As we all know, in the cold winter, the onset of coronary heart disease high frequency. Then in the hot summer whether the onset of angina seldom do?

     In fact, the thermal environment is likely to cause angina, especially in hot and wet circumstances, the angina attack rate, as if winter was the peak value of the state. This is due to heat and humidity makes the heart rate increased rapidly, stroke output is reduced, combined with hot and humid environment can increase ventricular volume, causing an increase in myocardial oxygen consumption, so that myocardial ischemia and hypoxia, and induce angina.

   To this end, coronary heart disease in the hot summer months should pay attention to the following points.

First, exercise training should be conducted in the early morning cooler, avoid exercising in the hot sun. Thunderstorm prior to the arrival of the hot and humid in the circumstances, should pay attention to the appropriate state of rest or keep quiet.

Second, pay attention to summer cooling, the outdoor activities or work should be wearing a visor and supply thereafter, water, and prevent expansion of peripheral blood vessels, blood volume makes the lack of coronary blood flow reduction induced by myocardial ischemia and angina.

Third, there is a history of angina pectoris in patients with preventable medication, such as propranolol, isosorbide dinitrate Danshen tablets and so on, if the travel required to carry nitroglycerin or amyl nitrite and other anti-angina drugs.

     The direct factors are likely to produce pain in the case of myocardial ischemia and anoxia in the accumulation of excess pyruvate phosphate metabolites such as lactic acid and other acidic substances; or similar material to stimulate the kinin peptide in the heart autonomic nerve transmission into the fiber endings by a ~ 5 thoracic sympathetic ganglia and the corresponding spinal cord segment transmitted to the brain to produce pain and feeling of this pain is reflected in the spinal cord and autonomic nervous to enter the same level as the distribution segment of the spinal nerves of the skin area that the sternum before the arms and after on both sides with the little finger, especially in the left side of the heart is not in anatomical position and multi-office has been suggested that ischemia in the region rich in nerve supply, abnormal coronary blood vessels can stretch or shrink pain impulse

To be mechanical stimulation to the heart does not cause pain, myocardial ischemia and hypoxia, but the pain is caused when the coronary blood flow and myocardial blood required contradiction between the coronary blood flow can not meet the needs of myocardial metabolism caused by a temporary rapid heart of ischemia and hypoxia that generate angina

The number of myocardial oxygen consumption by the myocardial contraction myocardial tension determined by the intensity and heart rate and therefore popular, “heart rate × systolic blood pressure” (ie, the double product), as indicators of myocardial oxygen consumption is estimated myocardial energy generation require large amounts of oxygen uptake for the myocardial cells of blood oxygen content of 65% to 75% while the uptake of the body while the others only 10% ~ 25% of the normal heart, therefore the absorption of oxygen in the blood is close to the maximum amount of oxygen required to increase further when more difficult from the uptake of oxygen in the blood is only be able to rely on to increase coronary blood flow to provide under normal circumstances, coronary circulation have great reserves of strength of the blood flow to the body’s physiological conditions with significant changes; the intense physical activities, expansion of coronary blood flow may be appropriate to break the 6 ~ 7-fold expansion of hypoxia also makes coronary artery blood flow 4 ~ 5 times Erzhi atherosclerotic coronary artery stenosis or occlusion of some branches when the weakening of its expansionary and reduced blood flow to the myocardium for the blood are relatively fixed, such as reduced myocardial blood supply to the heart usually able to cope with the needs of the rest can be asymptomatic if a sudden increase in cardiac load, such as left ventricular failure such as fatigue excited to myocardial tension increased (cardiac chamber volume to increase ventricular end-diastolic pressure increased) to increase myocardial contractility (systolic blood pressure increased ventricular pressure curve of the maximum pressure to increase the rate of change over time), and increased heart rate and fast Erzhi increased myocardial oxygen consumption increased demand for myocardial blood; or when the coronary artery spasm (eg, humoral regulation of excessive smoke or neurological disorder) is to further reduce coronary blood flow; or in a sudden decrease in blood flow circumstances (such as extreme shock, tachycardia, etc.); heart’s blood supply and demand will intensify the conflict between the heart’s blood supply gradually less severe anemia in patients with angina caused by myocardial blood flow while not reducing the case may be due to reduced blood oxygen-carrying red blood cells caused by insufficient Angina

