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      心脏病遗传吗

      【导读】心脏病是一类比较常见的循环系统疾病。循环系统由心脏、血管和调节血液循环的神经体液组织构成,循环系统疾病也称为心血管病,包括上述所有组织器官的疾病,在内科疾病中属于常见病,其中以心脏病最为多见,能显著地影响患者的劳动力。

      心脏病可分为先天跟后天:1、先天性心脏?。盒脑嘣谔ザ谥蟹⒂斐K?,病变可累及心脏各组织。2、后天性心脏?。撼錾笮脑嗍艿酵饫椿蚧迥谠谝蛩刈饔枚虏?。如:冠状动脉粥样硬化性心脏病、风湿性心脏病、高血压性心脏病、肺源性心脏病、感染性心脏病、内分泌性心脏病、血液病性心脏病、营养代谢性心脏病等。症状:常见症状有:心悸、呼吸困难、发绀、咳嗽、咯血、胸痛、水肿、少尿等。体征:常见体征有:心脏增大征、异常心音、心律失常征、脉搏异常等。

      心脏病人在日常饮食中要做到:1、少食 就是限制进食的数量和种类。心脏病人多半体重超重,因此应有意识地控制每日热量摄取量,减轻体重。建议每次进食不宜过饱,以免加重胃肠负担,引发心脏病发作。此外还应少食辛辣刺激性食物及过凉过热的食物,以减轻胃肠刺激。

      2、少脂 : 就是尽量少食用高脂肪和高胆固醇食物,如油类、肥肉类食品,动物内脏等。过多的脂肪可以造成肥胖、高血脂,长期高血脂是引起动脉硬化的主要因素,因此,要控制脂肪的摄入量。胆固醇含量多少直接影响人体健康,过高会发生冠心病、脂肪肝、高脂血症等病,应适当加以控制。在饮食方面,应避免动物性食品,少吃肥肉、奶油、黄油等脂肪类食物,少吃动物肝脏、脑、鱼子、墨斗鱼等含胆固醇高的食物;应多选用豆类食品,因黄豆中含有卵磷脂及无机盐,对防治冠心病十分有利。

      3、少盐 吃盐过多,会导致钠水潴留,增加血容量,加重心脏负担,对预防心脏病不利,因此每日食盐量最好不要超过6克。

      4、多补充膳食纤维素,膳食纤维素是一种不能被人体消化、吸收的物质,但它能促进胆酸从粪便中排出,减少胆固醇在体内生成,有利于冠心病的防治。纤维素主要存在于蔬菜中,以竹笋、梅干菜、芹菜、韭菜为代表,粮食作物中以黄豆、燕麦含量较多。国内认为,每天纤维素应吃15~30克左右,才能满足需要。据国外报道,如每天摄入26克纤维素,就可降低女性患心脏病的危险,同时心肌梗塞的危险也相对降低。

      5、多补充维生素,丰富的维生素有助于心脏健康。如维生素C能改善冠状动脉的血液循环,?;ぱ苣谄は赴耐暾?,还能促进胆固醇生成胆酸,从而降低血中有害的胆固醇。维生素E具有很强的抗氧化作用,能阻止不饱和脂肪酸发生过氧化,?;ば募?,预防血栓。维生素PP(即尼克酸、烟酸)能扩张末梢血管,防止血栓形成,还能降低血中胆固醇含量。绿叶蔬菜中富含维生素C;肉类、谷物、花生、酵母中富含维生素PP;油脂、豆类、蔬菜中富含维生素E。

      6、多补充微量元素,微量元素数量不多,但作用很大,心脏病人同样离不开。硒能?;ば脑?,防止病毒感染,是心脏的守护神。铬能强化胰岛细胞,预防糖尿病,还能抑制胆固醇吸收,从而减缓或阻止冠心病的发生、发展。此外,钙、镁、钾、碘等矿物元素也对?;ば脑嘤幸?。

      先天性心脏?。虺葡刃牟。┦翘ザ逼谛脑嘌芊⒂斐6纬傻南忍旎?,是小儿最常见的心脏病,其发病率约为出生活产婴的7~8‰。常见的先天性心脏病主要有室间隔缺损、房间隔缺损、动脉导管未闭等,其中以室间隔缺损最多,占先天性心脏病的12~20%。

      据介绍,先天性心脏病分为非紫绀型先天性心脏病和紫绀型先天性心脏病,非紫绀型先天性心脏病中最常见的是室间隔缺损,最常见症状是活动后心慌气短,易感冒,大的室间隔缺损甚至出现反复的肺炎、心衰、活动耐力下降、喂养困难、营养及发育障碍等,体检时可听到心脏杂音。紫绀型先天性心脏病的突出表现是青紫,可于出生后持续存在,也可于出生后3至4个月逐渐明显,在口唇、指(趾)甲床、鼻尖最明显,而潜伏青紫型心脏病平时并无青紫,只是在活动、哭闹、屏气或患肺炎时才出现青紫,晚期发生肺动脉高压和右心衰竭时可出现持续青紫。

      家长如果发现自己的孩子有上述症状,应及早到医院就诊,一旦确诊为先天性心脏病,由医生决定手术时机。李医师说,现在医学发展日新月异,绝大多数先天性心脏病已成为可完全治愈的疾病。

