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  he118768 2013-09-03 00:00:00

  Ischemic heart disease， is as follows: first， the primary primary cardiac arrest sudden cardiac arrest is a sudden event， conceived as a result of cardiac electrical instability caused. No other diagnosis can be made based on (certified for heart attacks occurred in the early days of death is not included， and thus considered to be death due to myocardial infarction). If no recovery or recovery failed， primary cardiac arrest attributed to sudden death (this report deliberately omitted the definition of sudden death， because death is the result of sudden cardiac arrest). Evidence of ischemic heart disease in the past marginal， if death occurred no one saw， the diagnosis is speculative in nature. Second， angina 1. exertional angina: Exertional angina is characterized， as exercise or other increased myocardial oxygen demand induced by brief attacks of angina. After a rest or sublingual nitroglycerin， pain can often quickly disappears. Exertional angina pectoris are divided into three categories: (1) primary exertional angina pectoris: the course in less than one month of exertional angina. (2) stable exertional angina: modifies the stable exertional angina in more than a month. (3) the deterioration of exertional angina pectoris: the same level of exertion-induced chest pain onset， severity， and duration of a sudden increase in the number. 2. spontaneous angina pectoris: is characterized by spontaneous angina pectoris， chest pain attack with no clear relationship between increased myocardial oxygen demand. Compare with exertional angina pectoris， the pain lasts longer， more heavy， and not easy to ease for nitroglycerin. Changes of no and electrocardiogram often occurs in some transient ST segment depression or t wave changes. Spontaneous angina pectoris can exist alone or in combination with exertional angina pectoris. Spontaneously in patients with angina pain， frequency， duration and degree of pain may have different clinical manifestations. Sometimes patients may have a longer duration of onset of chest pains， like heart attacks. But there is no characteristic changes of ECG and enzymes. Some spontaneous angina patients， there was a temporary ST elevation in attack， often referred to as Variant angina (this egg also known as Prinzmetal Angina， Prinzmetal prior reports by other authors of the report described the situation， so you should use "Variant angina，" this name. ）。 But in ECG of myocardial infarction has been recorded to this graphic， this name cannot be applied. First toil， aggravation of angina pectoris Angina Pectoris and spontaneous angina are often referred to as "unstable angina". This report use these specific names. Third， myocardial infarction 1. acute myocardial infarction: acute myocardial infarction clinical diagnosis based on medical history， electrocardiogram and serum enzyme changes made. History: the typical history is a serious and lasting chest pain. Sometimes history is not typical， pain can be mild or even no， mainly for other symptoms. ECG: positive changes of ECG is abnormal， sustained or QS Q wave and current evolutionary injury more than a day. When the ECG these positive changes， and ECG diagnosis alone. Other cases， EKG shows no change， including: ① static damage current. ② inverted t-wave symmetry. ③ single pathological Q waves in ECG record. ④ conduction disorders. Serum enzymes: ①the positive changes include the sequence changes in serum enzyme concentrations， or begin to rise and subsequent degradation. This change must be the specific enzyme and onset of symptoms associated with the interval of taking blood samples. Cardiac-specific isoforms of higher believe that certainty is change. ② not sure changing the concentration at the beginning， but without following the lower curve of the enzyme activity can be achieved. 2. in old myocardial infarction: the electrocardiogram changes in old myocardial infarction under certainty， no changes of history and make a diagnosis of acute myocardial infarction. If there is no legacy ECG changes， according to earlier characteristic ECG changes or based on previous positive serum enzyme changes in diagnosis. IV congestive heart failure， ischaemic heart disease heart failure of ischemic heart disease may occur for a variety of reasons， it can be a complication of acute myocardial infarction or heart attack earlier， or can be induced by angina or arrhythmia. In no previous clinical or electrocardiographic evidence of congestive heart failure in patients with ischemic heart disease (excluding other causes)， the diagnosis of ischemic heart disease is an iatrogenic. Five， arrhythmia arrhythmias are the only symptoms of ischemic heart disease. In such cases， unless there is proof of coronary Arteriography of coronary artery occlusion， or ischemic heart disease diagnosis is still guesswork.

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