In most cases, exertion-induced angina often the same “heart rate × systolic blood pressure” value occurs on the level of

     Incidence of young adults are more often first, the performance of primary infection, such as viral fever were frequent vomiting, diarrhea, cough, sore throat and muscle aches, etc. Most of the viral infection 1-3 weeks after the symptoms of myocarditis, arrhythmias can cause palpitations as a result of ejection lowering the volume a sense of weakness involving the pericardium and the pleural membrane and chest when the chest pain of angina may also have similar performance in severe cardiac dysfunction common signs of sinus tachycardia is not parallel with the body temperature may also have sinus bradycardia and various community to expand cardiac arrhythmia accounted for 1/3-1/2 found severe myocarditis due to enlargement of the heart can cause mitral or tricuspid regurgitation or sternal apical systolic murmur left lower margin of myocardial damage may have heard of serious or diastolic heart failure period gallop first heart sound may weaken the merger pericarditis pericardial friction sound heard

Light can completely asymptomatic heart failure or sudden death in serious cases the performance gap based on the clinical manifestations can be divided into six types: ① asymptomatic type: 1-4 weeks after infection occurs S-T changes in ECG ② asymptomatic arrhythmia type: the performance of the types of arrhythmia ventricular premature beat ③ most common type of heart failure: the emergence of heart failure symptoms and signs of myocardial necrosis ④ Type: Clinical presentation was similar to a large myocardial infarction by ⑤ heart: Mitral and tricuspid valve area enlargement of the heart contraction in phase noise ⑥ sudden death type: sudden death without aura

Bed rest should be to reduce the tissue damage associated with cardiac arrhythmia lesions speed recovery, should stay in bed for 2-4 weeks and then gradually increase the volume of activity associated with severe myocarditis enlargement of the heart should rest for 6 months to a year until the clinical symptoms disappeared completely restored cardiac size normal immune inhibitors: application of the hormone, but there is controversy associated with severe myocarditis, cardiogenic shock, atrioventricular block cardiac dysfunction may hormone
Common prednisone 40-60mg / day reduction condition improved gradually after a course of six weeks, when necessary, can also be used hydrocortisone pine or ground Cesson heart failure who used intravenous diuretic vasodilator cardiac arrhythmias are the same general rhythm the treatment of disorders

Myocarditis is a relatively common disease, multiple infections caused by a virus, its duration is longer, more difficult in patients with treatment adherence. When the body with low immunity or re-invasion by viruses and other pathogenic factors, the heart will once again came under attack, over time, continue to persistent and repeated illness, myocardial pathological changes irreversible, can be transformed into cardiomyopathy.

The prognosis of myocarditis and cardiomyopathy very different, generally speaking, myocarditis can be treated, but the pathological changes of cardiac cause was progressive deterioration, not reverse, the prognosis is poor. Therefore, to prevent heart disease, myocarditis into a very important significance. Myocarditis must not “sloppy.”

In order to prevent the disease myocarditis protracted and repeated, so that the following is very important.

1, increase awareness and vigilance of this disease. After a virus infection, such as patients with fatigue, palpitations, suffocation, pale and other symptoms should be fully mindful of the possible occurrence of viral myocarditis, it is timely given the necessary checks. In addition to a comprehensive physical examination, there should be ECG, X ray chest, enzymes, echocardiography, Holter monitoring and other checks, so that a timely diagnosis.

2, regular and timely treatment. After the diagnosis, treatment should be timely, accurate, formal. Condition improves to regularly followed up, review, long-term treatment adherence.

3, pay attention to the rest. After the diagnosis should immediately rest in bed for a month or so. For patients with suspected myocarditis should also be restrictions on the activities of early, regular follow-up. Condition improved, it should gradually increase the volume of activity and avoid strenuous exercise and excessive fatigue.

4, concurrent infection prevention and control. In addition to taking general preventive measures, for immunocompromised persons, can be properly applied immunomodulator, immune enhancer, or Chinese medicine. With chronic Gan Ranzao should be removed in due course. In addition to the prevention of respiratory tract infection, we must also note that the digestive tract infections, because disease-causing viruses such as Coxsackie myocarditis in A, Coxsackie B, ECHO viruses are enteric viruses.

5, a balanced nutritional diet. Proper diet, adequate calories, protein, various vitamins, minerals and trace elements intake, avoid partial eclipse, choose food, hungry, or eat too much saturated impermanence.