      饮酒对身体不好是大家都知道的,但是对心脏损害却并非人人皆知。医学已经证实,酒精本身可直接引起心肌损害,使心肌细胞及间质水肿和纤维化,引起心肌收缩力降低,临床上可表现为心脏普遍性扩大,酷似扩张型心肌玻病人可出现各种心律失常,如室性过早搏动、心房颤动等;由于心肌舒缩功能障碍,可出现心功能不全的症状。左心功能不全可引起肺淤血和肺水肿,病人会产生心跳、劳力性呼吸困难、咳嗽,重者夜间不能平卧,咯粉红色泡沫样痰,若不及时处理可以因心力衰竭致死。重者心功能不全时,会产生体循环淤血的症状,病人可表现尿少、下肢浮肿、肝肿大、颈静脉怒张、腹水等现象。

      心脏病的应急治疗处理:冠心病一、病理基础及发病高危因素冠心病是"冠状动脉粥样硬化性心脏病"的简称,是全身性动脉粥样硬化的一部分。其主要病变是冠状动脉内膜脂质沉着、粥样硬化斑块形成、局部纤维化或钙化,造成血管壁增厚、管腔狭窄或阻塞(见上图),从而导致狭窄远端的心肌在运动甚至休息时出现缺血。冠心病在中老年男性中比较多见,目前已成为中国城镇人口中致死率最高的疾病,严重影响患者的生活质量。目前我国冠心病高发区中青岛、北京、乌鲁木齐分别排在前三位。动脉粥样硬化的发生发展过程的具体原因尚没有明确,但是通过大规模临床统计分析认为高血压、高血糖(糖尿?。?、高血脂、吸烟、肥胖等是冠心病的主要的高危因素。

      二、临床表现和诊断冠心病的临床表现最为引人注目和常见的是"心绞痛",而危险性最大的是急性心肌梗塞,往往导致抢救不及而猝死。但有一部分病人却从未有过心绞痛,甚至在心肌梗塞时也未有过疼痛,而主要是表现为胸闷或心前区不适心绞痛患者的诊断主要依靠典型症状、发作时的心电图等即可诊断。对于症状不典型的患者应行运动心电图实验、核素心肌灌注扫描等检查以明确诊断,24小时持续心电监测(Holter)对诊断也有帮助。对于急性心肌梗塞,目前主要的诊断依据是典型症状、心电图演变过程和心肌酶学演变的证据。目前冠状动脉造影是诊断冠心病的"金标准",不仅可以明确冠状动脉病变的位置、性质、程度,而且对后期治疗起到决定性指导意义?!?/p>

      三、冠心病治疗方案的选择:由于目前冠心病的具体病因尚未明确,目前的医疗界尚无根治冠心病的方法或特效药物。所有的治疗的最终目的是控制症状的发作,提高患者的生活质量。冠心病的治疗方案主要有以下四类: A、调整生活习惯,控制冠心病高危因素:即控制血压、血脂、血糖,戒烟减肥等,平时加强锻炼身体。 B、内科药物治疗:主要是指硝酸酯类和中药合剂等冠脉扩张药物(硝酸甘油、消心痛、鲁南欣康、速效救心丸、丹参滴丸)。另外,钙离子拮抗剂(合心爽、络活喜)、β-受体阻断剂(倍他乐克)可以起到缓解冠脉痉挛、降低心肌耗氧量等作用,ACEI类(悦宁定、蒙诺)可以减低心脏后负荷,在医师的指导下可以酌情联合使用。对于急性心肌梗塞6小时的没有溶栓禁忌的患者,可以考虑施行溶栓治疗。

      由于溶栓治疗有脑出血等严重并发症的可能,所以溶栓治疗需要在专业医师的指导下进行,并且应具备一旦溶栓失败则转行急诊PTCA或急诊CABG治疗的条件。 C、内科介入治疗:包括PTCA、支架植入、激光旋切等方法。介入治疗最大的优点是创伤小,实施迅速,对于急性心梗等的治疗有独特的优势,患者易于接受。但由于其本身技术上的缺陷,对于冠脉病变弥漫、伴有偏心性钙化斑块、多支病变、左主干病变等属于绝对或相对禁忌。另外,在PTCA+支架植入6个月内约有1/4~1/3的患者出现冠脉内再狭窄,这是目前心脏内科急待解决的问题。近年来出现的覆膜支架使植入后再狭窄率明显下降,但尚无远期通畅率的报告,并且费用高昂。 D、外科手术治疗:主要是指冠状动脉搭桥术(CABG)和激光心肌血运重建术(TMLR)。

      CABG手术的远期效果在冠心病治疗中是最好的,采用乳内动脉、桡动脉等搭桥,10年通畅率在90%以上;即使采用大隐静脉等搭桥10年通畅率也在60%左右。在美国,每年CABG手术例数在几十万例以上,而在我国,由于心脏外科起步较晚、患者存在惧怕手术的心理、以及一些其他原因,每年CABG的手术例数不到5000例,并且都集中在北京等医疗水平相对高的地区,在全国的普遍推广尚需进一步努力。 E.激光打孔:激光打孔手术是在80年代发展的技术,适用于不能行PTCA,也不能耐受CABG手术,但必须治疗的严重冠心病患者,但现在其疗效尚未完全肯定。 F.心脏移植:终末期冠心病患者,大面积心肌梗塞,心功能低下,EF值。

      先天性心脏病的最佳治疗时机在学龄前。目前,在先天性心脏病治疗上,医学界主要采用外科手术治疗和内科介入治疗两种治疗方法,比如,近年来开展的封堵介入治疗适合于部分先天性心脏病患者,而外科手术治疗适合于各个部位、各种类型的室间隔缺损病症治疗。

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