart function is good, the majority can compensate. However, prolonged tachycardia or prolonged bradycardia can potentially lead to heart failure. Therefore, heart failure is different from tachycardia or bradycardia.
The main cause of sudden cardiogenic cardiac arrest
70% of sudden cardiac deaths are caused by arrhythmias, often referred to as malignant arrhythmias, with the most common ones being ventricular tachycardia and ventricular fibrillation. A small portion is caused by severe bradycardia. This condition is generally seen in patients with structural heart diseases, such as acute myocardial infarction, severe dilated cardiomyopathy, hypertrophic cardiomyopathy, or patients in the late stages of valvular insufficiency or stenosis. It can also occur in patients with severe electrolyte disturbances, who are prone to malignant arrhythmias.
Is a patent ductus arteriosus funnel type severe?
The arterial duct is a pathway through which blood from the maternal placenta is delivered to the fetus. This pathway usually closes at birth, and in most cases, it successfully closes within three months. If it remains open after one year, it can be diagnosed as a patent ductus arteriosus. The shapes of the arterial duct include funnel-shaped, tubular, and window-type. Regardless of the type, if it does not cause serious cardiac complications, it can be addressed with interventional treatments or surgical procedures, making it a relatively non-severe condition. However, if the patent ductus arteriosus remains open for a long time, leading to severe pulmonary arterial hypertension and even left-to-right shunts causing serious cardiac dysfunction, it is considered severe. Therefore, the shape of the patent ductus arteriosus does not have diagnostic significance regarding the severity of the condition. Rather, the severity is assessed based on the patient's symptoms, evaluation of cardiac function through echocardiography, and the condition of pulmonary artery pressure. In the early stages, most cases of patent ductus arteriosus are not very serious and can be resolved through treatment.
Can a patent ductus arteriosus heal by itself?
The ductus arteriosus is a duct that fetal blood must pass through as it is transported from the placenta to the aorta. This duct connects between the main pulmonary artery and the aorta of the fetus and generally closes on its own after birth. Most patients can close it spontaneously within three months, but the likelihood of closure diminishes if it surpasses one year. Therefore, for patent ductus arteriosus, some people can heal on their own, while others, especially children over one year old, cannot heal by themselves and are advised to undergo surgery as soon as possible. This is because the patent ductus arteriosus can cause a condition similar to an arteriovenous fistula, increasing the workload on the heart, leading to cardiac hypertrophy and eventual heart failure.
Can you get pregnant with patent ductus arteriosus?
Firstly, patent ductus arteriosus (PDA) is not a hereditary disease, so both males and females with PDA can reproduce. However, if the individual is female, it is advisable to treat PDA before pregnancy, as pregnancy can increase the load on the heart. Patients with PDA often have poorer cardiac function. If they are asymptomatic, their compensatory abilities may be reduced. Therefore, for safety, it is recommended that patients with PDA consider conception after minimally invasive interventional treatment or surgical treatment, which is safer. The majority of PDAs can be treated with minimally invasive procedures, so the trauma is relatively minor, and there is no need for excessive worry.
Can you get pregnant with patent ductus arteriosus?
Patent ductus arteriosus refers to a congenital channel between the aorta and the pulmonary artery that fails to close. This can lead to a mixing of blood between the veins and arteries, thus deteriorating heart function. Generally, individuals with this condition can become pregnant after treatment. Patent ductus arteriosus is a congenital heart defect that does not have hereditary properties and does not prevent one from having children. However, it is advised for individuals with this condition to undergo surgical treatment before attempting to conceive and bear children. If the ductus arteriosus remains untreated, the increased heart load during late pregnancy can cause symptoms such as difficulty breathing and respiratory distress. It is recommended that these individuals undergo minimally invasive surgical treatment or conventional surgical treatment before planning for pregnancy, as this will be more appropriate.