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发生了胸痛之后,应该做什么?
医院。胸痛,先排除心肺,因为心肺的胸痛最致命,其他的病可以排在第二第三位。尤其是平时什么不适都没有,但平白无故发作胸痛的患者。
首都医科医院心脏中心有一位患者李先生,38岁,一年前因为急性心梗住进心脏中心。
“我是去年11月5号,坐地铁的时候,出了一身汗,就站在两个地铁中间那个通风口,大概吹了半小时风。结果半小时后觉得越汗越来多,胸口开始疼,牙也开始疼了,我就觉得有点问题了。”
老李静止站了一分钟,发现没有丝毫缓解,医院,一点没耽搁。
急诊各项检查提示,当时已经发生了心梗,立刻上台造影,发现前降支近端已经闭死,后面的血流无法通过。
我们人的心脏血管主要是三支,前降支、回旋支和右冠状动脉。前降支作为供应左心室的前壁,包括心尖、前间隔,甚至部分侧壁,这一大面积的功能性心肌,十分重要,一旦它闭塞,这一大部分心肌缺血,时间长了就会坏死,导致心功能的严重受损。
急诊紧急开通前降支近端,置入一枚支架。支架扩张的一瞬间,血液通过,心肌不再缺血,胸痛马上缓解了。
“支架一下去我就感觉好了。后来这一年也都没疼过了。”
王彦富医生提醒:年的数据提示,咱们国人的发病至就诊时间还在5个小时以上。就是一个人发病了,因为各种原因,医院就诊的时间,仍然在5小时以上。5小时的时间是非常长的,而世界上最快的是德国,从发病到就诊时间大约一小时。
当然,咱们时间间隔长有各方面原因,但主要还是因为患者自身重视程度不够高。有的觉得胸口疼,忍一忍就过去了,其实不是,越忍可能病情越严重,后续连抢救的机会可能都没有了。还有的就是觉得自己年轻,不可能得心梗,不认为是这个病,不会重视,结果好多都耽误了。
李先生复查结果正常,与他这一年来的维护脱不开关系。一年里李先生每个月